ULTRASONIC ELASTOGRAPHY AS A DIAGNOSTICS DEVICE IN A PANCREATOBILIARIC SURGICAL PRACTICE

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

METHODS AND METHODOLOGIES

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

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

10.29254/2077-4214-2020-1-155-247-250