Effectiveness of Shear Wave Elastography in the diagnosis of acute pancreatitis on admission

Abstract

Aim: We aimed to investigate the effectiveness of shear wave elastography (SWE) in the diagnosis of acute pancreatitis (AP).

Material and methods: The pancreatic parenchyma of 50 patients whose clinical and laboratory findings were indicative of AP and of 70 healthy, asymptomatic volunteer participants with normal laboratory values was examined using SWE.
Computed tomography was performed in all patients with AP on admission. Elastographic measurements were performed by manually drawing the contours of the pancreatic parenchyma using the free region of interest. The quantitative SWE values (meters/second [m/s], kilopascal [kPa]) of the patients and asymptomatic volunteers group were compared.

Results: The mean SWE value of the pancreatic parenchyma was 2.60 ± 1.63 m/s in the asymptomatic volunteers and 3.48 ± 0.52 m/s in patients with AP, with a statistically significant difference (p<0.001, t=-3.685). The mean SWE value of the pancreatic parenchyma was 23.77±6.72 kPa in the asymptomatic volunteers and 45.71 ± 10.72 kPa in patients with AP, indicating a significant difference (p<0.001, t=-3.685). AP can be diagnosed with a sensitivity and specificity of 98.0% when 29.45 kPa was designated as cut-off value and with a 96.0% sensitivity and 98.3% specificity when 2.77 m/s was designated as the cut-off value. The superiority of SWE was found over B-mode US and CECT in the diagnosis of AP on admission. 

Conclusion: SWE can be used as an effective imaging method with high sensitivity and specificity for the diagnosis of AP. It may be used as an important imaging method to assist in the diagnosis of AP especially when B-mode US and CECT findings are normal.