Color Doppler Sonography of the gastroduodenal and superior pancreaticoduodenal artery as an early method for the differential diagnosis of the dilation of the head of the pancreas
OBJECTIVE: The visaulization of the pancreas is difficult and findings are usually missed at the early stages of the disease. Dilatation of the head of the pancreas is difficult to be differentially diagnosed on admission of the patient at hospital emergencies. The objective of this study is the use of Color Doppler Sonography flow parameters of the gastroduodenal and the superior pancreaticoduodenal atrery as a tool in the differential diagnosis of the dilatation of the head of the pancreas. METHOD: 45 individuals were enrolled in the study and divided into three Groups. Group A consisted of 15 healthy volunteers. Group B,15 patients with diagnosis of acute edematous pancreatitis with edema of the head of the pancreas of approximately 5 cm and Group C,15 patients with a diagnosis of tumor of the head of the pancreas of diameter 1.5-3 cm. The diagnosis of acute pancreatitis was
established by the Baltazaar and Apache criteria. All were examined by using Color Doppler Sonography and Ultrasonography of upper abdomen. Pulsatility and resistance index values were measured in the gastroduodenal and superior pancreaticoduodenal arteries. RESULTS: Pulasatility (PI) and resistance indices (RI) of the gastroduodenal and superior pancreaticoduodenal artery were higher in Group C(PI of GDA: 3.20-4.15 PI of sup PDA: 3.5-4.8, RI of GDA: 0.82-0.89,RI of sup PDA: 0.86- 0.94 in patients with pancreatic tumor of the head of the pancreas) than in Group A and B (PI of GDA: 2.10-2.50, PI of sup PDA: 2.20-2.70, RI of GDA and sup PDA: 0.7-0.8 in patients with acute pancreatitis). PI and RI in patients with acute pancreatitis assemble to those of healthy individuals. CONCLUSION: In our study there seems to be strong correlation between increased values of PI and RI in gastroduodenal and superior pancreaticoduodenal arteries and the presence of tumor of the head of pancreas.