Quantitative analysis of diagnosing pancreatic fibrosis using EUS-elastography (comparison with surgical specimens)
Quantitative analysis of diagnosing pancreatic fibrosis using EUS-elastography (comparison with surgical specimens)
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DOI：
10.1007/s00535-013-0880-4
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发表时间：
2014-07-01
影响因子：
6.3
通讯作者：
Hirooka, Yoshiki
中科院分区：
文献类型：
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作者：
Itoh, Yuya;Itoh, Akihiro;Hirooka, Yoshiki
胰腺纤维化的准确诊断在临床上具有重要意义，并有可能对慢性胰腺炎进行分期。本研究的目的是通过定量分析超声内窥镜弹性成像(EUS-EG)来诊断胰腺纤维化的程度。2004年9月至2010年10月，连续58例患者在胰腺切除术前接受了EUS-EG检查，检查对象均为胰腺肿瘤及其上游胰腺。对术前胰腺上游的EUS-EG图像进行统计量化，并将结果与术后同一区域的组织学纤维化进行回顾性比较。对于EUS-EG图像的量化，使用新的软件计算4个参数(平均值、标准差、偏度和峰度)。根据已报道的评分系统，将组织学纤维化分为4类(正常、轻度、显著和重度)，其中24例胰腺上游纤维化分级正常，19例轻度纤维化，6例显著纤维化，9例重度纤维化。纤维化分级与所有4个量化参数均显著相关(平均r=-0.75，标准差r=-0.54，偏斜度r=0.69，峰度r=0.67)。根据受试者操作特征分析，平均值是诊断胰腺纤维化最有用的参数。ROC曲线下面积分别为0.90、0.90和0.90。通过分析EUS-EG图像，可以对胰腺纤维化做出准确诊断。
An accurate diagnosis of pancreatic fibrosis is clinically important and may have potential for staging chronic pancreatitis. The aim of this study was to diagnose the grade of pancreatic fibrosis through a quantitative analysis of endoscopic ultrasound elastography (EUS-EG).From September 2004 to October 2010, 58 consecutive patients examined by EUS-EG for both pancreatic tumors and their upstream pancreas before pancreatectomy were enrolled. Preoperative EUS-EG images in the upstream pancreas were statistically quantified, and the results were retrospectively compared with postoperative histological fibrosis in the same area. For the quantification of EUS-EG images, 4 parameters (mean, standard deviation, skewness, and kurtosis) were calculated using novel software. Histological fibrosis was graded into 4 categories (normal, mild fibrosis, marked fibrosis, and severe fibrosis) according to a previously reported scoring system.The fibrosis grade in the upstream pancreas was normal in 24 patients, mild fibrosis in 19, marked fibrosis in 6, and severe fibrosis in 9. Fibrosis grade was significantly correlated with all 4 quantification parameters (mean r = -0.75, standard deviation r = -0.54, skewness r = 0.69, kurtosis r = 0.67). According to the receiver operating characteristic analysis, the mean was the most useful parameter for diagnosing pancreatic fibrosis. Using the mean, the area under the ROC curves for the diagnosis of mild or higher-grade fibrosis, marked or higher-grade fibrosis and severe fibrosis were 0.90, 0.90, and 0.90, respectively.An accurate diagnosis of pancreatic fibrosis may be possible by analyzing EUS-EG images.