Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake, Japan.
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Korean J Intern Med. 2022 Jan;37(1):27-36. doi: 10.3904/kjim.2021.252. Epub 2021 Dec 15.
Chronic pancreatitis (CP) is pathologically characterized by the loss of exocrine pancreatic parenchyma, irregular fibrosis, cellular infiltration, and ductal abnormalities. Diagnosing CP objectively is difficult because standard diagnostic criteria are insufficient. The change of parenchymal hardness is the key factor for the diagnosis and understanding of the severity of CP. The ultrasonography (US) or endoscopic ultrasonography (EUS) elastography have been used to diagnose pancreatic diseases. Both strain elastography (SE) and shear wave elastography are specific diagnostic techniques for measuring tissue hardness. Most previous studies were conducted with SE. There are three methods of interpreting SE; the method of recognizing the patterns in SE distribution images in the region of interest, the method of using strain ratio to compare the hardness of adipose tissue or connective tissue with that of the lesion, and the method of evaluating the hardness distribution of a target by histogram analysis. These former two methods have been used primarily for neoplastic diseases, and histograms analysis has been used to assess hardness distribution in the evaluation of CP. Since the hardness of the pancreas increases with aging, it is necessary to consider the age in the diagnosis of pancreatic disorders using US or EUS elastography.
慢性胰腺炎（CP）的病理学特征为外分泌胰腺实质丧失、不规则纤维化、细胞浸润和导管异常。由于标准诊断标准不足，客观诊断 CP 较为困难。实质硬度的变化是诊断和了解 CP 严重程度的关键因素。超声（US）或内镜超声（EUS）弹性成像已用于诊断胰腺疾病。应变弹性成像（SE）和剪切波弹性成像都是测量组织硬度的特定诊断技术。大多数先前的研究都采用 SE 进行。SE 有三种解释方法：在感兴趣区域识别 SE 分布图像模式的方法、使用应变比比较脂肪组织或结缔组织与病变硬度的方法以及通过直方图分析评估目标硬度分布的方法。前两种方法主要用于肿瘤性疾病，直方图分析用于评估 CP 的硬度分布。由于胰腺的硬度随年龄增长而增加，因此在使用 US 或 EUS 弹性成像诊断胰腺疾病时需要考虑年龄因素。
