Objective To measure the pancreatic hardness in patients with type 2 diabetes mellitus(T2DM)by shear wave elastography(SWE),and to analyze its relationship with microvascular lesions.Methods A total of 200 patients with T2DM(T2DM group)and 200 healthy subjects(control group)in our hospital were enrolled.The pancreatic size,morphology and internal echo were observed by two-dimensional ultrasound.The mean Young's modulus(Emean)of pancreatic head,body and tail tissues were detected by SWE.According to the clinical diagnosis of microvascular lesions,patients in T2DM group were divided into microvascular lesion group(n=86)and non-microvascular lesion group(n=114).The differences of the above parameters between T2DM group and control group,as well as between microvascular lesion and non-microvascular lesion groups were compared.Differences of SWE parameters in T2DM patients with different characteristics(age,gender,duration of T2DM)were analyzed.Multivariable Logistic regression was performed to analyze the independent influencing factors of SWE parameters in T2DM patients.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy SWE in the diagnosis of microvascular lesions in T2DM patients.Results The proportion of pancreatic hyperecho in T2DM group was higher than that in control group,the diameters and Emean of pancreatic head,body and tail were higher than those in control group,with statistically significant differences(all P<0.05).Emean of pancreatic body in microvascular lesion group was higher than that in non-microvascular lesion group(P<0.05),while the differences in the other parameters between the two groups were not statistically significant.Emean of pancreatic body in male,aged≥60 years and T2DM patients with microvascular lesion was higher than that in female,aged<60 years and T2DM patients without microvascular lesion,respectively,with statistically significant differences(all P<0.05).Emean of pancreatic body was gradually increased with the duration of T2DM(P<0.001).Multivariate Logistic regression analysis showed that gender,age,duration of T2DM and microvascular lesions were independent influencing factors for Emean of pancreatic body in T2DM patients.ROC curve analysis showed that the area under ROC curve,sensitivity and specificity of Emean of pancreatic body in the diagnosis of microvascular lesions were 0.792,82.55%and 71.93%,respectively.Conclusion SWE can accurately detect the increase of Emean in the head,body and tail of the pancreas in patients with T2DM.When patients combined with microvascular lesion,the increase of Emean in the body of pancreas is more obvious,which has certain clinical value.
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