Normative values of pancreas stiffness by shear wave elastography in healthy children and adolescents

Abstract

Purpose To define normal pancreas elasticity and velocity values with shear wave elastography (SWE) in healthy children and assess associations with gender, age, and body mass index (BMI). Methods This prospective study included a total of 100 cases (male: 50; female: 50), aged 3-17 years. Preschool, school, and adolescent periods of 3-6 years (n = 27), 7-12 years (n = 30), and 13-17 years (n = 43), respectively, were created in addition to two groups representing prepubertal and postpubertal periods of 3-10 years (n = 50) and 11-18 years (n = 50), respectively. Demographic data regarding the gender, age, height, body weight, and BMI were recorded. Pancreatic head, corpus, and tail SWE measurements were performed with a convex transducer (3.5-5 MHz). Correlations and comparisons were made for stiffness values between groups. Statistical analyses used Mann-WhitneyU, Kruskal-Wallis, and Spearman's correlation tests. Results Medians (25-75th percentage) of age and BMI were 7 (4.25-10) years and 15 (13-17) years and 17.47 (14.94-19.23) kg/m(2)and 21.22 (17.41-24) kg/m(2)in the two age groups, respectively. The median (interquartile range) elasticity and velocity values for the head, corpus, and tail sections of the pancreas were measured as 9.35 (2.9) kPa and 1.76 (0.26) m/s; 9.3 (2.5) kPa and 1.74 (0.21) m/s; and 8.75 (2) kPa and 1.69 (0.15) m/s, respectively. No significant differences were identified for stiffness values between gender and pancreatic section. Pancreatic stiffness values were significantly different among two (p = 0.001) and three (p = 0.028) age groups, and presented mild positive correlations with age (r: 0.23,p: 0.002), height (r: 0.18,p: 0.01), body weight (r: 0.38,p: 0.003), and BMI (r: 0.37,p: 0.045). Conclusion Normal elasticity and velocity values were defined for the pancreas with SWE in children. Pancreatic stiffness does not significantly change among pancreas parts, but it increases with the transition from childhood to adolescence.