Ultrasound uses high frequency sound waves to produce images of structures in your body. Ultrasound is done by a specially trained technologist. The quality and accuracy of the exam is dependent on the skill of the technologist. The quality of the exam is also dependent on how well the sound waves of ultrasound can penetrate the tissues.
Poor visualization of the pancreas on ultrasound is common because it is a deep seated organ. There is often bowel in front of the pancreas. This will cause poor penetration of the sound waves. The image formed will be poor. There will be dark shadows cast in the region of the pancreas or the pancreas will not be seen at all. Images are also often limited in obese patients for the same reasons. The sound waves have to travel through more fat.
This is frustrating because the cause of pain in the abdomen can sometimes be caused by disease of the pancreas. Sometimes only a portion of the pancreas will be seen. The limited visualization makes the ultrasound test incapable of excluding disease in the abdomen.
Additionally, in some cases I see ultrasound note abnormalities which are not really there. The surrounding bowel can cast shadows on the pancreas which look like abnormalities. Other artifacts can also cause the appearance of abnormalities. Fortunately, there are tests which are better for evaluating the pancreas.
In cases, where ultrasound does not allow a complete evaluation of the pancreas, the radiologist will note this in his report. In these cases, CT or MRI will often allow a very detailed evaluation. The reason ultrasound is done, is because it’s quick, cheaper, and does not use radiation. But CT or MRI will allow a more detailed view. These testS also do not depend on the skill of the technologist as much.
The radiologist saying that there is limited visualization of the pancreas on ultrasound is common in ultrasound. This is most common because of bowel loops in the way or abundant fat tissue which the sound waves have to get through. Thankfully, there are tests which are allow a detailed evaluation of the pancreas. This is important because abdominal pain can be caused by pancreatic abnormalities which ultrasound may not show.