Improving Approaches to Poor Visualization of the Pancreas in Abdominal Ultrasound Screening

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  • Senda Yuko
    Port Square Kashiwado Clinic, Kashiwado Memorial Foundation
  • Katou Rieko
    Port Square Kashiwado Clinic, Kashiwado Memorial Foundation
  • Itou Eri
    Port Square Kashiwado Clinic, Kashiwado Memorial Foundation
  • Uchida Yumi
    Port Square Kashiwado Clinic, Kashiwado Memorial Foundation
  • Okuda Keiko
    Port Square Kashiwado Clinic, Kashiwado Memorial Foundation
  • Fujii Kiyotaka
    Port Square Kashiwado Clinic, Kashiwado Memorial Foundation
  • Nakano Toshihiko
    Port Square Kashiwado Clinic, Kashiwado Memorial Foundation
  • Nagao Keiichi
    Port Square Kashiwado Clinic, Kashiwado Memorial Foundation
  • Yamaguchi Kazuya
    Chiba Foundation for Health Promotion and Disease Prevention
  • Takizawa Hirotaka
    Port Square Kashiwado Clinic, Kashiwado Memorial Foundation

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Other Title
  • 腹部超音波検診における膵描出不良所見に対する取組み
  • フクブ チョウオンパ ケンシン ニ オケル スイビョウシュツ フリョウ ショケン ニ タイスル トリクミ

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Abstract

<p>Objective: We aimed to improve the visualizing ability of pancreatic ultrasonography images by re-examining the pancreas. </p><p>Materials and Methods: This study included 14,096 people who underwent health check-ups in our clinic between November 2017 and October 2018. In November 2017, to improve and uniformly visualize pancreatic sonographic images, we changed some naming of the findings and created our own technical manual. After the routine examination, a notification was sent to the examinee who had shown non-detected parts in the pancreas, indicating the necessity of re-examination. Abdominal ultrasonography (US) was performed in response to the application of the patient. If the re-examination failed to depict the non-detected parts, the “liquid filled stomach method” was combined with beverage-in-take. The images were first scored at the time of routine examination, second at the time of re-examination, and third after beverage-ingestion, and a comparative study was conducted among the scores in consideration of each BMI. </p><p>Results: Of the 429 patients with non-detected parts, only 40 applied for the re-examination. Of the 40 patients, 12 had high obesity, with a BMI of 37.0, which achieved full-marked good images without beverage-intake. The liquid-filled stomach method was combined with beverage-intake in the remaining 28 patients with non-detected parts at the time of re-examination, and image improvements were observed in all 16 patients including those with high-grade obesity (BMI 45.0), showing higher scores after beverage-intake. </p><p>Conclusion: The re-examination of the pancreas with non-detected parts at the routine US showed a remarkable improvement in combination with the “liquid filled stomach method,” strongly suggesting a possibility of its decreasing effect on invasive diagnostic methods such as contrast enhanced CT. Further studies should be conducted to refine the diagnostic process of the pancreas.</p>

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