Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Internal Medicine

Background: Endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration (EUS{u2013}FNA) are currently considered procedures of choice for the differential diagnosis of focal pancreatic masses. As minimally invasive procedure, elastography increase accuracy of diagnosing solid pancreatic lesion in the form of qualitative and quantitative (strain ratio& strain histogram) methods by measuring tissue stiffness,The strain histogram is a mean value of elasticity strains in a selected region of interest, while the strain ratio is calculated as the ratio of the mean strain in a region of interest over the mean strain in a reference area that usually selected from the gut wall. Aim of the study To investigate the accuracy of the strain histogram endoscopic ultrasound (EUS)-based method for the diagnostic differentiation of patients with pancreatic masses Methods A prospective cross-section study on 72 patients with solid pancreatic masses, underwent EUS. Elastography (Strain ratio, Strain histogram) and final diagnosis by EUS-FNA. Results The cut-off point for Mode 1 was set at 87.5. where values under the cut-off point indicate the presence of malignancy (P= 0.041). the cut-off point for the Mode 2/Mode 1 ratio was set at 1.14 where values below the determined cut-off point were classified as malignant (P= 0.360)

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