Transabdominal Ultrasound Real-time Tissue Elastography as a Screening Method for Early Chronic Pancreatitis

A. Shimizu, Yasutaka Ishii, M. Serikawa, T. Tsuboi, K. Kurihara, Yumiko Tatsukawa, Ryota Kawamura, Ken Tsushima, Yuhei Saito, T. Sekito, Shinya Nakamura, Tetsuro Hirano, Ayami Fukiage, Takeshi Mori, Juri Ikemoto, K. Chayama
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Abstract

Background and Purpose: The concept of early chronic pancreatitis was proposed in Japan with the aim to improve the prognosis of patients with chronic pancreatitis. Endoscopic ultrasonography plays an important role in early diagnoses, but is limited by its invasiveness and poor objectivity. Hence, this study aimed to determine the usefulness of transabdominal ultrasound real-time tissue elastography as a screening method for early chronic pancreatitis. Methods: We retrospectively examined 73 patients who underwent simultaneous ultrasound real-time tissue elastography and endoscopic ultrasonography from 2011 to 2014. The correlation between feature values (MEAN, %AREA, COMP) calculated by real-time tissue elastography and the Rosemont classification of endoscopic ultrasonography diagnostic criteria for chronic pancreatitis, and the diagnostic ability of ultrasound real-time tissue elastography to recognize “indeterminate for chronic pancreatitis” findings, which correspond to early chronic pancreatitis, were evaluated. Main Results: Based on the Rosemont classification, 26 patients were “normal”, 16 were “indeterminate for chronic pancreatitis”, 13 were “suggestive of chronic pancreatitis”, and 18 were “consistent with chronic pancreatitis”. There were significant correlations between the feature values (MEAN, %AREA, COMP) and the Rosemont classification (p < 0.001; ρ = –0.788, 0.779, and 0.489, respectively). The area under the curve for the ability of MEAN to diagnose “indeterminate for chronic pancreatitis” was 0.889 (sensitivity, 93.8%; specificity, 76.9%). Conclusions: The feature values calculated by ultrasound real-time tissue elastography were correlated with the Rosemont classification. Ultrasound real-time tissue elastography may be a useful screening method for early chronic pancreatitis.
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经腹超声实时组织弹性成像筛查早期慢性胰腺炎
背景与目的:日本提出早期慢性胰腺炎的概念,旨在改善慢性胰腺炎患者的预后。超声内镜在早期诊断中发挥了重要作用,但受其侵入性和客观性差的限制。因此,本研究旨在确定经腹超声实时组织弹性成像作为早期慢性胰腺炎筛查方法的有效性。方法:回顾性分析2011年至2014年同时行超声实时组织弹性成像和超声内镜检查的73例患者。评估实时组织弹性成像计算的特征值(MEAN、%AREA、COMP)与慢性胰腺炎内镜超声诊断标准Rosemont分类的相关性,以及超声实时组织弹性成像识别“不确定的慢性胰腺炎”表现(对应早期慢性胰腺炎)的诊断能力。主要结果:根据Rosemont分级,“正常”26例,“不确定是否为慢性胰腺炎”16例,“提示慢性胰腺炎”13例,“符合慢性胰腺炎”18例。特征值(MEAN、%AREA、COMP)与Rosemont分类之间存在显著相关性(p < 0.001;ρ = -0.788、0.779和0.489)。MEAN诊断“慢性胰腺炎不确定”的能力曲线下面积为0.889(敏感性为93.8%;特异性,76.9%)。结论:超声实时组织弹性成像计算的特征值与Rosemont分类相关。超声实时组织弹性成像可能是早期慢性胰腺炎的一种有用的筛查方法。
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Hiroshima journal of medical sciences
Hiroshima journal of medical sciences Medicine-Medicine (all)
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