CHANTAROJANASIRI Tanyaporn^{1, 3}, HIROOKA Yoshiki², KAWASHIMA Hiroki¹, OHNO Eizaburo², HAYASHI Daijuro¹, KUWAHARA Takamichi¹, YAMAMURA Takeshi², FUNASAKA Kohei², NAKAMURA Masanao¹, MIYAHARA Ryoji¹, ISHIGAMI Masatoshi¹, WATANABE Osamu¹, HASHIMOTO Senju⁴, GOTO Hidemi^{1, 2}

Tanyaporn CHANTAROJANASIRI^{1, 3}, Yoshiki HIROOKA², Hiroki KAWASHIMA¹, Eizaburo OHNO², Daijuro HAYASHI¹, Takamichi KUWAHARA¹, Takeshi YAMAMURA², Kohei FUNASAKA², Masanao NAKAMURA¹, Ryoji MIYAHARA¹, Masatoshi ISHIGAMI¹, Osamu WATANABE¹, Senju HASHIMOTO⁴, Hidemi GOTO^{1, 2}

¹Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, ²Department of Endoscopy, Nagoya University Hospital, ³Department of Internal Medicine, Police General Hospital, ⁴Department of Liver, Biliary and Pancreas Diseases, Fujita Health University

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BACKGROUND
Ultrasound strain elastography is one of the useful methods for evaluating pancreatic lesions. During aging, several pancreatic parenchymal changes occur that may interfere with the interpretation of the ultrasound images. We studied age-related changes in pancreatic elasticity using transabdominal ultrasound strain elastography in subjects without known pancreatic disease.
METHODS
This study was conducted at Nagoya University Hospital, which is an academic medical center, and included 102 subjects （66 women and 39 men） aged 20 to 85 years （mean 58.6 ± 17.5） who underwent transabdominal ultrasonography for screening and follow-up for non-pancreatic diseases. Strain elastography of the pancreas was performed, and the results were subjected to quantitative strain histogram analysis. The correlations of age with four elastographic parameters （Mean, Standard deviation, Skewness, and Kurtosis） and other findings, including hyperechoic pancreas, hyperechoic liver, and diabetes, were evaluated.
RESULTS
There was a significant correlation between increasing age and elastographic parameters such as the Mean （P = 0.004）, Skewness （P = 0.007）, and Kurtosis （P = 0.03）, and these differences became significant after the age of 40. The prevalence of hyperechoic pancreas increased with age （P < 0.001）, and the Means were lower in those with hyperechoic pancreas （P = 0.004） and a higher body mass index （BMI, P = 0.008）. No significant correlations with diabetes, hyperechoic liver, or elastographic parameters were demonstrated.
CONCLUSION
Strain elastography demonstrated elastographic changes in the pancreas with aging that included a decreasing Mean and increasing Skewness and Kurtosis after the age of 40. The prevalence of pancreatic hyperechogenicity increased, and the pancreatic hyperechogenicity was significantly negatively correlated with the Mean.