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剪切波弹性成像能否作为受累的早期指标?对囊性纤维化患儿胰腺和肝脏的评估

Can Point Shear Wave Elastography Be Used as an Early Indicator of Involvement?: Evaluation of the Pancreas and Liver in Children With Cystic Fibrosis.

作者信息

Sağlam Dilek, Demirbaş Fatma, Bilgici Meltem Ceyhan, Yücel Serap, Çaltepe Gönül, Eren Esra

机构信息

Department of Pediatric Radiology, Malatya Education and Research Hospital, Yeşilyurt, Turkey.

Diyarbakır Education and Research Hospital, Diyarbakır, Turkey.

出版信息

J Ultrasound Med. 2020 Sep;39(9):1769-1776. doi: 10.1002/jum.15281. Epub 2020 Apr 20.

Abstract

OBJECTIVES

The aim of this study was to determine the effect of cystic fibrosis (CF) on pancreas and liver elasticity in young children using point shear wave elastography and to determine the relationship with clinical findings.

METHODS

Twenty-two patients with genetically proven CF, who were admitted to our pediatric gastroenterology clinic, and 22 healthy control participants were enrolled in the study. The shear wave velocity (SWV) of the liver and pancreas were measured with point shear wave elastography.

RESULTS

The 22 patients with CF included 45.5% girls with a mean age ± SD of 35 ± 35.8 months (range, 5-123 months). The 22 healthy control participants included 41.2% girls with a mean age of 58.9 ± 44.4 months (range, 2-159 months). The mean SWV of the pancreas in the patients with CF (1.06 ± 0.26 m/s) was significantly higher than that of the healthy control participants (0.85 ± 0.23 m/s; P = .01). The mean SWV of the liver in the patients with CF (1.46 ± 0.24 m/s) was significantly higher than that of the healthy control participants (1.12 ± 0.21 m/s; P = .001). The SWV of the pancreas and liver did not show any significant differences depending on ursodeoxycholic acid use, malnutrition status, and the presence of the F508 deletion mutation.

CONCLUSIONS

This study showed an increased SWV of the pancreas in children with CF, contrary to the literature. We also found an increased liver SWV even in the absence of CF-related liver disease. Ultrasound elastography may be a useful method of evaluating early changes in the pancreas and liver before the obvious clinical, laboratory, and B-mode ultrasound signs of CF-related involvement.

摘要

目的

本研究旨在使用点剪切波弹性成像技术确定囊性纤维化(CF)对幼儿胰腺和肝脏弹性的影响,并确定其与临床发现的关系。

方法

本研究纳入了22例经基因检测确诊为CF且入住我院儿科胃肠病门诊的患者,以及22名健康对照者。采用点剪切波弹性成像技术测量肝脏和胰腺的剪切波速度(SWV)。

结果

22例CF患者中,女孩占45.5%,平均年龄±标准差为35±35.8个月(范围5 - 123个月)。22名健康对照者中,女孩占41.2%,平均年龄为58.9±44.4个月(范围2 - 159个月)。CF患者胰腺的平均SWV(1.06±0.26 m/s)显著高于健康对照者(0.85±0.23 m/s;P = 0.01)。CF患者肝脏的平均SWV(1.46±0.24 m/s)显著高于健康对照者(1.12±0.21 m/s;P = 0.001)。胰腺和肝脏的SWV在使用熊去氧胆酸、营养状况以及是否存在F508缺失突变方面均未显示出任何显著差异。

结论

本研究显示CF患儿胰腺的SWV升高,这与文献报道相反。我们还发现,即使在没有CF相关肝病的情况下,肝脏的SWV也会升高。超声弹性成像可能是一种在CF相关受累的明显临床、实验室和B超征象出现之前,评估胰腺和肝脏早期变化的有用方法。

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