Evaluation of Pancreas with Strain Elastography in Children with Type 1 Diabetes Mellitus

Background: To investigate changes in pancreatic elasticity in children with type 1 diabetes mellitus (T1DM). Material/Methods: The study group consisted of 60 children with T1DM, and the control group was comprised of 60 healthy children. Strain ratios were obtained for the pancreas using ultrasound strain elastography (Toshiba Applio 500 device). Baseline descriptive data, hemoglobin A1c (%) level, time since diagnosis of T1DM (months), and strain ratio values were noted and compared between the 2 groups. Furthermore, correlation between strain ratio values and other variables was investigated. Results: ROC analysis yielded an optimal cut-off value of 2.245 (AUC=0.999, p<0.001, sensitivity=0.983, specificity=1.00) for the strain ratio. Strain ratio values greater than 2.245 were likely to be pathological, which could be attributed to increased tissue stiffness in T1DM. The strain ratio was significantly higher in T1DM patients than in the control group (3.38 +/- 0.66 vs. 1.32 +/- 0.35; p<0.001). The strain ratio correlated positively with age and duration of T1DM (p<0.001 for both), and there was a correlation between the strain ratio and age in the control group (p=0.011). Conclusions: Strain elastography is a promising, safe, non-invasive, and practical method for early detection, long-term screening, and follow-up in children with T1DM.