Pediatric Radiology Department, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey.
Pediatric Rheumatology Department, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey.
Br J Radiol. 2021 Dec;94(1128):20210237. doi: 10.1259/bjr.20210237. Epub 2021 Sep 14.
Amyloid deposits in a visceral organ can contribute to tissue stiffness that could be measured with shear wave elastography (SWE). We aimed to investigate changes in organ stiffness in conjunction with laboratory parameters in patients with Familial Mediterranean Fever (FMF) and amyloidosis.
This prospective study included 27 FMF patients, 11 patients with amyloidosis, and 38 healthy controls. Median shear wave elasticity values of the liver, spleen, both kidneys, and pancreas on SWE were compared among study and control groups. The mean values of CRP (C-reactive protein) and ESR (erythrocyte sedimentation rate) were compared by the -test and the median of SAA (serum amyloid A protein) was compared with the Mann-Whitney test between FMF groups with and without amyloidosis. Spearman's correlation analysis was performed to reveal the association between stiffness values and laboratory parameters.
The median liver, spleen, kidney, and pancreas elasticity values were significantly higher in the FMF group with amyloidosis compared to control subjects. The median kidney stiffness values in the FMF group with or without amyloidosis were significantly higher compared to control subjects. Median liver stiffness values in FMF patients with amyloidosis were significantly higher than FMF patients without amyloidosis. There were statistically significant positive correlations between the CRP ( = 0.001, = 0.56), ESR ( = 0.001, = 0.61), and SAA ( = 0.002, = 0.53) levels with spleen stiffness, and CRP ( = 0.006, = 0.48) and ESR ( = 0.001, = 0.61) levels with pancreas stiffness, and ESR ( = 0.004, = 0.51) levels with the left kidney stiffness.
SWE could be a potential tool for noninvasive follow-up of FMF patients and also amyloid deposition.
Both acute inflammation and amyloidosis in the FMF patients could increase organ stiffness.
内脏器官中的淀粉样沉积物可导致组织僵硬，这种僵硬可以通过剪切波弹性成像（SWE）进行测量。我们旨在研究家族性地中海热（FMF）和淀粉样变性患者的器官僵硬变化与实验室参数的关系。
这项前瞻性研究纳入了 27 名 FMF 患者、11 名淀粉样变性患者和 38 名健康对照者。比较了 SWE 下肝脏、脾脏、双肾和胰腺的中位剪切波弹性值在研究组和对照组之间的差异。采用 t 检验比较 FMF 组和对照组之间 CRP（C 反应蛋白）和 ESR（红细胞沉降率）的均值，采用 Mann-Whitney U 检验比较 FMF 有无淀粉样变性组之间 SAA（血清淀粉样 A 蛋白）的中位数。采用 Spearman 相关分析来揭示僵硬值与实验室参数之间的相关性。
有淀粉样变性的 FMF 组的中位肝脏、脾脏、肾脏和胰腺弹性值显著高于对照组。有或无淀粉样变性的 FMF 组的中位肾脏僵硬值显著高于对照组。有淀粉样变性的 FMF 患者的中位肝脏僵硬值显著高于无淀粉样变性的 FMF 患者。CRP（r=0.56，p=0.001）、ESR（r=0.61，p=0.001）和 SAA（r=0.53，p=0.002）水平与脾脏僵硬之间存在统计学显著的正相关，CRP（r=0.48，p=0.006）和 ESR（r=0.61，p=0.001）水平与胰腺僵硬之间存在统计学显著的正相关，ESR（r=0.51，p=0.004）水平与左肾僵硬之间存在统计学显著的正相关。
SWE 可能是一种非侵入性随访 FMF 患者和淀粉样变性的潜在工具。
FMF 患者的急性炎症和淀粉样变性均可增加器官僵硬。
