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声辐射力脉冲(ARFI)弹性成像在急性胰腺炎诊断及临床病程中的重要性。

The importance of acoustic radiation force impulse (ARFI) elastography in the diagnosis and clinical course of acute pancreatitis.

作者信息

Kaya Muhsin, Değirmenci Serdar, Göya Cemil, Tuncel Elif Tuba, Uçmak Feyzullah, Kaplan Mehmet Ali

机构信息

Department of Gastroenterology, Dicle University School of Medicine, Diyarbakır, Turkey.

Department of Internal Medicine, Dicle University School of Medicine, Diyarbakır, Turkey.

出版信息

Turk J Gastroenterol. 2018 May;29(3):342-347. doi: 10.5152/tjg.2018.17338.

Abstract

BACKGROUND/AIMS: Acute pancreatitis (AP) is characterized by acute inflammation of the pancreas and it has a highly variable clinical course. The aim of our study was to evaluate the value of acoustic radiation force impulse (ARFI) elastography in the diagnosis and clinical course of AP.

MATERIALS AND METHODS

Consecutive patients with a diagnosis of AP (patients group) and healthy subject (control group) were prospectively enrolled to the study. Demographic features and clinical, laboratory, and radiological data were recorded. Virtual Touch Tissue Quantification (VTQ) was used to implement ARFI elastography. The tissue elasticity is proportional to the square of the wave velocity (SWV).

RESULTS

A total of 108 patients (age, 57±1.8 y) and 79 healthy subjects (age, 53.6±1.81 y) were included in the study. There were 100 (92.5%) edematous and 8 (7.4%) necrotizing AP. The mean SWV was significantly higher in the patient group than in the control group (2.43±0.08 vs. 1.27±0.025 m/s, p < 0.001). There was not significant difference between patient and control group regarding age and gender. SWV cutoff value of 1.63 m/s was associated with 100% sensitivity and 98% specificity for the diagnosis of AP. There was not significant difference between patients with and without complications and patients with edematous and necrotizing AP regarding mean SWV value. There was also not significant correlation between mean SWV value and age, mean length of hospital stay, and mean amylase level.

CONCLUSION

ARFI elastography may be a feasible method for the diagnosis of AP, but it has no value for the prediction of clinical course of AP.

摘要

背景/目的:急性胰腺炎(AP)的特征是胰腺急性炎症,其临床病程变化很大。本研究的目的是评估声辐射力脉冲(ARFI)弹性成像在AP诊断及临床病程中的价值。

材料与方法

前瞻性纳入连续诊断为AP的患者(患者组)和健康受试者(对照组)。记录人口统计学特征以及临床、实验室和放射学数据。采用虚拟触诊组织定量(VTQ)实施ARFI弹性成像。组织弹性与波速平方(SWV)成正比。

结果

本研究共纳入108例患者(年龄57±1.8岁)和79例健康受试者(年龄53.6±1.81岁)。其中有100例(92.5%)水肿性AP和8例(7.4%)坏死性AP。患者组的平均SWV显著高于对照组(2.43±0.08 vs. 1.27±0.025 m/s,p<0.001)。患者组与对照组在年龄和性别方面无显著差异。SWV临界值为1.63 m/s时,诊断AP的灵敏度为100%,特异度为98%。有并发症和无并发症的患者之间以及水肿性和坏死性AP患者之间的平均SWV值无显著差异。平均SWV值与年龄、平均住院时间和平均淀粉酶水平之间也无显著相关性。

结论

ARFI弹性成像可能是诊断AP的一种可行方法,但对预测AP的临床病程无价值。

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