CLINICAL RELEVANCE OF COMPRESSION ELASTOGRAPHY IN DIFFERENTIAL DIAGNOSIS OF PANCREATIC CYSTIC MASSES

The aim of the investigation was to assess the capabilities of compression elastography in differential diagnosis of pancreatic cystic tumors. Materials and Methods. 15 patients with pancreatic cystic masses were examined. There were the following clinical forms: pancreatic pseudocysts in chronic pancreatitis - 9 (60%), pancreatic cystadenocarcinoma - 4 cases (26.7%), pancreatic cyst in intraductal papillarymucinous adenoma - 2 cases (13.3%). The patients underwent pancreatic and hepatic sonography, fibrogastroduodenoscopy and compression elastography with endosonography. Referential techniques were helical computed tomography and ultrasound- guided pancreatic paracenthesis. The patients were operated on within 3-4 months, the diagnoses were histologically verified. Compression elastographic strain ratio (SR) was calculated by the program in ultrasonic apparatus, i.e.: the image was fixed in "an interest area" (a focal lesion), from two to three measuring points were established using a special cursor, and the program calculated SR. Results. We determined optimal threshold values of compression elastography indices, when diagnostic sensitivity, specificity and accuracy of the technique were maximum; and showed significant clinical capabilities and prospects of compression elastography applied in endosonography. SR in cystadenocarcinoma was 34.1-42.5 RU, in solid pseudopapillary tumor - from 44.7 RU, in postnecrotic cysts - from 13 to 25 RU. Conclusion. The data analysis showed that the application of compression elastography in endosonography enabled to increase the informative value of clinical laboratory examination of patients with pancreatic cystic masses.