Ultrasound histography in assessing the degree of pancreatic fibrosis in chronic pancreatitis

Abstract

Aim: to analyze the clinical and pathogenetic significance of ultrasound histography in pancreatic fibrosis in patients with chronic pancreatitis (CP).
 Materials and methods. One hundred and eighty-six patients with CP were examined. Complete blood count, urinalysis, biochemical blood and urine tests, duodenal intubation test, coproscopy, enzyme immunoassay, and radioimmune assay were performed. The levels of blood transforming growth factor β1 (TGFβ1) and fecal elastase 1 were measured. Ultrasonography and ultrasound histography of the pancreas and liver, Doppler sound study of the abdominal aorta, celiac trunk, and superior mesenteric artery were carried out.
 Results. There were correlations suggesting decreased exocrine pancreatic function as its fibrosis progressed, which was indirectly reflected in the increased L index of an ultrasound histogram. The positive correlation between L index and TGFβ1 also showed increased L index in more severe pancreatic fibrosis. CP exacerbation was accompanied by decreased Kgst and N, which were confirmed by evident hyperenzymemia (the blood enzyme deviation) with the decrease of those indices. The clinical signs of CP, especially the rise in the number of dyspeptic complaints that show decreased pancreatic exocrine secretion, revealed pancreatic fibrosis. This was also shown by the fact that the debit hour of lipase and the activity of fecal elastase 1 decreased as the L index increased. There were signs that decreased blood flow in the pancreas made the fibrosis and insufficiency of the organ worse. Furthermore, ultrasound histographic findings reflected a positive correlation between pancreatic and hepatic fibrosis.
 Conclusion. An examination of pancreatic ultrasound histographic correlations led to the conclusion that this technique could be used to estimate the degree of pancreatic fibrosis and CP exacerbation indirectly.