Steatometry and elastometry as methods of noninvasive diagnostics of pancreatic steatosis and fibrosis in children

Background. Obesity is associated with accumulation of fat in parenchymal organs, including pancreas, with formation of its steatosis. Pancreatic steatosis can lead to chronic inflammation and fibrosis of the pancreas. Limitation in invasive studies in children causes need of development and implementation of advanced non-invasive methods for pancreatic observation. The purpose of our study was to investigate the possibility of ultrasound diagnosis of steatosis and fibrosis of the pancreas in children using steatometry (estimation of ultrasound attenuation) and elastometry. Materials and methods. We examined 60 children hospitalized in the Department of Pediatric Gastroenterology of SI “Institute of Gastroenterology of NAMS of Ukraine”. The patients were grouped on the basis of of obesity and overweight presence: group 1 consisted of 44 patients with obesity and overweight, group 2 consisted of 16 children with normal weight. Sonological research, elastometry, steatometry of the pancreas were made using apparatus Ultima PA Expert (“Radmir”, Ukraine). The presence and degree of pancreatic steatosis using pair-wise comparison of pancreatic echogenicity with renal and retroperitoneal fat echogenicity. Results. 25 patients of group 1 (56.8 %) were found to have sonological signs of pancreatic steatosis; third of patients had sonographic signs of non-specific inflammatory changes in the pancreas. We found that the average coefficient of ultrasound attenuation was significantly higher in children of group 1 compared to group 2 (p < 0.05) and amounted to (2.45 ± 0.39) dB/cm in group 1 and (1.8 ± 0.23) dB/cmin group2. The average pancreas stiffness in children with normal weight group was higher compared to patients with obesity and overweight, but the significance of differences was not sufficient and amounted (3.69 ± 0.78) kPa in group 1 and (3.78 ± 0.27) kPa in group 2. Conclusions. We established that the average coefficient of ultrasound attenuation during pancreatic sonological study in children with obesity and overweight was significantly higher compared to the patients with normal weight that can be explained by the presence of pancreatic steatosis in children with obesity/overweight. The study demonstrates the possibility of steatometry and elastometry usage for diagnosis of pancreatic steatosis and fibrosis in children