Evaluation of Pancreatic Shear Wave Elastography in Pediatric Type 1 Diabetes

Abstract

Objective: This study aims to assess the pancreatic tissue using Shear Wave Elastography (SWE) in pediatric patients diagnosed with Type 1 Diabetes Mellitus (T1DM), and to juxtapose the potential variations in tissue rigidity with that of healthy pediatric subjects. Additionally, the research seeks to explore the efficacy of 2-Dimensional SWE as a non-invasive imaging modality for the monitoring of Diabetes Mellitus (DM). Furthermore, the study aims to ascertain the presence of any correlation between quantitative/clinical parameters and SWE measurements.

Methods: The study encompassed a control group, individuals with T1DM, and T1DM patients with nephropathy. An examination was conducted to ascertain any potential variances in pancreatic elasticity values across the aforementioned groups. Moreover, parameters such as age, gender, height, weight, pancreas size, duration of illness, levels of hemoglobin A1C (HbA1C), and pancreas elasticity values were subjected to analysis.

Results: A total of 85 participants, comprising 46 individuals in the control group, 29 patients with T1DM but without nephropathy, and 10 T1DM patients with nephropathy, were enrolled in the study. The assessment revealed a notably higher pancreatic elasticity value in the T1DM cohort compared to the control group, with even higher readings observed in the nephropathy group, in contrast to both the control and non-nephropathy groups (p<0.001). Noteworthy was the significant positive relationship identified between pancreatic elasticity values and parameters such as pancreatic head and body dimensions, age, height, weight, disease duration, and HbA1C levels. Through Receiver Operating Characteristic (ROC) curve analysis, specific pancreatic head, body, and tail elasticity threshold values were established for the identification of T1DM (≥5.88, ≥5.92, and ≥5.38 kPa, respectively).

Conclusion: The current study concludes that pancreatic parenchymal elasticity values determined by 2-D SWE in pediatric patients with T1DM exhibit an elevation in comparison to the general populace, with even higher values detected in individuals with nephropathy, indicating a more progressed disease stage. Furthermore, a direct correlation was observed between HbA1C levels and disease duration alongside elasticity values. Moreover, a positive relationship was identified between age, height, weight, and dimensions of the pancreatic head and body. These outcomes imply that SWE has the potential to serve as a non-invasive imaging modality for the monitoring and assessment of the severity of T1DM in children.