Purpose

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.

Methods

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.

Results

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).

Conclusion

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.

中文翻译：

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基于Rosemont标准的内镜超声剪切波弹性成像对多个胰腺区域慢性胰腺炎的诊断准确性

目的

尽管超声内镜（EUS）已广泛用于诊断慢性胰腺炎（CP），但使用罗斯蒙特标准（RC）对纤维化的评估通常是主观的。使用 EUS 的剪切波弹性成像 (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诊断 CP 的诊断准确性。

方法

对 50 例接受 EUS-SWE 的 CP 或疑似 CP 患者进行回顾性分析。根据 RC，他们被分为两类：CP 和非 CP。除了确定诊断 CP 的相关 Vs 截止值之外，还通过测量剪切波 (Vs) 的速度来评估胰腺硬度。评估Vs和RC之间的相关性以及影响胰腺硬度的RC因素。

结果

在 CP 组中，所有区域的 Vs 均显着较高 ( P  < 0.001)。CP 诊断准确性的 Vs 在体内最高 [曲线下面积 (AUC)：0.87]。所有区域的 RC 和 V 数量之间均存在显着相关性，其中胰体的相关系数最高（rs = 0.55）。多变量分析显示，蜂窝状小叶是胰腺硬度的独立影响因素（P  =0.02）。

结论

胰体是使用 EUS-SWE 评估胰腺硬度的合适区域。此外，量化 Vs 是诊断 CP 的一个有价值的客观指标。