Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy.
Department of Biomedical and Clinical Sciences Luigi Sacco, Università degli Studi di Milano, Milano, Italy.
Pancreatology. 2017 Nov-Dec;17(6):905-910. doi: 10.1016/j.pan.2017.10.003. Epub 2017 Oct 13.
Objectives: ElastPQ-pSWE is an ultrasound technique developed to stage disease severity in patients with chronic liver diseases. Little data is available about its application to the pancreas. We aimed to assess the feasibility and reproducibility of pancreatic stiffness (PS) measurements in patients with chronic pancreatitis and their relationship with clinical and laboratory data.
52 consecutive patients with chronic pancreatitis (CP) (40 males; median age 60 years) underwent hepatic and pancreatic pSWE. Liver stiffness was measured by transient elastography, 42 healthy subjects being controls (25 males; median age 54 years). Pancreatic pSWE inter-observer agreement was analyzed by intraclass correlation coefficient (ICC). The effects of clinical, laboratory and US data on PS measurements were evaluated by linear regression.
pSWE was feasible in all the CP patients, but one. Pancreatic stiffness was significantly higher in CP patients than healthy controls (4.3 ± SD 2.4 vs. 2.8 ± SD 1.1 kPa, respectively, p = 0.001). Significantly higher values in the CP group were observed in patients with longer disease duration (>10 vs. ≤10 years) (5.8 ± SD 4 vs. 3.9 ± SD 1.5 kPa, respectively, p = 0.01), on chronic analgesic drugs (6.0 vs. 3.5 kPa, p < 0.05) and with lower body weight (p < 0.05, r = -0.38). At multivariate analysis all the three variables resulted independently associated to the pancreatic stiffness value. The ICC for PS was 0.77.
ElastPQ-pSWE is promising and reproducible in assessing pancreatic stiffness, which mainly reflects disease length and severity. Accordingly, its use is of potential value in stratifying CP patients by identifying those with a more serious degree of disease.
目的：ElastPQ-pSWE 是一种超声技术，用于对慢性肝病患者的疾病严重程度进行分期。关于其在胰腺中的应用，数据较少。我们旨在评估慢性胰腺炎患者胰腺硬度（PS）测量的可行性和可重复性及其与临床和实验室数据的关系。
52 例连续的慢性胰腺炎（CP）患者（40 例男性；中位年龄 60 岁）接受了肝和胰腺 pSWE 检查。肝脏硬度通过瞬时弹性成像测量，42 名健康受试者作为对照（25 例男性；中位年龄 54 岁）。通过组内相关系数（ICC）分析胰腺 pSWE 的观察者间一致性。通过线性回归评估临床、实验室和 US 数据对 PS 测量的影响。
CP 患者均可行 pSWE，但有一例患者除外。CP 患者的胰腺硬度明显高于健康对照组（分别为 4.3±2.4kPa 和 2.8±1.1kPa，p=0.001）。在疾病持续时间较长（>10 年与≤10 年）的 CP 患者中，CP 组的数值明显更高（分别为 5.8±4kPa 和 3.9±1.5kPa，p=0.01），在长期使用慢性镇痛药的患者中（6.0 与 3.5kPa，p<0.05）和体重较低的患者中（p<0.05，r=-0.38）。多变量分析显示，这三个变量均与胰腺硬度值独立相关。PS 的 ICC 为 0.77。
ElastPQ-pSWE 具有评估胰腺硬度的潜力，重复性好，主要反映疾病的长度和严重程度。因此，它可以通过识别疾病严重程度较高的患者，对 CP 患者进行分层，具有潜在的应用价值。
