Value of Two‐Dimensional Shear‐Wave Elastography in Differentiating Pancreatic Steatosis From Pancreatic Fibrosis

Objectives Pancreatic steatosis (PS) and pancreatic fibrosis (PF) both show increased pancreatic echogenicity on conventional B‐mode ultrasound. In this study, we assessed the applicability of two‐dimensional shear‐wave elastography (2D‐SWE) for their discrimination. Methods We gathered data from 120 adults with valid 2D‐SWE measurements, comprising 40 healthy individuals, 55 individuals diagnosed with PS via non‐enhanced computed tomography (CT), and 25 patients clinically diagnosed with non‐calcific chronic pancreatitis. The participants were divided into three groups: normal pancreas (NP), PS, and PF. pancreatic echogenicity, pancreatic stiffness, and CT values between groups were analyzed. Results The 2D‐SWE and CT values among the NP, PS, and PF groups all showed significant differences ( P < .001). For the diagnosis of PS and PF using 2D‐SWE, the area under the curve (AUC) values were 0.9100 and 0.9940, respectively, with optimal cut‐off values of 5.7 kPa for predicting PS and 8.2 kPa for predicting PF. Conclusions The 2D‐SWE technique enabled rapid and quantitative assessment of the hardness of hyperechoic pancreas visualized on conventional B‐mode ultrasound, which holds certain value in distinguishing PS from PF.