Abstract：Objective: To evaluate the accuracy of the endoscopic ultrasonography(EUS) elastography score and strain ratio(SR) in the differential diagnosis of benign and malignant solid pancreatic lesions. Methods: A total of 38 patients with solid pancreatic lesions identified by endoscopic ultrasound were enrolled in the study to evaluate the efficacy of elastography and SR in differentiating malignant from benign lesions. The semiquantitative score of elastography was represented by the SR method. Sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV), and accuracy were calculated by comparing the diagnoses made by elastography, SR and final diagnoses. According to Young’s modulus, a receiver operating characteristic(ROC) curve was drawn, and it used to identify the value of strain ratio for differential diagnosis of solid pancreatic lesions. Result: Elastography was successfully performed in all patients and there were no procedure related complications. Twenty-six patients were finally diagnosed with pancreatic carcinoma, 2 with benign endocrine tumor and 10 with focal pancreatitis. According to our diagnostic criteria of elastography, the overall accuracy of EUS elastography for the differential diagnosis of focal pancreatic masses was 89.5%(34/38), with a sensitivity, specificity of 92.3%, 83.3%, respectively. Malignant lesions had significantly higher median SR(34.04±18.33) than benign lesions(11.64±13.47). The best cut-off level of SR to obtain the maximal area under the curve was 22.46 with a sensitivity of 79.6%, specificity of 91% through ROC curve. Combined elastography to SR resulted in an accuracy of 94.7%, sensitivity of 96.2%, specificity of 91.7%, PPV of 96.2%, and NPV of 91.7% for the diagnosis of solid pancreatic lesions. Conclusion: EUS elastography has a relatively high accuracy for the differentiation of benign and malignant pancreatic lesions, combined with SR would increase the accuracy.
叶颖剑，刘 波，李琼霞，李秀梅，张 娟. 超声内镜弹性成像和应变率在胰腺实性肿块
良恶性鉴别诊断中的价值初探[J]. 中国临床医学影像杂志, 2019, 30(3): 183-186.
YE Ying-jian, LIU Bo, LI Qiong-xia, LI Xiu-mei, ZHANG Juan. Endoscopic ultrasonography elastography score and strain ratio in the differential diagnosis of
benign and malignant solid pancreatic lesions. JOURNAL OF CHINA MEDICAL IMAGING, 2019, 30(3): 183-186.
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