Endoscopic ultrasound elastography for small solid pancreatic lesions with or without main pancreatic duct dilatation

Background/Objectives: Endoscopic ultrasound elastography (EUS-EG) is useful for diagnosis of small solid pancreatic lesions (SPLs), particularly in excluding pancreatic cancer (PC), but its dependence on main pancreatic duct dilatation (MPDD) has not been examined. We aimed to investigate EUS-EG for diagnosis of small SPLs with and without MPDD.MethodsPatients with pathologically diagnosed SPLs of ≤20 mm were included and retrospectively analyzed. Using the blue:green ratio, an EUS-EG image was classified as blue-dominant, equivalent, or green-dominant. Using multiple EUS-EG images per patient, a lesion with a greater number of blue-dominant than green-dominant images was classified as stiff, and the others as soft. EUS-EG images in random order were judged by three raters. Considering stiff SPLs as PC, diagnostic performance of EUS-EG was examined for SPLs with and without MPDD.ResultsOf 126 cases analyzed, 65 (52%) were diagnosed as PC, and 63 (50%) had MPDD. A total of 1077 EUS-EG images were examined (kappa coefficient = 0.783). Lesions were classified as stiff in 91 cases and soft in 35 (kappa coefficient = 0.932). The ratio of stiff to soft lesions was significantly higher in PC than in non-PC (62:3 vs. 29:32, P < 0.001). The sensitivity, specificity, and negative predictive value of a stiff lesion with vs. without MPDD for diagnosis of PC were 94%, 23%, and 50% vs. 100%, 60%, and 100%, respectively.ConclusionsUsing the EUS-EG stiffness classification for small SPLs, PC can be excluded with high confidence and concordance for a soft lesion without MPDD.     

An initial trial of quantitative evaluation of autoimmune pancreatitis using shear wave elastography and shear wave dispersion in transabdominal ultrasound

Background/ObjectivesWe aimed to examine therapeutic efficacy and prognosis prediction of autoimmune pancreatitis (AIP) using shear wave elastography (SWE) and shear wave dispersion (SWD) in transabdominal ultrasound (US).MethodsThe subjects were 23 patients with diffuse type 1 AIP who underwent SWE and SWD, and 34 controls with a normal pancreas. Elasticity and dispersion were defined as the pancreatic elastic modulus (PEM) and dispersion slope, respectively. PEM and dispersion slope were compared between AIP and control cases, and the short-term therapeutic effect and long-term prognosis were examined.ResultsPEM (30.9 vs. 6.6 kPa, P < 0.001) and dispersion slope (15.3 vs. 13.0 (m/sec)/kHz, P = 0.011) were significantly higher in AIP cases than in controls. Among the 17 AIP patients followed-up in two weeks after treatment, these parameters were 12.7 kPa and 10.5 (m/sec)/kHz with median decrease rate of 37.2% and 32.8%, respectively, which were significantly higher than the change in the size of pancreatic parenchyma (14.4%, P = 0.026). Fourteen of these subjects were followed up for >12 months, during which 2 had relapse; diabetes improved in 5 and worsened in 2; in 60% of cases, the pancreatic parenchyma was atrophied. The % change in PEM after two weeks was tended to be higher in non-atrophy cases.ConclusionSWE and SWD measurement in US may be useful for quantitative assessment of AIP and evaluation of short-term treatment efficacy.     

Placental Elasticity as a New Non-invasive Predictive Marker of Pre-eclampsia

Point shear wave elastography is an ultrasonography technique used to evaluate tissue elasticity. We examined whether placental elasticity is useful for predicting the onset of pre-eclampsia. Two hundred twenty-one participants were divided into two groups: one group at low risk (n?=?185) and the other at high risk (n?=?36) for pre-eclampsia. The two groups were compared with respect to shear wave velocity (SWV) of the placenta. Use of SWV as a predictor of pre-eclampsia was also investigated by creating a receiver operating characteristic (ROC) curve. The ROC curve was used to set a cutoff SWV value for predicting pre-eclampsia. The SWV of the high-risk group was significantly higher than that of the low-risk group (p < 0.001). Thirteen participants developed pre-eclampsia after SWV measurements, and the SWVs of these participants were significantly higher than those of participants in who pre-eclampsia did not develop. The cutoff value and area under the ROC curve were 1.188 m/s and 0.9118, respectively. Placental elasticity was significantly increased even before the onset of pre-eclampsia onset and, thus, may be a parameter used to predict the onset of pre-eclampsia.     

瞬时弹性记录仪Fibroscan在慢性乙型肝炎肝纤维化中的应用价值

目的：探讨瞬时弹性记录仪（FibroScan）对慢性乙型肝炎肝纤维化的临床应用价值。方法：对134例慢性乙型肝炎患者行FibroScan检查,将所检测到的肝硬度值与按照Scheuer系统进行肝组织活检纤维化分级的结果进行比较,用Spearman等级相关系数方法进行统计学分析。结果：134例慢性乙型肝炎患者中,S0期10例、S1期16例、S2期24例、S3期30例、S4期54例。除1例患者因肥胖导致瞬时弹性超声检测失败以外,其余均顺利受检。133例患者的瞬时弹性超声硬度值与其肝纤维化分期有显著相关性（r=0.905,P〈0.01）。轻、中度纤维化组（S0、S1、S2期）与重度纤维化组（S3、S4期）的瞬时弹性超声硬度值相比,t=-16.671,P〈0.01,差异有统计学意义。结论：FibroScan可以较准确地估计慢性乙型肝炎患者的纤维化程度,在乙型肝炎纤维化程度的长期随访与疗效评估中有着较好的应用价值。     

超声弹性成像在妇产领域中的应用进展

超声弹性成像可以客观测量组织弹性这一基本生物学特性,具有重要的临床意义和广阔的应用前景。目前,超声弹性成像已在甲状腺、乳腺、肾脏、肝脏、淋巴结、血管、皮肤和肌肉系统等领域取得显著应用成果,其在妇产领域中的价值也日益凸显,在预测引产结局、检测宫颈及宫体病变等方面的研究陆续展开。本文就超声弹性成像在妇产领域中的应用进展进行综述。     

剪切波弹性成像评估腹膜透析患者腹膜硬化程度的应用价值

目的 应用剪切波弹性成像（SWE）评估腹膜透析患者腹膜硬化程度,探讨其临床应用价值。方法 选取我院行持续非卧床腹膜透析（CAPD）患者168例,根据不同腹膜透析时间分为≤3年组71例、3～11年组78例、≥11年组19例,应用常规超声观测各组肠壁、腹膜厚度及回声、有无钙化等,并对其进行超声评分;应用SWE测量肠壁、腹膜杨氏模量平均值（Emean）,比较各组超声评分、SWE参数的差异;分析超声评分、SWE参数与透析时间的相关性。结果 ≤3年组、3～11年组、≥11年组超声评分分别为0(0,0)分、4.9(3.5,7.4)分、7.5(5.7,8.9)分;≤3年组、3～11年组、≥11年组肠壁Emean分别为1.0(0,2.0)kPa、9.9(6.3,14.1)kPa、11.9(6.5,18.6)kPa,腹膜Emean分别为2.0(0,3.0)kPa、11.4(6.5,20.9)kPa、20.3(11.0,30.4)kPa;3～11年组、≥11年组超声评分及肠壁、腹膜Emean均高于≤3年组,差异均有统计学意义（均P<0.01）;3～11年组与≥11年组上述参数比较差异均无统计学意义。...     

超声弹性成像在下肢深静脉血栓形成分期中的应用价值

目的 探讨超声弹性成像在下肢深静脉血栓形成分期中的应用价值。方法 选取我院110例下肢深静脉血栓患者,其中急性期43例、亚急性期37例、慢性期30例。应用超声弹性成像获取弹性成像评分及杨氏模量平均值（Emean）,比较急性期、亚急性期、慢性期下肢深静脉血栓形成患者弹性成像评分、Emean及实验室指标的差异;分析弹性成像评分、Emean与实验室指标的相关性。应用Logistic回归分析下肢深静脉血栓形成分期的影响因素;绘制受试者工作特征（ROC）曲线分析弹性成像评分联合Emean对下肢深静脉血栓形成急性期的诊断效能。结果 急性期下肢深静脉血栓形成患者弹性成像评分、Emean均减低,活化部分凝血活酶时间（aPTT）、凝血酶原时间（PT）、纤维蛋白原（Fbg）均增高,与亚急性期、慢性期血栓形成患者比较差异均有统计学意义（均P<0.05）。相关性分析显示,弹性成像评分、Emean与aPTT、PT、Fbg均呈负相关（均P<0.05）。Logistic回归分析显示,弹性成像评分、Emean均为下肢深静脉血栓形成分期的独立影响因素（OR=2.136,1.201,均P<0.05）。R...