Radiology, Vol 150, 803-808, Copyright © 1984 by Radiological Society of North America
Hemorrhagic pancreatic fluid collections examined by ultrasound
BE Hashimoto, FC Laing, RB Jeffrey Jr and MP Federle
Ultrasound examination of nine patients revealed that the appearance of
their hemorrhagic pancreatic fluid collections varied depending on the age
of the hemorrhage. Acute hemorrhage was visualized as a well- defined
homogeneous mass, while subacute hemorrhage (studied about a week after the
bleeding episode) appeared as a mass that contained cystic and solid
elements or was septated. Remote hemorrhage, studied several weeks after
the acute event, was visualized as a simple cyst. Findings of CT, which
were available for correlation in eight patients, revealed that acute
hemorrhagic collections had CT numbers between 45 and 65 HU: older
collections had CT numbers between 14 and 25 HU. The ultrasonographic
evolution of hemorrhagic pancreatic fluid collections followed a pattern
similar to that described by in vitro studies, which determined that
hemorrhage and clotted blood may appear either echogenic or sonolucent,
depending on the age of the hemorrhage and the transducer used. Factors
that affect the echogenicity of hemorrhagic collections and the
difficulties encountered in recognizing them by ultrasound are discussed.
