Use of Shear Wave Elastography to Diagnose Acute Pancreatitis: A Cross-sectional Study
Introduction: Acute inflammation process of the pancreas with or without involvement of surrounding tissues and remote organ systems is termed as Acute Pancreatitis (AP). Contrast Enhanced Computed Tomography (CECT) if performed immediately may underestimate the severity. Therefore, ultrasound e...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Pvt. Ltd.
2021-04-01
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| Series: | International Journal of Anatomy Radiology and Surgery |
| Subjects: | |
| Online Access: | http://www.ijars.net/articles/PDF/2619/46213_CE[Ra1]_F(SHU)_PF1(AG_SHU)_PFA(SHU)_PB(AG_SHU)_GC(SHU)_PN(SHU).pdf |
| Summary: | Introduction: Acute inflammation process of the pancreas with
or without involvement of surrounding tissues and remote organ
systems is termed as Acute Pancreatitis (AP). Contrast Enhanced
Computed Tomography (CECT) if performed immediately may
underestimate the severity. Therefore, ultrasound examination
remains the first imaging diagnostic method in suspected cases of
AP. The sensitivity of B-mode sonography for the early diagnosis of
AP can be increased by the detection of an increase in pancreatic
tissue stiffness with Shear Wave Elastography (SWE).
Aim: To evaluate the efficacy of SWE in the analysis of AP.
Materials and Methods: A cross-sectional study was
conducted in Tertiary Care Hospital attached to Mysore Medical
College and Research Institute, Mysuru, Karnataka, India, from
August 2019 to September 2019. The pancreatic parenchyma
of 30 patients with symptoms of AP that included acute onset of
severe central epigastric pain, poorly localised tenderness and
pain increased by supine positioning radiating to the back. The
study also included 40 healthy, asymptomatic volunteer who
were examined using B-mode sonography and SWE. Computed
Tomography (CT) was performed in all patients with AP with a
SEIMENS SOMATOM DEFINITION EDGE 128 slice CT scanner.
Elastographic measurements were performed and quantitative
SWE values represented in kilopascal (kPa) of the patients
and asymptomatic volunteers group were compared. Patients’
amylase and lipase levels were done by biochemical tests.
Descriptive and Inferential statistical analysis was carried out
in the present study. Student’s t-test (two tailed, independent),
Leven’s test for homogeneity of variance and Chi-square test
was used to find the significance of study parameters.
Results: The mean SWE values for the asymptomatic volunteers
with normal pancreatic parenchyma were 9.53±2.62 kPa.
The mean SWE values for the pancreatic parenchyma of the
patients with AP were 17.23±6.24 kPa. The mean SWE value
for the patients with AP was significantly higher than the value
for the control group (p<0.001). A SWE cut-off value of 13.5 kPa
was associated with 70% sensitivity and 92.5% specificity for
diagnosis of AP.
Conclusion: For the diagnosis of AP at initial hospital admission,
SWE can be used as it is a rapid, radiation-free, and noninvasive tool. It is a useful imaging method with high sensitivity
and specificity for the diagnosis of AP. |
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| ISSN: | 2277-8543 2455-6874 |