Pancreatic ultrasound evaluates the pancreatic head, body, and tail for pathology including acute and chronic pancreatitis, pancreatic ductal dilation, cystic lesions, and pancreatic adenocarcinoma. While CT and MRI/MRCP are preferred for comprehensive pancreatic staging, ultrasound is the first imaging modality in many patients presenting with upper abdominal pain.
Sonographers assess pancreatic echogenicity (decreased in acute pancreatitis, increased with fatty infiltration or chronic disease), pancreatic duct diameter (normally less than 3 mm), and focal masses. Cystic lesions — including pseudocysts, serous cystadenomas, and intraductal papillary mucinous neoplasms (IPMNs) — are characterized by size, septations, and internal architecture. Endoscopic ultrasound (EUS) provides superior pancreatic imaging at closer range with higher frequency transducers.
Pancreatic ultrasound is covered under the ARDMS Abdomen (AB) specialty within the RDMS. Limited acoustic access due to overlying bowel gas is a common technical challenge, requiring patient positioning adjustments and careful probe angulation. Sonographers in gastroenterology and hepatobiliary programs encounter pancreatic pathology frequently and should be familiar with the differential diagnosis of pancreatic masses and cysts.