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Assessing IgG4-related autoimmune pancreatitis with contrast-enhanced ultrasonography based on time-intensity curve: a single-centre prospective study
M. Lu1, H. Wang2, Y. Wang3, Y. Zhang4, X. Zheng5, Y. Guo6, H. Zhou7, L. An8, J. Zhu9
- Chinese PLA Medical School, PLA General Hospital, Beijing; and Department of Rheumatology and Immunology, The Fourth Medical Center of PLA General Hospital, Beijing, China.
- Department of Rheumatology and Immunology, The First Medical Center of PLA General Hospital, Beijing, China.
- Department of Rheumatology and Immunology, The First Medical Center of PLA General Hospital, Beijing; and State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, Beijing, China.
- Department of Rheumatology and Immunology, The First Medical Center of PLA General Hospital, Beijing, China.
- Department of Rheumatology and Immunology, The First Medical Center of PLA General Hospital, Beijing, China.
- Department of Rheumatology and Immunology, The First Medical Center of PLA General Hospital, Beijing, China.
- Department of Rheumatology and Immunology, The Fourth Medical Center of PLA General Hospital, Beijing, China.
- Department of Ultrasound, The First Medical Center of PLA General Hospital, Beijing, China. alc301@126.com
- Chinese PLA Medical School, PLA General Hospital, Beijing; Department of Rheumatology and Immunology, The First Medical Center of PLA General Hospital, Beijing; and State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, Beijing, China. jian_jzhu@126.com
CER17889
2025 Vol.43, N°3
PI 0410, PF 0417
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PMID: 39436717 [PubMed]
Received: 31/05/2024
Accepted : 02/09/2024
In Press: 15/10/2024
Published: 12/03/2025
Abstract
OBJECTIVES:
The aim of this study was to investigate the changes in various parameters of contrast-enhanced ultrasound (CEUS) before and after treatment in patients with IgG4-related autoimmune pancreatitis (IgG4-AIP), and to identify potential indicators that can assist in evaluating disease activity.
METHODS:
In this prospective study, we enrolled patients diagnosed with IgG4-AIP from June 2021 to November 2022. Demographic characteristics, clinical features, laboratory tests were recorded. Baseline and follow-up, conventional ultrasound and CEUS were conducted. Additionally, a region of interest (ROI) within lesions, pancreatic head, pancreatic body, and pancreatic tail was taken to draw time-intensity curves (TIC) and parameters of TIC were recorded and analysed.
RESULTS:
Seventy-three active IgG4-AIP patients were enrolled. Follow-up, a notable decrease in the size of the pancreatic lesion was observed with a reduction in the maximum diameter from 4.3 ± 2.0 cm to 1.7 ± 1.6 cm (p=0.01). The results revealed a statistically significant increase in peak intensity (PI) in the head, body, and tail regions of the pancreas (p<0.001), along with a significant rise in the area under the curve (AUC) in the tail region of the pancreas (p=0.029) after treatment compared to baseline. In contrast, no statistically significant differences were observed in other parameters of TIC. A significant increase of PI was observed in 12 patients with diffuse IgG4-AIP following treatment. Following treatment, there was a significant increase in PI in the focal area among the 12 patients with focal lesions.
CONCLUSIONS:
CEUS based on TIC holds great potential for assessing response to treatment in patients with IgG4 AIP.
