Echogenicity is one of the characteristics of the investigated tissues by ultrasound diagnostics. This indicator allows you to estimate the density of the body, and in case of its deviation in one direction or another, specialist advice is necessary. In conclusion, the doctor may indicate that the echogenicity of the pancreas is increased. The meaning of this formulation will be described below.
The value of echogenicity
Ultrasound is based on the principles of echolocation - the ability of tissues to reflect ultrasound. During the procedure, the doctor sees a black and white image, since different organs reflect ultrasound waves differently. The denser the fabric, the brighter it looks on the screen.
If there is fluid inside the body (gall bladder), then their image will be black. Therefore, the concept of normal echogenicity for different structures is very conditional. The diagnostician knows what the norm should be for a particular organ, and immediately notices the changes.
When assessing the echogenicity of the pancreatic parenchyma, it is necessarily compared with the echogenicity of the liver that serves as a sample. Normally, these organs have identical tonality, otherwise it is possible to assume the development of pathology.
However, it should be noted that a slight difference in color is permissible. If the patient does not complain about anything, and there are no other signs of deviation, then this is considered normal. In addition, the structure of the object and its contours are necessarily taken into account.
Normally, the structure of organs is homogeneous. If there are any extraneous inclusions, then in the conclusion of the ultrasound is also indicated. Uneven contours of the pancreas may also indicate the development of the inflammatory process.
If the pancreas is healthy, then the term "isoechogenicity" is used in the description, which means a homogeneous structure.
Lipomatosis is an irreversible process of transformation of healthy cells of the pancreas into fat
Increased echogenicity of the pancreas can be local (focal) or diffuse. Diffuse changes can provoke factors such as a drastic change in nutrition, tight diets or a dense meal before the study. Distortion of results is often observed in a certain season - as a rule, the echo density increases in the offseason, in spring and autumn.
Moderate hyperechogenicity can also cause an infectious disease. In addition, a slight increase in pancreas echogenicity is the norm for the elderly. This is due to the aging of the body and the partial loss of glandular cells containing fluid.
Diffuse-heterogeneous structure may be a sign of various diseases, but most often it is observed in various forms of pancreatitis. This means that scars have formed on the organ and connective (fibrous) tissue grows.
Local hyperechogenicity indicates the presence of cysts, calcifications and various neoplasms.
Other reasons include the following:
- lipomatosis (fatty lipomatosis, steatosis, hepatosis, fibrolimatosis). It develops mainly against the background of a long course of pancreatitis or pancreatic necrosis, characterized by the replacement of gland cells with connective tissue and adipose cells;
- acute pancreatitis, which is accompanied by swelling and an increase in the pancreas;
- pancreatic necrosis - a complication of pancreatitis of a destructive nature, accompanied by the death of cells of the organ;
- fibrosis (sclerosis) - chronic inflammation of the pancreas, in which healthy cells are fully or partially replaced by connective tissue foci;
- malignant neoplasms.
For accurate results, 2-3 days prior to the study should not eat gas-forming products (legumes, grapes, cabbage) and foods high in protein.
The level of increased echogenicity can be moderate, medium and high. With a moderate indicator, the cause is most often physiological, but in some cases chronic inflammation is possible.
The average excess, as a rule, indicates the degeneration of cells into fat. A high degree of increase is observed in acute pancreatitis. If there are solid inclusions in the pancreas (concrements, calcifications), then we can speak of a mixed type of echogenicity and heterogeneous structure.
Sometimes with acute or chronic pancreatitis echo, on the contrary, is reduced. This phenomenon is due to a strong expansion of the main pancreatic duct, completely closing the gland due to its atrophy. The cause in most cases is chronic pancreatitis.
Hypoechoic areas occur in hemorrhagic pancreatitis, when the structure of the gland has edema. When using high-precision equipment, the main duct of the gland is also visualized as a hypoechoic area, which increases with age.
If the ultrasound showed hyperechoic inclusions in the pancreas, then its function is impaired. In most cases, there is a shortage of digestive enzymes and specific symptoms:
- flatulence and bloating;
- upset stool;
- loss of appetite and weight;
- low blood pressure;
- tachycardia (heart palpitations);
- pain in the upper abdomen, under the ribs;
- nausea, vomiting;
- feeling of fullness in the stomach;
If the echogenicity of the pancreas is increased in an infant, then the probability of abnormal organ development is high.
In the absence of pronounced symptoms, hyperechogenicity may be caused by errors in nutrition. With proper adjustment and exclusion from the diet of certain products, the following study will show the norm.
With increased echogenicity of the pancreas, the patient must undergo an additional examination and pass blood tests, urine and feces. Diagnosis and treatment is carried out by a gastroenterologist. The basic principle of treatment of acute pancreatitis is the rule: "cold, hunger and peace." In the first days of the disease, the patient must comply with bed rest and refuse any food.
Therapeutic tactics can vary significantly depending on the patient's condition, the prevalence and intensity of the pathological process. Some forms of the disease require surgery.
For the relief of pain, analgesics and antispasmodics are prescribed, as well as nonsteroidal anti-inflammatory drugs - Diclofenac, Ketoprofen, Papaverine, No-spa, Drotaverin.
Pancreatin tablets is the gold standard for treating pancreatic diseases that are accompanied by a lack of enzymes.
Since acute pancreatitis dramatically increases the production of enzymes, means are used to suppress the activity of the pancreas (Somatostatin). Antibiotics are necessary to prevent bacterial infection.
If a diagnosis of "lipomatosis" is made, then it can be treated with therapeutic methods only with small sizes of fat inclusions. In the case of large accumulations, the fatty islands squeeze the pancreatic ducts and disrupt the pancreas. Then lipomas are surgically removed.
Lipomatosis therapy consists of dieting and weight loss. Medicines do not help get rid of fat formations, so all activities are aimed at preventing their further growth.
When enzyme deficiency, which accompanies chronic pancreatitis, tumor processes and a number of other diseases, replacement enzyme therapy is prescribed. Preparations are selected strictly individually, the most frequently used is Mezim, Pancreatin and Creon. During treatment, it is recommended to follow the diet number 5 and not to drink alcohol.
It is important to remember that an increased indicator of echogenicity is only a signal to the body about possible ill-being. However, it is impossible to ignore him, and in any case, you should consult with a specialist.