Sonographic evaluation of pancreatic segments in a normal adult population in Nigeria
European Journal of Scientific Research
Department of Radiation Medicine, College of Medicine, University of Nigeria, Nsukka, Nigeria; Department of Medical Radiography, College of Medicine, University of Nigeria, Nsukka, Nigeria
Aim: To sonographically determine the normal range of values of pancreatic segments and their relationship with each other in a normal adult population in Nigerian and to determine if these values show any racial bias. Materials and methods: The anteroposterior (AP) diameters of the pancreatic segments (Head, Neck, Body and Tail) were measured prospectively in the transverse/oblique planes by trans-abdominal sonography in 500 healthy adults (aged 18 to 67 years) from the South-Eastern region of Nigeria. The subjects gave informed consent and were selected by convenient sampling. Results: The normal range of AP diameters of the pancreatic head, neck, body and tail were (18-32)mm, (7-12)mm, (10-20)mm and (10-20)mm respectively and the overall mean AP diameters were 27.83±2.14mm, 9.51±1.35mm, 13.26±1.47mm and 13.30±1.68mm in the same respective order. The ratios of each segment relative to each other were found to be 3:1 (Head/Neck); 2:1 (Head/Body); 2:1 (Head/Tail); 2:3 (Neck/Body); 2:3 (Neck/Tail); 1:1 (Body/Tail).When each segment was related to the entire pancreas, the ratios were 3:7; 1:7; 3:14; 3:14; for the Head/ pancreas, Neck/pancreas, Body/pancreas and Tail/pancreas respectively. The subjects' ages showed negative correlation (P<0.001) with the pancreatic sizes and there was progressive decline in size of the pancreatic segments after the fifth decade of life. There were statistical significant differences between the mean AP diameters of the pancreatic segments of this study population and that of the Caucasian values obtained from literature, except for the neck. Conclusion: This study recommends that in assessing the pancreas, ratios of the (Head/Neck); (Head/Body); (Head/Tail); (Neck/Body); (Neck/Tail); (Body/Tail), Head/pancreas, Neck/pancreas, Body/pancreas and Tail/ pancreas, which exceeds 3:1, 2:1, 2:1, 2:3, 2:3, 1:1, 3:7, 1:7; 3:14; 3:14; respectively, should raise suspicion for focal enlargement. The positive correlation between each segment and the pancreas shown in this study, suggest that these ratios may be used alone to discriminate accurately between focal and diffuse involvement of the pancreas. The population-specific values have the potential to enable; early detection/ screening of patients with cancer and inflammatory disorders of the pancreas, monitoring response in patients with starvation disorders and discriminating between insulin-dependent diabetes mellitus (IDDM) and non-insulin dependent diabetes mellitus, (NIDDM) patients. © EuroJournals Publishing, Inc. 2006.