内镜超声引导下剪切波测量评估自身免疫性胰腺炎活动度的可行性及实用性：一项前瞻性探索性研究

Feasibility and usefulness of endoscopic ultrasonography-guided shear-wave measurement for assessment of autoimmune pancreatitis activity: a prospective exploratory study.

作者信息

Ohno Eizaburo, Hirooka Yoshiki, Kawashima Hiroki, Ishikawa Takuya, Tanaka Hiroyuki, Sakai Daisuke, Ishizu Yoji, Kuzuya Teiji, Nakamura Masanao, Honda Takashi

机构信息

Department of Gastorenterology and Hepatology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, 466-8550, Japan.

Department of Endoscopy, Nagoya University Hospital, 65 Tsuruma-cho, Showa-ku, Nagoya, 466-8550, Japan.

出版信息

J Med Ultrason (2001). 2019 Oct;46(4):425-433. doi: 10.1007/s10396-019-00944-4. Epub 2019 Apr 16.

PURPOSE

To assess the feasibility and the clinical usefulness of a newly developed endoscopic ultrasonography (EUS) shear-wave elastography technique (EUS shear-wave measurement: EUS-SWM) in the diagnosis and treatment of autoimmune pancreatitis (AIP).

METHODS

Tissue elasticity was measured in the pancreas in 160 patients. The success rate of EUS-SWMs, the velocity of the shear wave (Vs, m/s), and the reliability index of the Vs measurement (VsN) were evaluated, and the elasticity (median Vs) was compared between AIP patients (n = 14) and normal controls.

RESULTS

A total of 3837 EUS-SWMs were performed without adverse events. Overall, 97.6% (3743/3837) were successful. The median VsN was 74%. The median Vs values of the pancreas were as follows: 2.22 m/s in the pancreatic head (push position), 2.36 m/s in the head (pull position), 1.99 m/s in the body, and 2.25 m/s in the tail. The median Vs of the AIP group (2.57 m/s) was significantly higher than that of the normal controls (1.89 m/s) (P = 0.0185). The mean Vs significantly decreased from 3.32 m/s to 2.46 m/s after steroid therapy (n = 6) (P = 0.0234).

CONCLUSION

EUS-SWM is feasible and generates credible results. EUS-SWM was a useful method for assessment of the effect of steroid therapy in AIP patients.

目的

评估新开发的内镜超声（EUS）剪切波弹性成像技术（EUS剪切波测量：EUS-SWM）在自身免疫性胰腺炎（AIP）诊断和治疗中的可行性及临床实用性。

方法

对160例患者的胰腺组织弹性进行测量。评估EUS-SWM的成功率、剪切波速度（Vs，米/秒）以及Vs测量的可靠性指标（VsN），并比较AIP患者（n = 14）与正常对照者之间的弹性（Vs中位数）。

结果

共进行了3837次EUS-SWM，无不良事件发生。总体而言，97.6%（3743/3837）成功。VsN中位数为74%。胰腺各部位的Vs中位数如下：胰头（推位）为2.22米/秒，胰头（拉位）为2.36米/秒，胰体为1.99米/秒，胰尾为2.25米/秒。AIP组的Vs中位数（2.57米/秒）显著高于正常对照组（1.89米/秒）（P = 0.0185）。6例患者接受类固醇治疗后，平均Vs从3.32米/秒显著降至2.46米/秒（P = 0.0234）。