Pancreatic neoplasms: how useful is evaluation with US?

The usefulness of ultrasonography (US) in the evaluation of pancreatic neoplasms was assessed in 51 patients. Indications for US included jaundice (n = 19), pain (n = 16), weight loss and anorexia (n = 4), clinically palpable mass (n = 3), bleeding in the upper gastrointestinal tract (n = 1), and gastric outlet obstruction (n = 1). Three patients were investigated because of a previous abnormal US examination; in four the mass was an incidental observation. Sonograms were interpreted without knowledge of results from other procedures. Pancreatic masses were detected in 50 patients. Biliary and pancreatic duct obstructions were seen in 29 and 27 patients, respectively. Liver metastases were identified in 16 patients and missed in three that were not detected with either US or computed tomography. Vascular involvement was predicted in 12 patients and missed in four, while lymphadenopathy was seen in 16 and missed in five. Thirty-one cases of unresectable disease were correctly predicted with US. Resectability was not as accurately determined; only seven of 19 "resectable" lesions were successfully removed. US is an effective tool in the detection and preoperative evaluation of pancreatic malignancy.