Evaluation of ultrasound based acoustic radiation force impulse (ARFI) and eSie touch sonoelastography for diagnosis of inflammatory pancreatic diseases.

CONTEXT Pathology changes the consistency of the tissues. OBJECTIVE To prospectively assess the accuracy of per-abdominal US elastography in the form of acoustic radiation force impulse--virtual touch tissue quantification (ARFI-VTQ) and eSie touch elasticity imaging in characterizing and differentiating inflammatory pancreatic diseases. PATIENTS One-hundred and 66 patients from among the patients that visited the Asian Institute of Gastroenterology, Hyderabad, India, during the period April 2009 to December 2010, for master health check-up, blood donation and those with pancreatic pathology. SETTING Based on the clinical symptomatic criteria and diagnostic imaging findings, the patients were divided into normal, chronic and acute, or acute resolving, pancreatitis group. MAIN OUTCOME MEASURES The ultrasound based ARFI-VTQ and eSie touch elasticity imaging techniques were applied. DESIGN Prospective single-center study. RESULTS The mean ARFI-VTQ values were 1.28 m/s, 1.25 m/s and 3.28 m/s for the normal, chronic and acute pancreas, respectively. The eSie touch gray scale and color elastograms were light gray and purple-greenish, respectively for both normal and chronic pancreas, while for acute pancreas the elastograms were dark black on the gray scale and orange to red on color scale. CONCLUSION Both the ARFI-VTQ and eSie touch elasticity imaging techniques may be successfully adopted in order to diagnose acute pancreatitis, to assess extent of inflammation (whether focal or diffuse), to assess peripancreatic edema, to identify presence of necrotic areas and early pseudocyst formation, to early diagnose acute recurrent attacks and to monitor patient's response to treatment.