الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 134 |  |  |
| | | from | 134 | | |
Abstract
Early and proper diagnosis of solid pancreatic lesions is mandatory as most cases are diagnosed at a late stage with no operable solutions. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is approved as one of the gold standard tests in the diagnosis of solid pancreatic masses with a sensitivity, specificity, and negative predictive value (NPV) of 91%, 94%, and 85%, respectively, and so negative results cannot exclude malignancy. Elastography is used to assist in diagnosis by evaluating tissue elastic properties without being an invasive measure. It is considered a qualitative measure to distinguish between malignant and benign lesions. Giovannini and colleagues developed a 5-point scoring system, but it is still very subjective. Strain elastography is a quantitative method that is used to evaluate tissue stiffness by the degree of its distortion under manual compression. Strain ratio (SR) is the comparison between an area of interest and a reference control area in a greyscale image. The other quantitative method is strain histogram (SH). Many of the new generation ultrasound systems have incorporated strain (hue) histogram calculation software, which automatically calculates the graph in real time. Within this research, we analyzed the accuracy of the strain ratio (SR) and strain histogram (SH) based on EUS methods to identify and differentiate patients with pancreatic massesThis prospective research was carried on from March 2017 to January 2019, after obtaining the approval of our ethics committee. Prior to study registration, all patients participating in the study gave written consent. Inclusion criteria were patients above 18 years old, with solid pancreatic lesions diagnosed with imaging modalities, and acceptance to participate in the study. Exclusion criteria were cystic-component tumors, patients with procedure contraindications, and those who refused to participate. Our analysis included 100 patients. Both endosonographic measurements were performed by 2 qualified EUS examiners. Pentax linear probes FG-38 UX and EG-3870 UTK EUS with Hitachi Avius ultrasound devices were used to capture elastography images. SH was automatically determined by software in areas of interest selected by the examiner and presented as the average values (Mode 1 over the lesion and Mode 2 over a homogenous portion of the pancreas adjacent to the area of interest). SR was later determined by dividing the B2 value by the B1 value for every patient.