D'Onofrio Mirko, De Robertis Riccardo, Crosara Stefano, Poli Cristina, Canestrini Stefano, Demozzi Emanuele, Pozzi Mucelli Roberto
Department of Radiology, G.B. Rossi Hospital, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy.
Department of Radiology, G.B. Rossi Hospital, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy.
Pancreatology. 2016 Jan-Feb;16(1):106-9. doi: 10.1016/j.pan.2015.12.003. Epub 2015 Dec 21.
Acoustic Radiation Force Impulse (ARFI) is a new ultrasound technique that evaluates mechanical properties of tissues. To evaluate the use of ARFI with shear waves speed quantification for pancreatic masses characterization during the ultrasound examination.
123 pancreatic lesions were prospectively evaluated. Median shear waves speeds were compared with Mann-Whitney U test. Two reading methods were applied for the characterization of adenocarcinoma: more than one measurement above the top shear waves speed (SWS) value. Two reading methods were applied to diagnose mucinous lesion: at least 2 (method 1) or 3 (method 2) numerical measurements. Sensitivity, specificity, positive and negative predictive values and accuracy of each reading method were calculated. Forty volunteers were included for normal ARFI values.
In the adenocarcinoma group median SWS value was 2.74 m/s. In the volunteers group the median SWS value was 1.17 m/s. Significant difference between SWS median values of adenocarcinoma and normal pancreas was found (P < 0.05). For the diagnosis of pancreatic solid masses if more than one measurement is above the top SWS value of 4.00 m/s results in the study, the diagnosis of ductal adenocarcinoma is highly specific with specificity and PPV of 100%. Good sensitivity (73.3%) and specificity (83.3%) were obtained for the characterization of mucinous cystic lesions.
Acoustic Radiation Force Impulse imaging could help in the non-invasive characterization of solid and cystic lesions of the pancreas during a conventional US examination.
声辐射力脉冲（ARFI）是一种评估组织力学特性的新型超声技术。目的是评估在超声检查中使用ARFI及剪切波速度定量来对胰腺肿块进行特征性诊断。
前瞻性评估123例胰腺病变。采用Mann-Whitney U检验比较剪切波速度中位数。应用两种读取方法对腺癌进行特征性诊断：超过一个测量值高于最高剪切波速度（SWS）值。应用两种读取方法诊断黏液性病变：至少2次（方法1）或3次（方法2）数值测量。计算每种读取方法的敏感性、特异性、阳性和阴性预测值及准确性。纳入40名志愿者获取正常ARFI值。
腺癌组SWS中位数为2.74 m/s。志愿者组SWS中位数为1.17 m/s。发现腺癌与正常胰腺的SWS中位数之间存在显著差异（P<0.05）。对于胰腺实性肿块的诊断，如果研究中超过一个测量值高于4.00 m/s的最高SWS值，则导管腺癌的诊断具有高度特异性，特异性和阳性预测值均为100%。对于黏液性囊性病变的特征性诊断，敏感性良好（73.3%），特异性良好（83.3%）。
声辐射力脉冲成像有助于在常规超声检查期间对胰腺实性和囊性病变进行非侵入性特征性诊断。
