title: EUS elastography to predict pancreatic exocrine insufficiency in patients with chronic pancreatitis.
abstract: BACKGROUND
  Diagnosis of pancreatic exocrine insufficiency (PEI) is hindered by methodological difficulties of pancreatic function tests. The probability of PEI in chronic pancreatitis (CP) increases as pancreatic fibrosis develops. Pancreatic fibrosis in CP may be quantified by EUS elastography.
  
  
  OBJECTIVE
  To evaluate whether EUS-elastography can predict PEI in patients with CP.
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  Department of Gastroenterology, University Hospital of Santiago de Compostela, Spain.
  
  
  METHODS
  Patients diagnosed with CP based on EUS and magnetic resonance imaging and MRCP findings.
  
  
  METHODS
  Diagnosis of PEI was based on the (13)C-mixed triglyceride breath test. EUS-elastography was performed with PENTAX echoendoscopes and Hitachi-Preirus US platform. Two areas were selected for elastographic evaluation: area A corresponds to the pancreatic parenchyma and area B to a soft peripancreatic reference area. The quotient B/A (strain ratio [SR]) was considered the elastographic result.
  
  
  METHODS
  Pancreatic SR in CP patients with and without PEI.
  
  
  RESULTS
  A total of 115 patients with CP (mean age, 50.2 years, range, 21-81; 92 male) of different etiologies were included; 35 patients (30.4%) had PEI. Pancreatic SR was higher in patients with PEI (4.89; 95% confidence interval, 4.36-5.41) than in those with a normal breath test result (2.99; 95% confidence interval, 2.82-3.16) (P < .001). A direct relationship was found between the SR and the probability of PEI, which increases from 4.2% in patients with an SR less than 2.5 to 92.8% in those with an SR greater than >5.5.
  
  
  CONCLUSIONS
  Single-center study.
  
  
  CONCLUSIONS
  The degree of pancreatic fibrosis as measured by EUS-guided elastography allows quantification of the probability of PEI in patients with CP.
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Foundation for Research in Digestive Diseases (FIENAD), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: J Enrique
authors.initials: JE
authors.lastname: Dominguez-Muñoz
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Foundation for Research in Digestive Diseases (FIENAD), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Iglesias-Garcia
authors.affiliation: Foundation for Research in Digestive Diseases (FIENAD), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Margarita
authors.initials: M
authors.lastname: Castiñeira Alvariño
authors.affiliation: Foundation for Research in Digestive Diseases (FIENAD), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Luaces Regueira
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Foundation for Research in Digestive Diseases (FIENAD), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Lariño-Noia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D054459:Elasticity Imaging Techniques / Q000379:methods*; D019160:Endosonography / Q000379:methods*; D010188:Exocrine Pancreatic Insufficiency / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D005355:Fibrosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000473:pathology; D050500:Pancreatitis, Chronic / Q000150:complications / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D055815:Young Adult