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Utility of Elastography with Endoscopic Ultrasonography Shear-Wave Measurement for Diagnosing Chronic Pancreatitis

Gut and Liver 2020년 14권 5호 p.659 ~ 664
Yamashita Yasunobu, Tanioka Kensuke, Kawaji Yuki, Mitamura Takashi, Nuta Junya, Hatamaru Keiichi, Itonaga Masahiro, Yoshida Takeichi, Ida Yoshiyuki, Maekita Takao, Iguchi Mikitaka, Kitano Masayuki,
소속 상세정보
 ( Yamashita Yasunobu ) - Wakayama Medical University Department of Internal Medicine
 ( Tanioka Kensuke ) - Wakayama Medical University Clinical Study Support Center
 ( Kawaji Yuki ) - Wakayama Medical University Department of Internal Medicine
 ( Mitamura Takashi ) - Wakayama Medical University Department of Internal Medicine
 ( Nuta Junya ) - Wakayama Medical University Department of Internal Medicine
 ( Hatamaru Keiichi ) - Wakayama Medical University Department of Internal Medicine
 ( Itonaga Masahiro ) - Wakayama Medical University Department of Internal Medicine
 ( Yoshida Takeichi ) - Wakayama Medical University Department of Internal Medicine
 ( Ida Yoshiyuki ) - Wakayama Medical University Department of Internal Medicine
 ( Maekita Takao ) - Wakayama Medical University Department of Internal Medicine
 ( Iguchi Mikitaka ) - Wakayama Medical University Department of Internal Medicine
 ( Kitano Masayuki ) - Wakayama Medical University Department of Internal Medicine

Abstract


Background/Aims: Rosemont classification (RC) with endoscopic ultrasonography (EUS) is important for diagnosing chronic pancreatitis (CP) but is based only on subjective judgement. EUS shear wave measurement (EUS-SWM) is a precise modality based on objective judgment, but its usefulness has not been extensively studied yet. This study evaluated the utility of EUS-SWM for diagnosing CP and estimating CP severity by determining the presence of endocrine dysfunction along with diabetes mellitus (DM).

Methods: Between June 2018 and December 2018, 52 patients who underwent EUS and EUS-SWM were classified into two groups according to RC: non-CP (indeterminate CP and normal) and CP (consistent and suggestive of CP). The EUSSWM value by shear wave velocity was evaluated with a median value. The EUS-SWM value was compared with RC and the number of EUS features. The diagnostic accuracy and cutoff value of EUS-SWM for CP and DM and its sensitivity and specificity were calculated.

Results: The EUS-SWM value significantly positively correlated with the RC and the number of EUS features. The EUS-SWM values that were consistent and suggestive of CP were significantly higher than that of normal. The area under the receiver operating characteristic (AUROC) curve for the diagnostic accuracy of EUS-SWM for CP was 0.97. The cutoff value of 2.19 had 100% sensitivity and 94% specificity. For endocrine dysfunction in CP, the AUROC was 0.75. The cutoff value of 2.78 had 70% sensitivity and 56% specificity.

Conclusions: EUS-SWM provides an objective assessment and can be an alternative diagnostic tool for diagnosing CP. EUS-SWM may also be useful for predicting the presence of endocrine dysfunction.

키워드

Pancreatitis, chronic; Shear wave EUS elastography; Rosemont classification; Diabetes mellitus

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