Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan, 65 Tsuruma-Cho, Showa-ku, Nagoya City, 466-8550, Japan.
Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan 65 Tsuruma-Cho, Showa-ku, Nagoya City, 466-8550, Japan.
Pancreatology. 2021 Jun;21(4):682-687. doi: 10.1016/j.pan.2021.02.014. Epub 2021 Feb 20.
BACKGROUND/OBJECTIVES: We aimed to examine therapeutic efficacy and prognosis prediction of autoimmune pancreatitis (AIP) using shear wave elastography (SWE) and shear wave dispersion (SWD) in transabdominal ultrasound (US).
The subjects were 23 patients with diffuse type 1 AIP who underwent SWE and SWD, and 34 controls with a normal pancreas. Elasticity and dispersion were defined as the pancreatic elastic modulus (PEM) and dispersion slope, respectively. PEM and dispersion slope were compared between AIP and control cases, and the short-term therapeutic effect and long-term prognosis were examined.
PEM (30.9 vs. 6.6 kPa, P < 0.001) and dispersion slope (15.3 vs. 13.0 (m/sec)/kHz, P = 0.011) were significantly higher in AIP cases than in controls. Among the 17 AIP patients followed-up in two weeks after treatment, these parameters were 12.7 kPa and 10.5 (m/sec)/kHz with median decrease rate of 37.2% and 32.8%, respectively, which were significantly higher than the change in the size of pancreatic parenchyma (14.4%, P = 0.026). Fourteen of these subjects were followed up for >12 months, during which 2 had relapse; diabetes improved in 5 and worsened in 2; in 60% of cases, the pancreatic parenchyma was atrophied. The % change in PEM after two weeks was tended to be higher in non-atrophy cases.
SWE and SWD measurement in US may be useful for quantitative assessment of AIP and evaluation of short-term treatment efficacy.
背景/目的：本研究旨在通过经腹超声剪切波弹性成像（SWE）和剪切波分散度（SWD）评估自身免疫性胰腺炎（AIP）的疗效和预后预测。
本研究纳入 23 例弥漫型 1 型 AIP 患者和 34 例胰腺正常的对照组患者进行 SWE 和 SWD 检查。弹性和分散度分别定义为胰腺弹性模量（PEM）和分散斜率。比较 AIP 与对照组之间的 PEM 和分散斜率，并评估短期治疗效果和长期预后。
AIP 组的 PEM（30.9 比 6.6 kPa，P < 0.001）和分散斜率（15.3 比 13.0（m/sec）/kHz，P = 0.011）均显著高于对照组。在 17 例接受两周治疗后随访的 AIP 患者中，这些参数分别为 12.7 kPa 和 10.5（m/sec）/kHz，中位下降率分别为 37.2%和 32.8%，明显高于胰腺实质大小的变化（14.4%，P = 0.026）。其中 14 例患者随访时间超过 12 个月，其中 2 例复发；5 例糖尿病改善，2 例恶化；60%的患者胰腺实质萎缩。两周后 PEM 的变化百分比在无萎缩病例中趋于更高。
SWE 和 SWD 测量在超声检查中可能有助于 AIP 的定量评估和短期治疗效果的评估。
