Shear Wave Elastography of Spleen in Acute Pancreatitis: Its Correlation With Severity and Outcome

To correlate the spleen's shear wave elastography (SWE) with the severity of acute pancreatitis (AP) and the outcome.

In this IRB-approved prospective study, 38 patients with a diagnosis of AP were enrolled. Patients were taken up for 2D-SWE of the spleen, which was measured in kPa. Mean SWE values of the spleen were compared with the severity of AP according to the Modified Marshall score and intervention using the Kruskal-Wallis test.

Splenic stiffness increased progressively with the severity of acute pancreatitis. Among the three splenic regions, the lower pole showed the most consistent association with disease severity, demonstrating significantly higher stiffness in patients with severe forms of pancreatitis (p = 0.042). Higher overall splenic SWE values were also observed in patients who required more invasive management, such as necrosectomy or surgical drainage, compared with those managed conservatively or with percutaneous drainage. No significant relationship was noted between splenic SWE and demographic factors, etiology of pancreatitis, or splenic vascular changes.

A significant positive association was seen between SWE values of the lower pole of the spleen and the severity of the Modified Marshall severity score. There was a significant positive association between the overall SWE values of the spleen and the nature of the intervention, which was highest in patients who underwent necrosectomy or surgical drainage.