From the Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA.
Department of Medicine, Stony Brook University Hospital, Stony Brook, NY.
Pancreas. 2023 Feb 1;52(2):e115-e120. doi: 10.1097/MPA.0000000000002213.
The aim of this study was to assess the safety, feasibility, and reproducibility of endoscopic ultrasound shear wave elastography (EUS-SWE) in the pancreas.
This is a prospective registry of consecutive patients undergoing clinically indicated EUS. Ten readings of SWE velocities (Vs [distance/time, m/s]) were obtained in the head (HOP), body, and tail of pancreas to quantify tissue stiffness. Each Vs score was accompanied by a reliability measurement VsN (%) with VsN >50% considered reliable. Safety was evaluated by perioperative complications rate. Feasibility was determined by technical success of obtaining measurements. Reproducibility was evaluated using intraclass correlation coefficient analysis.
Total of 3320 EUS-SWE measurements were performed on 117 patients without perioperative complications. Measurement success rate was 100% across all locations. Reliable measurements were more common in the HOP (953/1120 [85.1%]) followed by body (853/1130 [75.5%]) and tail of pancreas (687/1070 [64.2%]) (P < 0.001). The analysis showed good reproducibility in all locations (intraclass correlation coefficient range, 0.80-0.89).
Endoscopic ultrasound-SWE is safe, has 100% technical success rate, and is highly reproducible when used in the pancreas. Our study suggests that SWE measurements in the HOP offer the highest reliability, likely because of large study area and less respiratory artifact.
本研究旨在评估内镜超声剪切波弹性成像（EUS-SWE）在胰腺中的安全性、可行性和可重复性。
这是一项连续患者接受临床指征性 EUS 的前瞻性登记研究。在胰腺头部（HOP）、体部和尾部获取 10 次 SWE 速度（Vs[距离/时间，m/s]）读数，以量化组织硬度。每个 Vs 评分都伴有可靠性测量 VsN（%），VsN>50%被认为是可靠的。通过围手术期并发症发生率评估安全性。通过获得测量的技术成功率来确定可行性。使用组内相关系数分析评估可重复性。
在 117 名无围手术期并发症的患者中总共进行了 3320 次 EUS-SWE 测量。所有部位的测量成功率均为 100%。可靠的测量在 HOP（953/1120[85.1%]）中更为常见，其次是体部（853/1130[75.5%]）和尾部（687/1070[64.2%]）（P<0.001）。分析表明，所有部位的可重复性均良好（组内相关系数范围为 0.80-0.89）。
EUS-SWE 在胰腺中是安全的，具有 100%的技术成功率，并且具有高度的可重复性。我们的研究表明，HOP 中的 SWE 测量具有最高的可靠性，这可能是因为研究区域较大且呼吸伪影较少。
