The real-time ultrasound images of the pancreas in 273 children without pancreatic disease were prospectively analyzed to determine the normal appearance of the pancreas. The dimensions of the head, body, and tail of the pancreas were correlated with patient age, weight, height, and body surface area. Correlation between pancreatic dimensions and patient age was as good as or better than that obtained with the other physical parameters. In general, the normal pancreas had a similar sized head and tail with a thinner body as compared with the abnormal pancreas, and an echogenicity that was equal to or slightly greater than that of the liver. Analysis of the images of 13 patients with pancreatitis showed that the presence of a dilated main pancreatic duct was the most useful feature in suggesting an abnormality. Evaluation of pancreatic size, configuration, and echogenicity was not reliable in the differentiation of the normal from the abnormal pancreas.
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