• Chronic pancreatitis
• Rosemont score
• Shear wave elastography
• Transabdominal ultrasound

• acoustic radiation force impulse
• chronic pancreatitis
• disease severity
• shear wave elastography

• Humans
• Elasticity Imaging Techniques/methods
• Pancreatitis, Chronic/diagnostic imaging
• Male
• Middle Aged
• Female
• Prospective Studies
• Adult
• Pancreas/diagnostic imaging
• Pancreas/pathology
• Severity of Illness Index
• ROC Curve
• Aged
• Liver Cirrhosis/diagnostic imaging
• Liver Cirrhosis/complications
• Case-Control Studies
• Sensitivity and Specificity
• Predictive Value of Tests
• Hypertension, Portal/diagnostic imaging
• Hypertension, Portal/etiology
• Hypertension, Portal/diagnosis
• Spleen/diagnostic imaging
• Spleen/pathology

• Deutsche Forschungsgemeinschaft

• elastography pancreas рSWE shear wave ultrasound

• Elasticity Imaging Techniques/methods
• Reference Values
• Pancreas/diagnostic imaging

• Chronic pancreatitis
• Elastography
• Endoscopic ultrasound

• Humans
• Elasticity Imaging Techniques
• Retrospective Studies
• Pancreas/diagnostic imaging
• Pancreatitis, Chronic/diagnostic imaging
• Endosonography
• Fibrosis

Preoperative prediction of the postoperative pancreatic fistula risk is critical in the current era of minimally invasive pancreatic surgeries to tailor perioperative management, thereby minimizing postoperative morbidity. Pancreatic duct diameter can be readily measured by any routine imaging used to diagnose pancreatic disease. However, radiological evaluation of pancreatic texture, an important determinant of pancreatic fistula, has not been widely used to predict the risk of postoperative pancreatic fistula. Qualitative and quantitative assessment of pancreatic fibrosis and fat fraction provides the basis for predicting pancreatic texture. Traditionally computed tomography has been utilized in identifying and characterizing pancreatic lesions and background parenchymal pathologies. With the increasing utilisation of endoscopic ultrasound and magnetic resonance imaging for evaluating pancreatic pathologies, elastography is emerging as a promising tool for predicting pancreatic texture. Also, recent studies have shown that early surgery for chronic pancreatitis is associated with better pain relief and preservation of pancreatic function. Pancreatic texture assessment can allow early diagnosis of chronic pancreatitis, facilitating early intervention. The present review outlines the current evidence in utilizing various imaging modalities for determining the pancreatic texture based on different parameters and image sequences. However, multidisciplinary investigations using strong radiologic-pathologic correlation are needed to standardize and establish the role of these non-invasive diagnostic tools in predicting pancreatic texture.

• Pancreatic fistula
• Minimally invasive
• Pancreaticoduodenectomy
• Pancreatic cancer
• Neoplasms
• Computed tomography
• Endoscopic ultrasound
• Ultrasonography
• Magnetic resonance imaging

• chronic
• diagnostic ultrasound
• pancreatitis
• ultrasonic waves
• ultrasound imaging

Introduction: A variety of imaging techniques exists for the diagnosis of pancreatic disorders. None of the broadly applied diagnostic methods utilizes elasticity as an indicator of tissue damage. A well-known fact is that both chronic pancreatitis (CP) and pancreatic ductal adenocarcinoma (PDA) are associated with the development of prominent fibrosis (increased tissue stiffness). Purpose: To prospectively assess the accuracy of point shear wave elastography (pSWE) in differentiating between benign and malignant pancreatic diseases, establish a cut-off value for the diagnosis of PDA, and evaluate the influence of certain variables on the obtained results. Materials and methods: The present study included 78 patients who were admitted at the Department of Gastroenterology at the university hospital “Kaspela” between December 2017 and August 2021 for diagnosis and/or treatment of pancreatic disorders. Based on the clinical criteria, diagnostic imaging, and histological findings, patients were divided into the CP and PDA group. The ultrasound based pSWE technique was applied and shear wave velocity (SWV) was measured. The depth of region of interest (ROI) and successful measurement rate were also recorded. Results: The mean ± SD SWV values established through pSWE were 1.75 ± 0.34 m/s and 2.93 ± 0.91 m/s for the CP and PDA, respectively. With a cut-off value of 2.09 m/s, we calculated the sensitivity (Se), specificity (Sp), and accuracy for differentiating between CP and PDA of 89.47%, 91.20%, and 88.60%, respectively. Of the examined variables, BMI and depth of ROI in the CP group and sex in the PDA group showed a statistically significant influence on the obtained results. Conclusions: pSWE may be utilized as a differential diagnostic modality in patients with suspected CP or PDA.

• Chronic pancreatitis
• Elastography
• Ultrasonography

• Elasticity Imaging Techniques/methods
• Endosonography/methods
• Fibrosis
• Humans
• Pancreas/diagnostic imaging
• Pancreas/pathology
• Pancreatitis, Chronic/diagnostic imaging

• Acute pancreatitis
• Shear-wave velocity
• Ultrasound elastography

• chronic pancreatitis
• endocrine dysfunction
• exocrine dysfunction
• shear wave EUS elastography

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).

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 EUS-SWM 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.

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.

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.

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

• Child
• Pancreas
• Shear wave elastography

• early chronic pancreatitis
• non-histologic diagnosis
• pancreatic fibrosis

• Endoscopic ultrasound
• Neuroendocrine tumour
• Shear wave elastography
• Ultrasound

• Alcoholic cirrhosis
• Elastography
• Pancreatic alcoholic damage
• Shear-wave elastography

• Adult
• Aged
• Case-Control Studies
• Elasticity
• Elasticity Imaging Techniques
• Feasibility Studies
• Female
• Germany
• Humans
• Italy
• Linear Models
• Liver/diagnostic imaging
• Liver/pathology
• Liver Cirrhosis/diagnostic imaging
• Liver Cirrhosis/pathology
• Liver Diseases, Alcoholic/complications
• Male
• Middle Aged
• Multivariate Analysis
• Pancreas/diagnostic imaging
• Pancreas/pathology
• Prospective Studies
• Reference Values
• Reproducibility of Results
• Young Adult

The aims of this study were to establish shear wave elastography of the pancreas by comparing measurements in patients with type 1 diabetes (T1D) and healthy volunteers and to consider whether this method could contribute to the screening or prevention of T1D.

This pilot study included 15 patients with T1D (10 men, 5 women) and 15 healthy volunteers (10 men, 5 women) as controls. Measurements were performed with a Siemens Acuson S3000 (Siemens Healthcare, Erlangen, Germany) using a 6C1 convex transducer and the Virtual Touch™ tissue quantification (VTQ) method.

The mean shear wave velocity of the head of the pancreas was 1.0 ± 0.2 m/s (median: 1.1 m/s) for the study group and likewise 1.0 ± 0.2 m/s (median: 0.9 m/s) for the control group. Velocities of 1.2 ± 0.2 m/s (median: 1.2 m/s) were measured in the body of the pancreas in both groups. There was a significant difference between the values obtained in the tail of the pancreas: patients 1.1 ± 0.1 m/s (median: 1.0 m/s) versus controls 0.9 ± 0.1 m/s (median: 0.8 m/s) (p = 0.0474). The mean value in the whole pancreas of the study group was not significantly above that of the control group: 1.1 ± 0.1 m/s (median: 1.0 m/s) versus 1.0 ± 0.1 m/s (median: 1.0 m/s) (p = 0.2453).

Sonoelastography of the pancreas revealed no overall difference between patients with T1D and healthy volunteers. Patients with T1D showed higher values only in the tail segment. Future studies need to determine whether specific regional differences can be found in a larger study population.

• Healthy volunteers
• Pancreas
• Type 1 diabetes
• Ultrasound p-shear wave elastography

To determine strain index (SI) values at various locations in the pancreas and to investigate the relationship between age, gender, body weight, height, body mass index (BMI), and elasticity values of the pancreas in healthy children.

This cross-sectional trial was performed in 147 healthy children who underwent transabdominal ultrasonography for strain elastography of the pancreas. A convex, 3.5–5-MHz probe was used to obtain the images. Baseline descriptive data including age (months), body weight (kg), height (cm), and BMI (kg/m2) were noted. Strain index values were calculated for the head, body, and tail of the pancreas, and a mean value was obtained. The relationship between demographic variables and SI values was assessed. Correlation between variables with normal distribution was evaluated with Pearson’s correlation coefficient and Spearman’s rho.

The average SI values in girls and boys were 1.30±0.34 and 1.32±0.22, respectively. There was no significant difference between SI values measured in the head, trunk, and tail of the pancreas (p=0.594). The average SI value did not differ between girls and boys (p=0.751). Correlation analysis revealed that SI was positively associated with age (p=0.005), body weight (p=0.004), height (p=0.003), and BMI (p=0.005).

This study determined normal elasticity values of the pancreas in healthy children. SI values of pancreas change with age, body weight, height, and BMI in the pediatric population. Information obtained from healthy children can serve as a baseline against which pancreatic diseases can be examined.

• Child
• Elasticity Imaging Techniques
• Pancreas

• MR elastography
• T1 mapping
• chronic pancreatitis
• diagnosis

• R01 EB001981 NIBIB NIH HHS
• R37 EB001981 NIBIB NIH HHS

• Rosemont classification
• chronic pancreatitis
• pancreas
• shear wave elastography

• Adult
• Aged
• Chronic Disease
• Early Diagnosis
• Elasticity Imaging Techniques/methods
• Endosonography/methods
• Female
• Humans
• Male
• Middle Aged
• Pancreatitis/diagnostic imaging
• ROC Curve
• Regression Analysis
• Retrospective Studies
• Severity of Illness Index

• ARFI
• Chronic pancreatitis
• Elastography

• Adult
• Aged
• Elasticity Imaging Techniques/methods
• Female
• Humans
• Liver Diseases/diagnosis
• Liver Diseases/pathology
• Male
• Middle Aged
• Pancreas/diagnostic imaging
• Pancreatitis, Chronic/classification
• Pancreatitis, Chronic/diagnostic imaging
• Pancreatitis, Chronic/pathology
• Reproducibility of Results

Elastography is one of technologies assisting diagnosis of solid pancreatic lesions (SPL). This technology has been previously used for measuring the stiffness of various organs based on a principle of “harder the lesions, higher chance for malignancy”. Two elastography techniques; strain and shear wave elastography, are available. For endoscopic ultrasound (EUS), only the former is existing. To interpret results of EUS elastography for SPL, 3 methods are used: (1) pattern recognition; (2) strain ratio; and (3) strain histogram. Based on results of existing studies, these 3 techniques provide high sensitivity but low to moderate specificity and accuracy rate. This review will summarize all available information in order to update current situation of using elastography for an evaluation of SPLs to readers.

• Elastography
• Endoscopic ultrasound
• Solid pancreatic lesions
• Pancreatic cancer
• Chronic pancreatitis

• Chronic pancreatitis
• Diagnostic accuracy
• Exocrine pancreatic function
• Mayo score
• Sensitivity
• Specificity
• Transabdominal Ultrasound

• Adult
• Aged
• Female
• Humans
• Male
• Middle Aged
• Pancreas/diagnostic imaging
• Pancreatitis, Chronic/diagnostic imaging
• Prospective Studies
• Reproducibility of Results
• Sensitivity and Specificity
• Ultrasonography/methods
• Young Adult

Changes in liver structure are an important issue in chronic hepatopathies. Until the end of the 20^th century, these changes could only be determined by histological analyses of a liver specimen obtained via biopsy. The well-known limitations of this technique (i.e., pain, bleeding and the need for sedation) have precluded its routine use in follow-up of patients with liver diseases. However, the introduction of non-invasive technologies, such as ultrasound and magnetic resonance imaging, for measurement of liver stiffness as an indirect marker of fibroses has changed this situation. Today, several non-invasive tools are available to physicians to estimate the degree of liver fibrosis by analysing liver stiffness. This review describes the currently available tools for liver stiffness determination that are applicable to follow-up of liver fibrosis/cirrhosis with established clinical use in children, and discusses their features in comparison to the “historical” tools.

• Children
• Transient elastography
• Liver fibrosis
• Liver biopsy