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Endoscopy 2013; 45(10): 781-788
DOI: 10.1055/s-0033-1344614
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Quantitative elastography associated with endoscopic ultrasound for the diagnosis of chronic pancreatitis

Julio Iglesias-Garcia
1   Department of Gastroenterology, University Hospital of Santiago de Compostela, Spain
2   Foundation for Research in Digestive Diseases (FIENAD), University Hospital of Santiago de Compostela, Spain
,
J. Enrique Domínguez-Muñoz
1   Department of Gastroenterology, University Hospital of Santiago de Compostela, Spain
2   Foundation for Research in Digestive Diseases (FIENAD), University Hospital of Santiago de Compostela, Spain
,
Marga Castiñeira-Alvariño
2   Foundation for Research in Digestive Diseases (FIENAD), University Hospital of Santiago de Compostela, Spain
,
Maria Luaces-Regueira
2   Foundation for Research in Digestive Diseases (FIENAD), University Hospital of Santiago de Compostela, Spain
,
Jose Lariño-Noia
1   Department of Gastroenterology, University Hospital of Santiago de Compostela, Spain
2   Foundation for Research in Digestive Diseases (FIENAD), University Hospital of Santiago de Compostela, Spain
› Author Affiliations
Further Information

Publication History

submitted 18 September 2012

accepted after revision 01 July 2013

Publication Date:
09 September 2013 (online)

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Background and study aims: Endoscopic ultrasonography (EUS) has become the method of choice for the diagnosis of chronic pancreatitis in clinical practice. However, the criteria allowing the specific diagnosis of the disease, mainly at non-advanced stages, are still under debate. Analysis of tissue stiffness by quantitative EUS–elastography may provide additional relevant information in this setting. The aim of this study was to evaluate the information provided by quantitative EUS–elastography for the diagnosis of chronic pancreatitis.

Patients and methods: A prospective, consecutive, 1-year study was designed, and included patients who underwent EUS for epigastric pain syndrome or known chronic pancreatitis. EUS–elastography was performed using radial Pentax EUS and Hitachi EUB900. The strain ratio was measured in the head, body, and tail of the pancreas, and the elastographic result was the mean of these three values. EUS criteria of chronic pancreatitis and the Rosemont classification were also evaluated. Data were analyzed by analysis of variance and linear regression; diagnostic accuracy was based on the receiver operating characteristic (ROC) curve analysis.

Results: A total of 191 patients (mean age 52 years, range 21 – 85; 103 male) were included; 92 (48.2 %) of them were finally diagnosed with chronic pancreatitis. A highly significant direct linear correlation was found between the number of EUS criteria of chronic pancreatitis and the strain ratio (r = 0.813; P < 0.0001). The area under the ROC curve was 0.949 (95 % confidence interval 0.916 – 0.982) and the accuracy of EUS–elastography for diagnosing chronic pancreatitis was 91.1 % (cut-off strain ratio of 2.25). The strain ratio varied significantly in different Rosemont classification groups (P < 0.001).

Conclusions: EUS–elastography was an accurate tool for the diagnosis of chronic pancreatitis and provided relevant and objective information to support EUS findings.

 

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