Sonography in patients with a possible pancreatic mass shown on CT.

During the past decade, pancreatic imaging has advanced rapidly as indirect methods have been supplanted by direct methods. CT and sonography allow direct imaging of pancreatic tissue, and ERCP can display the ductal pattern. Because sonography and CT are noninvasive, they have become the primary imaging methods for the detection of pancreatic masses. Their success rate in detecting pancreatic carcinomas has continued to improve with advances in equipment, scanning techniques, and interpretive skills [1 -5]. When either sonography or CT fails to establish the presence or absence of a mass, ERCP is often used next [6, 7]. Although it is recognized that CT is useful for evaluating the pancreas when visualization of the gland by sonography is incomplete, the use of sonography to resolve inconclusive findings on CT has had little emphasis [8, 9]. We report a retrospective review of 27 patients in whom a pancreatic mass could not be confidently confirmed or excluded on CT. In these cases, the complementary use of sonography, with its ability to detect changes of parenchymal echotexture, was instrumental in confirming or excluding a lesion.