Department of Medicine, Shiga University of Medical Science, Seta Tsukinowa, Otsu, Shiga, 520-2192, Japan.
Department of Radiology, Shiga University of Medical Science, Otsu, Japan.
J Med Ultrason (2001). 2023 Oct;50(4):485-492. doi: 10.1007/s10396-023-01350-7. Epub 2023 Aug 16.
Although endoscopic ultrasound (EUS) has been widely used for diagnosing chronic pancreatitis (CP), the assessment of fibrosis using the Rosemont criteria (RC) is generally subjective. Shear wave elastography using EUS (EUS-SWE) has been advocated as an objective approach to evaluating pancreatic fibrosis; however, it is unknown which pancreatic region should be selected for measurement. This study aims to compare the diagnostic accuracy in diagnosing CP by measurement site.
Fifty patients with CP or suspected CP who underwent EUS-SWE were retrospectively analyzed. As per the RC, they were classified into two groups: CP and non-CP. Pancreatic stiffness was evaluated by measuring the velocities of the shear wave (Vs) in addition to determining the relevant cutoff value of Vs for diagnosing CP. The correlation between Vs and RC, and the RC factors affecting pancreatic stiffness were evaluated.
In the CP group, the Vs were notably higher in all regions (P < 0.001). The Vs for diagnostic accuracy of CP were highest in the body [area under the curve (AUC): 0.87]. A significant correlation was seen between the number of RC and Vs in all regions, with the correlation coefficient being highest in the pancreatic body (rs = 0.55). Multivariate analysis revealed that lobularity with honeycombing was an independent factor for pancreatic stiffness (P = 0.02).
The pancreatic body is a suitable region for assessing pancreatic stiffness using EUS-SWE. Additionally, quantifying Vs is a valuable objective indicator for diagnosing CP.
尽管内镜超声（EUS）已广泛用于诊断慢性胰腺炎（CP），但罗森蒙特标准（RC）评估纤维化通常是主观的。EUS 剪切波弹性成像（EUS-SWE）已被提倡作为评估胰腺纤维化的客观方法；然而，尚不清楚应该选择哪个胰腺区域进行测量。本研究旨在比较不同测量部位对 CP 诊断的准确性。
回顾性分析了 50 例接受 EUS-SWE 的 CP 或疑似 CP 患者。根据 RC，将其分为 CP 和非 CP 两组。通过测量剪切波速度（Vs）来评估胰腺硬度，并确定 Vs 的相关截断值以诊断 CP。评估了 Vs 与 RC 的相关性，以及影响胰腺硬度的 RC 因素。
在 CP 组中，所有区域的 Vs 均明显升高（P<0.001）。在体部，Vs 对 CP 的诊断准确性最高（曲线下面积 [AUC]：0.87）。所有区域的 RC 与 Vs 之间均存在显著相关性，其中胰腺体部的相关性系数最高（rs=0.55）。多变量分析显示，蜂巢状分叶是胰腺僵硬的独立因素（P=0.02）。
EUS-SWE 评估胰腺硬度时，胰腺体部是一个合适的区域。此外，定量 Vs 是诊断 CP 的有价值的客观指标。
