Çölyak hastalığı tanılı çocuklarda pankreas elastografisinin değerlendirilmesi

Amaç: Çalışmamızda Çölyak Hastalarında (ÇH) pankreas parankimi transabdominal ultrasonografi (USG) ve elastografi ile değerlendirildi. Çalışmada ÇH’lerde pankreas elastografi ve pankreas boyutunun ölçümü ile hastaların gelişim eğrilerinin karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Çalışmamız tek merkezli, prospektif tasarlanmış olup Çölyak Hastalığı tanılı, 5-18 yaş arası hastalar dahil edilmiştir. Çalışmaya uygun olan 106 hastanın pankreas boyutları ve parankim elastografi ölçümleri tek radyolog tarafından yapıldı. Hastaların boy, kilo, vücut kitle indeksi (VKİ), fekal elastaz değerleri, tanı yaşları, hastalık süreleri ve özgeçmişleri değerlendirildi. Hastalar gelişim eğrileri standart deviasyon SD skoruna göre dört gruba ayrıldı. Bulgular: Çalışmamıza 106 ÇH dahil edilmiş olup bunların 72’si kız, 34’ü erkek idi. Hastaların tanı yaşları ortalama 100,4±97,5 ay, tanı süreleri ise 4,1±2,5 yıl olarak hesaplandı. Hastalar gelişim eğrilerinin SD skorlarına göre (<-2SD, -1, -2SD, -1,0SD, >0 SD grupları) 4 grupta incelendi. Gruplar arasında pankreas elastografi değerleri arasında anlamlı farklılık saptanmadı. Yine bu gruplar arasında pankreas baş kısmı boyutlarında farklılık saptanmadı. Gözlemlendiği kadarıyla gövde ve kuyruk kısmı ön-arka çapları ile SD skoru arttıkça pozitif korelasyon izlendi (sırası ile pankreas gövde; 9,75±1,4, 8,9±1,5, 10,2±1,8, 10,7±1,9 mm, pankreas kuyruk; 7,75±0,9, 7,2±1,4, 8,14±1,4, 8,4±1,4 mm). Fekal elastaz değerleri arasında da bir fark saptanmadı. Sonuç: Çölyak hastalarında kilogram SD skoruna göre yapılan değerlendirmede SD skoru yüksek olan hastaların pankreas boyutlarının daha büyük olduğu saptandı. Ancak kilogram SD skoruna göre pankreas elastografi değerleri arasında anlamlı bir faklılık saptanmadı.

Anahtar Kelimeler:

çocuk, pankreas, elastografi, fekal elastaz, Çölyak hastalığı

Evaluation of pancreas elastography in pediatric patients diagnosed with Celiac disease

Purpose: The goal of this study was to evaluate the pancreatic parenchyma in celiac patients with transabdominal ultrasonography (US) and ultrasound elastography (UE). The aim of this study is to identify the difference of pancreatic elastography values and pancreatic dimension between the different four pediatric coeliac patient groups with respect to their development curve standart deviation (SD) scores. Materials and Methods: This study is single-center, prospective study. We included 5–18 years old patients diagnosed with Celiac Disease (CD). Pancreatic dimension and parenchymal elastography measurements of 106 patients eligible for the study were performed by a single radiologist. Height, weight, body mass index (BMI), fecal elastase values, age at diagnosis, duration of illness and medical history of the patients were evaluated. The patients were divided into four groups with respect to their development curve SD scores. Results: Our study group included 106 CD patients, 72 female and 34 male children were included in our study. The age at diagnosis of the patients was 100.4±97.5 months, and the disease duration was 4.1±2.5 years. The patients were examined in 4 groups. There was no difference in pancreatic elastography values between four groups. There was no difference in the dimensions of the pancreatic head between these groups. It was observed that the anteroposterior diameters of the body and tail increased as SD values increased. There was no difference between fecal elastase values. Conclusion: Pancreas dimensions were higher in celiac patients with a higher kilogram SD score. However, no significant difference in pancreatic elastography values was observed when the kilogram SD score was used.

Keywords:

celiac disease, child, pancreas, elastography, fecal elastases,

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