Diagnostic accuracy of MRI with MRCP and B-Mode-sonography with elastography of the pancreas in patients with cystic fibrosis: a point-to-point comparison

Kloth, Christopher; Fabricius, Dorit; Wendlik, Inka; Schmidt, Stefan A.; Pfahler, Matthias; Lormes, Elisabeth; Beer, Meinrad; Kratzer, Wolfgang; Schmidberger, Julian

doi:10.1186/s13104-019-4193-4

Cited by 5 publications

(4 citation statements)

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“…Aufgrund der widersprüchlichen Datenlage kann die Milzelastografie derzeit jedoch noch nicht als etabliertes Verfahren eingestuft werden [44]. Andere extrahepatische Anwendungen, wie die Elastografie des Pankreas, sind aktuell Gegenstand wissenschaftlicher Untersuchungen [45].…”

Section: Klinische Anwendungenunclassified

Ultrasound 2020 – Diagnostics & Therapy: On the Way to Multimodal Ultrasound: Contrast-Enhanced Ultrasound (CEUS), Microvascular Doppler Techniques, Fusion Imaging, Sonoelastography, Interventional Sonography

Kloth

Kratzer

Schmidberger

et al. 2020

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Background Ultrasound as a non-ionizing imaging procedure is one of the most important diagnostic procedures in everyday clinical practice. The technology is widely used. Due to constant technical innovations, sonographic procedures, such as contrast-enhanced ultrasound (CEUS), sonoelastography, new microvascular Doppler modalities and, as an example of interventional procedures, sonographically controlled microwave ablation (MWA), are becoming increasingly important in diagnostic imaging and interventional medicine alongside CT and MRI. However, this also requires greater expertise, specialization and qualification on the part of users. Method This review article provides information about the range of technical innovations in ultrasound in recent years and describes the underlying technology, the clinical applications, and their diagnostic value. These are presented in the context of the current literature, explaining their advantages and disadvantages and their clinical value. Results and Conclusion Contrast-enhanced ultrasound (CEUS), microvascular Doppler modalities, fusion imaging and elastography complement B-scan ultrasound and conventional Doppler procedures for various problems. Microwave ablation (MWA) has a firm place as an ablative procedure for local tumor therapy in different organ systems and can be performed under ultrasound guidance. Thanks to new developments, the possibilities of ultrasound are now greater than ever. Knowledge of the technology, indications, and possible applications of newer procedures is essential for adequate patient care. Key Points: Citation Format

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Section: Klinische Anwendungenunclassified

Ultrasound 2020 – Diagnostics & Therapy: On the Way to Multimodal Ultrasound: Contrast-Enhanced Ultrasound (CEUS), Microvascular Doppler Techniques, Fusion Imaging, Sonoelastography, Interventional Sonography

Kloth

Kratzer

Schmidberger

et al. 2020

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“…Pancreatic parenchyma tissue can be obtained by EUS-guided biopsy, percutaneous biopsy, or surgical biopsy. The non-histologic diagnosis of pancreatic fibrosis is an image-based method using different bio-physical mechanisms, including ultrasound elastography, computed tomography (CT), and magnetic resonance imaging (MRI) [14]. There are two types of ultrasound elastography-strain elastography through endoscopic [15] or transcutaneous routes [16] and shear wave elastography using only the transcutaneous route [17].…”

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confidence: 99%

“…(3) cystic fibrosis in the pancreas [14,29]; (4) prediction of post-operation pancreatic fistula [30]; and (5) surveillance of pancreatic fibrosis in a fatty pancreas [31]. The cut-off value of pancreatic fibrosis using acoustic radiation force impulse is 1.4 m/s [32].…”

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confidence: 99%

“…One recent study showed that body composition and pancreatic fibrosis could both be factors associated with quality of life and treatment outcomes in patients with chronic pancreatitis or pancreatic duct adenocarcinoma. Pancreatic fibrosis can be calculated by MRI images using T1 signals, apparent diffusion coefficient maps, and T1w flash and T2w HASTE sequences [14,41].…”

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Pancreatic Fibrosis and Chronic Pancreatitis: Mini-Review of Non-Histologic Diagnosis for Clinical Applications

et al. 2020

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Pancreatic fibrosis is the dominant reversible pathological change and diagnostic factor in early chronic pancreatitis, defined by a mechanistic approach proposed in 2016. Main guidelines for chronic pancreatitis were published by the American Pancreas Association in 2014, the Japanese Society of Gastroenterology in 2015, and United European Gastroenterology in 2017. All three sets of guidelines mentioned that the staging of chronic pancreatitis is important but challenging. There are various image modalities for the non-histologic diagnosis of pancreatic fibrosis: (1) shear wave elastography, such as an acoustic radiation force impulse with a cut-off value of 1.4 m/s; (2) strain elastography using grades of strain; (3) endoscopic ultrasonography using the Rosemont criteria or endoscopic ultrasound criteria for early chronic pancreatitis proposed by the Japan Pancreas Society; (4) computed tomography using the Hounsfield scale or number of micro-calcifications; and (5) magnetic resonance imaging using the apparent diffusion coefficient and the T1w flash and T2w HASTE sequences. The clinical applications are to (1) evaluate pancreatic tumors and inflammatory disease; (2) monitor dyspepsia with early chronic pancreatitis; (3) monitor individuals with a high risk of pancreatic cancer; (4) analyze a fatty pancreas with fibrosis; (5) predict a fistula after pancreatic surgery; and (6) predict outcomes for chronic pancreatitis or pancreatic cancer. The selection of tools will be dependent on the clinical scenario. Conclusion: There are various modalities for the non-histologic diagnosis of pancreatic fibrosis. The selection of the optimal device will be dependent on the clinical scenario.

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Can Point Shear Wave Elastography Be Used as an Early Indicator of Involvement?

Sağlam¹,

Demirbaş

Bilgici

et al. 2020

J of Ultrasound Medicine

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ObjectivesThe aim of this study was to determine the effect of cystic fibrosis (CF) on pancreas and liver elasticity in young children using point shear wave elastography and to determine the relationship with clinical findings.MethodsTwenty‐two patients with genetically proven CF, who were admitted to our pediatric gastroenterology clinic, and 22 healthy control participants were enrolled in the study. The shear wave velocity (SWV) of the liver and pancreas were measured with point shear wave elastography.ResultsThe 22 patients with CF included 45.5% girls with a mean age ± SD of 35 ± 35.8 months (range, 5–123 months). The 22 healthy control participants included 41.2% girls with a mean age of 58.9 ± 44.4 months (range, 2–159 months). The mean SWV of the pancreas in the patients with CF (1.06 ± 0.26 m/s) was significantly higher than that of the healthy control participants (0.85 ± 0.23 m/s; P = .01). The mean SWV of the liver in the patients with CF (1.46 ± 0.24 m/s) was significantly higher than that of the healthy control participants (1.12 ± 0.21 m/s; P = .001). The SWV of the pancreas and liver did not show any significant differences depending on ursodeoxycholic acid use, malnutrition status, and the presence of the F508 deletion mutation.ConclusionsThis study showed an increased SWV of the pancreas in children with CF, contrary to the literature. We also found an increased liver SWV even in the absence of CF‐related liver disease. Ultrasound elastography may be a useful method of evaluating early changes in the pancreas and liver before the obvious clinical, laboratory, and B‐mode ultrasound signs of CF‐related involvement.

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Diagnostic accuracy of MRI with MRCP and B-Mode-sonography with elastography of the pancreas in patients with cystic fibrosis: a point-to-point comparison

Cited by 5 publications

References 22 publications

Ultrasound 2020 – Diagnostics & Therapy: On the Way to Multimodal Ultrasound: Contrast-Enhanced Ultrasound (CEUS), Microvascular Doppler Techniques, Fusion Imaging, Sonoelastography, Interventional Sonography

Ultrasound 2020 – Diagnostics & Therapy: On the Way to Multimodal Ultrasound: Contrast-Enhanced Ultrasound (CEUS), Microvascular Doppler Techniques, Fusion Imaging, Sonoelastography, Interventional Sonography

Pancreatic Fibrosis and Chronic Pancreatitis: Mini-Review of Non-Histologic Diagnosis for Clinical Applications

Can Point Shear Wave Elastography Be Used as an Early Indicator of Involvement?

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