Muraviov P. T., Borodaev I. E., Shevchenko V. G., Kharkhouri Makrem, Volkov V. B.


About the author:

Muraviov P. T., Borodaev I. E., Shevchenko V. G., Kharkhouri Makrem, Volkov V. B.



Type of article:

Scentific article


Elastography is one of the most advanced and promising technologies in ultrasound diagnostics. Despite the success of the first works, where elastography is considered as a highly informative method for the diagnosis of pancreatic pathology, the development of the method is constrained by the difficulties in standardization of the technique, as well as the low availability of diagnostic modules. The purpose of the current study was to analyze the diagnostic value of ultrasonographic elastography of the pancreas. The data of 50 patients who were examined for pathology of the pancreatic head complicated by mechanical jaundice with sonoelastography during 2017-2019 were analyzed. The complaints structure was dominated by abdominal pain (88.0%), skin and mucous membranes (96.0%), dyspeptic manifestations, including nausea – in 100% of patients, diarrhea – in 22.0% of patients, constipation – in 16.0% of patients, flatulence – in 18.0% of patients. Also the weight loss – 45 (90%) cases, lack of appetite (88,0%) and citophobia (34,0%) were expressed. Courvoisier’s syndrome was detected in 42 (84.0%) patients. Imaging was compared using classical ultrasound, CT and elastography. The average age of the surveyed persons was 49.8±1.2 years. According to a CT scan, 18 (36.0%) of patients had pseudotumoral chronic pancreatitis, with the changes similar to the pancreatic cancer. During routine ultrasound, signs of enlargement and compaction of the pancreatic head were determined, in 86% of patients solid hyperechogenic formation as well as dilation of bile ducts and (or) Virsung duct, enlargement of lymph nodes were determined. In 14% of patients, in addition to nonspecific changes in the parenchyma density, no other pathological changes were identified with ultrasound. Higher values of Young’s modulus were found for pancreatic cancer – 15.1±1.3 versus 3.1±0.2 (p<0.05). When comparing ultrasound elastography with CT data, a positive correlation of the mean force was found to be r = 0.68 (p <0.05). When comparing MSCT with elastography, the main operational characteristics of the diagnostic test were determined: specificity – 72.4%, sensitivity – 95.2%, which corresponds to J = 0.676. Thus, ultrasonographic elastography as a minimally invasive method for the diagnosis of pancreatic pathology may be recommended for screening purposes. Diagnosis verification requires the use of additional clinical imaging methods.


sonoelastography, pancreas, density, chronic pancreatitis, pancreatic cancer, mechanical jaundice


  1. Zykin BI, Postnova NA, Medvedev ME. Ul’trazvukovaja jelastografija. Medicinskij alfavit. 2013;10:14-9. [in Russiаn].
  2. Osipov LV. Tehnologii jelastografii v ul’trazvukovoj diagnostike. Medicinskij alfavit. 2013;23:5-21. [in Russiаn].
  3. Rudenko OV, Safonov DV, Ryhtik PI, Gurbatov SN, Romanov SV. Fizicheskie osnovy jelastografii. Chast’ 2. Jelastografija na sdvigovoj volne (lekcija). Radiologija – praktika. 2014;4:62-72. [in Russiаn].
  4. Ozturk A, Grajo JR, Dhyani M, Anthony BW, Samir AE. Principles of ultrasound elastography. Abdom Radiol (NY). 2018 Apr;43(4):773-85.
  5. Sigrist RMS, Liau J, Kaffas AE, Chammas MC, Willmann JK. Ultrasound Elastography: review of Techniques and Clinical Applications. Theranostics. 2017 Mar 7;7(5):1303-29.
  6. Les’ko KA. Kachestvennaja jelastografija v ul’trazvukovoj diagnostike melkih dobrokachestvennyh obrazovanij molochnoj zhelezy pri gipotireoze. Medicinskaja vizualizacija. 2014;3:32-9. [in Russiаn].
  7. Carlsen J, Ewertsen C, Sletting S, Vejborg I, Schäfer FK, Cosgrove D, Bachmann Nielsen M. Ultrasound Elastography in Breast Cancer Diagnosis. Ultraschall Med. 2015 Dec;36(6):550-62; quiz 563-5.
  8. Sencha AN, Mogutov MS, Patrunov JuN, Beljaev DV, Sergeeva ED, Kashmanova AV. Kolichestvennye i kachestvennye pokazateli ul’trazvukovoj jelastografii v diagnostike raka shhitovidnoj zhelezy. Ul’trazvukovaja i funkcional’naja diagnostika. 2013;5:85-98. [in Russiаn].
  9. Morozov SV, Kucherjavyj JuA, Stukova NJu, Krasnjakova EA. Neprjamaja ul’trazvukovaja jelastografija pecheni: ot diagnostiki fibroza pecheni – k kontrolju nad lecheniem. Dokazatel’naja gastrojenterologija. 2013;2:31-7. [in Russiаn].
  10. Berdnikov SN, Sholohov VN, Patjutko JuI, Mahotina MS, Chuchuev ES, Abirov KJe. Jelastometrija i jelastografija v differencial’noj diagnostike gepatocelljuljarnogo raka. Annaly hirurgicheskoj gepatologii. 2013;18(1):63-8. [in Russiаn].
  11. Morozova TG, Borsukov AV. Klinicheskoe znachenie kompressionnoj jelastografii v differencial’noj diagnostike kistoznyh obrazovanij podzheludochnoj zhelezy. Sovremennye tehnologii v medicine. 2014;2:103-9. [in Russiаn].
  12. Basset C, Guillermet-Guibert J. Experimental pancreatic cancer develops in soft pancreas: novel leads for an individualized diagnosis by ultrafast elasticity imaging. Theranostics. 2019 Aug 14;9(22):6369-79.
  13. Dietrich CF, Hocke M. Elastography of the Pancreas, Current View. Clin endosc. 2019 Nov;52(6):533-40.
  14. Hirooka Y, Kuwahara T, Irisawa A, Itokawa F, Uchida H, Sasahira N, et al. JSUM ultrasound elastography practice guidelines: pancreas. J Med Ultrason (2001). 2015 Apr;42(2):151-74.
  15. Kostromina EV, Bershtejn LM, Vasil’ev DA, Radzhabova ZAG, Krasil’nikova LA. Sopostavlenie rezul’tatov jelastografii s gormonal’nometabolicheskim statusom bol’nyh pri diagnostike novoobrazovanij shhitovidnoj zhelezy. Voprosy onkologii. 2013;1(59):78-82. [in Russiаn].

Publication of the article:

«Bulletin of problems biology and medicine» Issue 1 (155), 2020 year, 247-250 pages, index UDK 616.36/.37-089-073.48