Shear wave elastography (SWE) using transabdominal ultrasonography (US) is widely used for diagnosis of tissue stiffness. Ultrasound shear wave dispersion (SWD) enables evaluation of tissue viscosity using SWE. The objective of this study was to investigate the reliability and clinical significance of SWD in pancreatic screening.
SWE and SWD were measured in 76 patients examined by US in pancreatic screenings performed between November 2017 and November 2018. The median pancreatic elastic modulus (PEM) and dispersion slope were obtained from at least five measurements. The reproducibility of these values and their correlations with patient characteristics, pancreatic echogenicity, and the pancreas-to-spleen attenuation ratio (P/S) on plain CT, which is associated with fatty change in pancreatic parenchyma, were investigated retrospectively.
The median PEM and dispersion slope were 7.4 kPa and 15.7 (m/sec)/kHz, respectively, and both values had high intraclass correlation coefficients, showing high reproducibility (ρ = 0.869 and ρ = 0.867, respectively). The interquartile range/median value of PEM and dispersion slope were 0.36 and 0.28, respectively. PEM had a positive correlation with age (rs = 0.348, p = 0.002), and dispersion slope was positively correlated with age (rs = 0.278, p = 0.016) and BMI (rs = 0.397, p < 0.001). The hyperechoic pancreas had significantly higher PEM (6.6 vs. 7.8 kPa, p = 0.037) and dispersion slope (13.2 vs. 16.3 (m/sec)/kHz, p < 0.001). On plain CT performed in 50 patients, the P/S was not correlated with PEM (rs = − 0.180, p = 0.221), but was inversely correlated with dispersion slope (rs = − 0.338, p = 0.019).
Measurement of SWD in pancreatic screening was highly reproducible and may permit objective evaluation of fatty change of the pancreas.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Takeuchi H, Sugimoto K, Oshiro H, et al. Liver fibrosis: noninvasive assessment using supersonic shear imaging and FIB4 index in patients with non-alcoholic fatty liver disease. J Med Ultrason. 2018;45:243–9.
Iyama T, Takata T, Koda M, et al. Renal shear wave elastography for the assessment of nephron hypertrophy: a cross-sectional study in chronic kidney disease. J Med Ultrason. 2018;45:571–6.
Kandemirli SG, Bayramoglu Z, Caliskan E, Sari ZNA, Adaletli I. Quantitative assessment of thyroid gland elasticity with shear-wave elastography in pediatric patients with Hashimoto's thyroiditis. J Med Ultrason. 2018;45:417–23.
Huang M, Jiang T, Zhao Q, et al. Breast adenoid cystic carcinoma: report of a case with emphasis on routine sonographic findings and shear wave elastography. J Med Ultrason. 2018;45:181–4.
Kuwahara T, Hirooka Y, Kawashima H, et al. Usefulness of shear wave elastography as a quantitative diagnosis of chronic pancreatitis. J Gastroenterol Hepatol. 2018;33:756–61.
Kuwahara T, Hirooka Y, Kawashima H, et al. Quantitative evaluation of pancreatic tumor fibrosis using shear wave elastography. Pancreatology. 2016;16:1063–8.
Barry CT, Mills B, Hah Z, et al. Shear wave dispersion measures liver steatosis. Ultrasound Med Biol. 2012;38:175–82.
Barry CT, Hazard C, Hah Z, et al. Shear wave dispersion in lean versus steatotic rat livers. J Ultrasound Med. 2015;34:1123–9.
Hashizume K, Hirooka Y, Kawashima H, et al. The propagation display method improves the reproducibility of pancreatic shear wave elastography. Ultrasound Med Biol. 2019;45:2242–7.
Chamberlain JJ, Rhinehart AS, Shaefer CF, et al. A diagnosis and management of diabetes: synopsis of the 2016 American Diabetes Association Standards of Medical Care in Diabetes. Ann Intern Med. 2016;164:542–52.
Expert panel on detection, evaluation treatment of high blood cholesterol in adults. Executive summary of the Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001;285:2486–97
Ito T, Ishiguro H, Ohara H, et al. Evidence-based clinical practice guidelines for chronic pancreatitis 2015. J Gastroenterol. 2016;51:85–92.
Kim SY, Kim H, Cho JY, et al. Quantitative assessment of pancreatic fat by using unenhanced CT: pathologic correlation and clinical implications. Radiology. 2014;271:104–12.
Vigano M, Massironi S, Lampertico P, et al. Transient elastography assessment of the liver stiffness dynamics during acute hepatitis B. Eur J Gastroenterol Hepatol. 2010;22:180–4.
Chen S, Sanchez W, Callstrom MR, et al. Assessment of liver viscoelasticity by using shear waves induced by ultrasound radiation force. Radiology. 2013;266:964–70.
Barr RG, Ferraioli G, Palmeri ML, et al. Elastography assessment of liver fibrosis: society of radiologists in ultrasound consensus conference statement. Radiology. 2015;276:845–61.
Sugimoto K, Moriyasu F, Oshiro H, et al. Viscoelasticity measurement in rat livers using shear wave US elastography. Ultrasound Med Biol. 2018;44:2018–24.
Yoo J, Lee JM, Joo I, et al. Prospective validation of repeatability of shear wave dispersion imaging for evaluation of non-alcoholic fatty liver disease. Ultrasound Med Biol. 2019. https://doi.org/10.1016/j.ultrasmedbio.2019.06.411.
Marks WM, Filly RA, Callen PW. Ultrasonic evaluation of normal pancreatic echogenicity and its relationship to fat deposition. Radiology. 1980;137:475–9.
Gullo L, Salizzoni E, Serra C, et al. Can pancreatic steatosis explain the finding of pancreatic hyperenzymemia in subjects with dyslipidemia? Pancreas. 2006;33:351–3.
Catanzaro R, Cuffari B, Italia A, et al. Exploring the metabolic syndrome: nonalcoholic fatty pancreas disease. World J Gastroenterol. 2016;22:7660–755.
Wu WC, Wang CY. Association between non-alcoholic fatty pancreatic disease (nafpd) and the metabolic syndrome: case–control retrospective study. Cardiovasc Diabetol. 2013. https://doi.org/10.1186/1475-2840-12-77.
Fukuda Y, Yamada D, Eguchi H, et al. CT density in the pancreas is a promising imaging predictor for pancreatic ductal adenocarcinoma. Ann Surg Oncol. 2017;24:2762–9.
Hori M, Onaya H, Hiraoka N, et al. Evaluation of the degree of pancreatic fatty infiltration by area-based assessment of CT images: comparison with histopathology-based and CT attenuation index-based assessments. Jpn J Radiol. 2016;34:667–76.
Matsuda A, Makino N, Tozawa T, et al. Pancreatic fat accumulation, fibrosis, and acinar cell injury in the Zucker diabetic fatty rat fed a chronic high-fat diet. Pancreas. 2014;43:735–43.
van Geenen EJ, Smits MM, Schreuder TC, et al. Smoking is related to pancreatic fibrosis in humans. Am J Gastroenterol. 2011;106:1161–6.
Mathur A, Pitt HA, Marine M, et al. Fatty pancreas: a factor in postoperative pancreatic fistula. Ann Surg. 2007;246:1058–64.
Tomita Y, Azuma K, Nonaka Y, et al. Pancreatic fatty degeneration and fibrosis as predisposing factors for the development of pancreatic ductal adenocarcinoma. Pancreas. 2014;43:1032–41.
Takahashi M, Hori M, Ishigamori R, et al. Fatty pancreas: a possible risk factor for pancreatic cancer in animals and humans. Cancer Sci. 2018;109:3013–23.
Chantarojanasiri T, Hirooka Y, Kawashima H, et al. Age-related changes in pancreatic elasticity: when should we be concerned about their effect on strain elastography? Ultrasonics. 2016;69:90–6.
Conflict of interest
The authors declare that they have no conflicts of interest. This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. But, the Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine received consigned research expenses from Canon Medial Systems Corp. Canon Medial Systems Corp. had no role in the design, practice, or analysis of this study.
The study was approved by our institutional ethics committee for human research.
Informed consent to the protocol was obtained from all patients.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Suzuki, H., Kawashima, H., Ohno, E. et al. What is the role of measuring shear wave dispersion using shear wave elastography in pancreatic parenchyma?. J Med Ultrasonics (2020). https://doi.org/10.1007/s10396-020-01033-7
- Transabdominal ultrasonography
- Shear wave elastography
- Shear wave dispersion
- Pancreatic parenchyma
- Fatty pancreas