Real-time Shear Wave Elastography Research Articles

Predictive value of placental real-time shear wave elastography combined with 3-dimensional power Doppler index for preeclampsia.

This study aimed to investigate the value of placental real-time shear wave elastography combined with three-dimensional power Doppler index (3D-PDI) in the prediction of preeclampsia. We conducted a retrospective study selecting 60 pregnant women diagnosed with preeclampsia as the experimental group and 60 normal pregnant women as the control group from January 2021 to December 2022. The elastic modulus values of different regions of the placenta and placental 3D-PDI were detected and compared between the two groups. The ROC curve was used to evaluate the diagnostic value of each parameter, alone or in combination, for preeclampsia. The study findings demonstrated that the elastic modulus values of different regions of the placenta and 3D-PDI of the two groups have statistical significance. The values of SWE, VI, FI, and VFI are different in prediction of preeclampsia, and the combination of various parameters can improve the prediction value. Overall, our study provides a valuable method for the prediction of preeclampsia with the advantages of non-invasiveness, efficiency, and simplicity.

Preliminary application of real-time shear wave elastography to evaluate endometrial receptivity and predict pregnancy outcome

BACKGROUND: Endometrial receptivity is crucial for the establishment of a healthy pregnancy outcome. Previous research on endometrial receptivity primarily examined endometrial thickness, endometrial echo types, and endometrial blood supply. OBJECTIVE: To explore the differences in the elastic modulus of the endometrium in women with various pregnancy outcomes by real-time shear wave elastography (SWE) and to investigate its application value in evaluation of endometrial receptivity. METHODS: A total of 205 pregnant women who were admitted at Wenzhou People’s Hospital between January 2021 and December 2022 were selected. Three-dimensional transvaginal sonography and real-time shear wave elastography were performed in the proliferative phase and receptive phase of the endometrium, and the average elastic modulus of the endometrium in the two phases was obtained and compared. According to whether the pregnancy was successful or not, the participants were divided into the pregnancy group (n= 72) and non-pregnancy group (n= 133), and the differences in intimal thickness, 3D blood flow parameters, and average elastic modulus of intima were compared between the two groups. RESULTS: The average elastic modulus of the endometrium in the proliferative phase and receptive phase was (23.92 ± 2.31) kPa and (11.82 ± 2.24) kPa, respectively, and the difference was statistically significant P< 0.05. The average elastic modulus of the endometrium in the pregnancy group and non-pregnancy group was (9.97 ± 1.08) kPa and (12.82 ± 2.06) kPa, respectively, and the difference was statistically significant P< 0.05. The area under the curve of predicting pregnancy by the average elastic modulus of the endometrium in the receptive phase was 0.888 (0.841∼0.934), with corresponding P value < 0.05. The critical value was 11.15, with a corresponding sensitivity of 81.7% and specificity of 78.2%. CONCLUSION: Real-time shear wave elastography can quantitatively evaluate endometrial elasticity, indirectly reflect the endometrial phase, and provide a new diagnostic concept for evaluating endometrial receptivity and predicting pregnancy outcome in infertile patients.

Bowel Stiffness Assessed by Shear-Wave Ultrasound Elastography Predicts Disease Behavior Progression in Patients With Crohn's Disease.

There is a lack of reliable predictors of disease behavior progression in patients with Crohn's disease (CD). Real-time shear-wave elastography (SWE) is a novel method for evaluating tissue stiffness. However, its value for assessing CD has not yet been investigated. We aimed to explore the value of SWE and other ultrasound parameters at diagnosis in predicting CD behavior progression. We retrospectively collected data from patients with CD with the nonstenotic nonpenetrating disease (B1 phenotype based on the Montreal classification). All patients underwent intestinal ultrasound at baseline and were followed up. The end point was defined as disease behavior progression to stricturing (B2) or penetrating (B3) disease. Cox regression analysis was performed for the association between baseline characteristics and subsequent end points. In addition, a multivariate nomogram was established to predict the risk of disease behavior progression quantitatively. A total of 130 patients with CD with B1 phenotype were enrolled. Twenty-seven patients (20.8%) developed B2 or B3 disease, with a median follow-up of 33 months. Multivariate analysis identified that SWE was the only independent predictor of disease behavior progression (hazard ratio 1.08, 95% confidence interval 1.03-1.12, P = 0.001). A reverse of the HR appeared at the cutoff 12.75 kPa. The nomogram incorporating SWE and other clinical characteristics showed a good prediction performance (area under the curve = 0.792). Intestinal stiffness assessed using SWE is an independent predictor of disease behavior progression in patients with CD. Patients with CD with SWE >12.75 kPa at diagnosis are prone to progress toward stricturing or penetrating diseases.

P289 Bowel Stiffness Assessed by Shear-wave Ultrasound Elastography Predicts Disease Behavior Progression in Patients with Crohn’s Disease

Abstract Background There is a lack of reliable predictors of disease behavior progression in patients with Crohn’s disease (CD). Real-time shear-wave elastography (SWE), a novel method for evaluating tissue stiffness, is reportedly helpful in determining the prognosis of liver cirrhosis or breast cancer. However, its value for assessing CD has not yet been investigated. We aimed to explore the value of SWE and other ultrasound parameters at diagnosis in predicting CD behavior progression. Methods We retrospectively collected data from CD patients with the non-stenotic non-penetrating disease (B1 phenotype based on the Montreal classification). All patients underwent intestinal ultrasound with SWE measurement at baseline and were followed up. The endpoint was defined as disease behavior progression to stricturing (B2) or penetrating (B3) disease. A multivariate Cox regression model was used to explore the association between baseline SWE and subsequent outcome. We also established a multivariate nomogram to predict the risk of disease behavior progression and evaluated its performance with receiver operating characteristic curve and decision curve analysis. Results A total of 130 CD patients with B1 phenotype were enrolled. Twenty-seven patients (20.8%) developed B2 or B3 disease, with a median follow-up of 33 months. Multivariate analysis identified that SWE ≥12.75 kPa was the only independent predictor of disease behavior progression (HR 1.08, 95% CI 1.03-1.12, P=0.001, Fig 1A). A restricted cubic spline with multiple covariates adjusted showed an approximately linear positive correlation between SWE and the risk of disease behavior progression, with a cut-off of 12.75 kPa (Fig 1B). We further established a multivariate nomogram incorporating SWE and other clinical characteristics to predict the risk of disease behavior progression quantitatively (Fig 1C). Compared to the model composed solely of SWE, the multivariate nomogram showed a higher but less significant performance (0.738 vs. 0.792, p=0.169, Fig 1D). However, the decision curve analysis showed that the model outperformed the single indicator of SWE in predicting endpoint events, especially those occured after 12 months of baseline (Fig 1E). Conclusion Intestinal stiffness assessed using SWE is an independent predictor of disease behavior progression in patients with CD. CD patients with SWE ≥12.75 kPa at diagnosis are prone to progress toward stricturing or penetrating diseases, which warrants timely intervention.

Quantitative Analysis of the Impact of Different Delivery Modes on Cervical Elasticity Based on Real-time Shear Wave Imaging Technology and Artificial Intelligence.

Real-time shear wave elastography (SWE) has emerged as a useful imaging modality for detecting the lesion location of various diseases, including cervical diseases. In this paper, the SWE was used to quantitatively determine the tissue hardness of the internal and external orifice of the cervix (IOC & EOC) and to relatively objectively analyze the impact of different production methods on the hardness of the cervical tissue. A total of 48 patients were selected, and they were divided into three groups according to different production methods: control group (16 cases), cesarean section group (16 cases), and spontaneous delivery group (16 cases). Artificial intelligence has also been incorporated into this work. A deep flexible neural tree model and a new set of FNT models were proposed to assist in classifying cervical physical data in different states. The physical data was extracted as the features, and the different states were considered as category labels. There was no statistically significant difference in the elasticity of the IOC and the EOC between the groups. However, the difference in the elasticity of the IOC and the EOC within each group was statistically significant. The classification results corresponded with the results of the statistical analysis. The hardness of the EOC is generally lower than that of the IOC, and there was no significant difference in hardness between the IOC and the EOC in the three groups. There is no significant difference in the cervical elasticity hardness between different delivery modes.

Experimental study on monitoring microwave ablation efficacy by real-time shear wave elastography in ex vivo porcine brain

Objective: Glioma constitutes the most common primary malignant tumor in the central nervous system. In recent years, microwave ablation (MWA) was expected to be applied in the minimally invasive treatment of brain tumors. This study aims to evaluate the feasibility and accuracy of microwave ablation in ex vivo brain tissue by Shear Wave Elastography (SWE) to explore the application value of real-time SWE in monitoring the process of MWA of brain tissue. Methods: Thirty ex vivo brain tissues were treated with different microwave power and ablation duration. The morphologic and microscopic changes of MWA tissues were observed, and the diameter of the ablation areas was measured. In this experiment, SWE is used to quantitatively evaluate brain tissue’s degree of thermal injury immediately after ablation. Results: This study It is found that the ablation range measured by SWE after ablation is in good consistency with the pathological range [ICCSWEL1-L1 = 0.975(95% CI:0.959 − 0.985), ICCSWEL2-L2 = 0.887(95% CI:0.779 − 0.938)]. At the same time, the SWE value after ablation is significantly higher than before (mean ± SD,9.88 ± 2.64 kPa vs.23.6 ± 13.75 kPa; p < 0.001). In this study, the SWE value of tissues in different pathological states was further analyzed by the ROC curve (AUC = 0.86), and the threshold for distinguishing normal tissue from tissue after ablation was 13.7 kPa. The accuracy of evaluating ablation tissue using SWE can reach 84.72%, providing data support for real-time quantitative observation of the ablation range. Conclusion: In conclusion the accurate visualization and real-time evaluation of the organizational change range of the MWA process can be realized by real-time SWE.

Combined Assessment of 2-D Ultrasound and Real-Time Shear Wave Elastography of Low-Intensity Pulsed Ultrasound Therapy Efficacy in Rabbits with Achilles Tendinopathy

ObjectivesLow-intensity pulsed ultrasound (LIPUS) has been gradually used to treat Achilles tendinopathy. However, there are limited noninvasive and efficient instruments for monitoring the LIPUS efficacy in Achilles tendinopathy. The purpose of this study was to assess the therapeutic effectiveness of LIPUS following Achilles tendinopathy by two-dimensional (2D) ultrasound and real-time shear wave elastography (SWE). MethodsNinety New Zealand white rabbits were divided into control, sham, and LIPUS groups after tendinopathy modeling. On days 1, 4, 7, 14, and 28, the Achilles tendon thickness and SWE Young's modulus on the long axis were measured. The tissues of the Achilles tendon were then evaluated histologically. ResultsThe mean SWE values increased while the average thickness and histologic scores decreased, especially in the LIPUS group (9.5% and 80.7% on Day 28, respectively). The SWE values in the LIPUS group were significantly lower than those in the control group on Day 1 (121.0 KPa vs. 177.6 KPa) and peaked on Day 7 (173.7 KPa, p<0.001). By Day 28, the SWE value had approached that of the control (191.2 KPa vs. 192.4 KPa), and it had been significantly higher than that in the sham group since Day 7. SWE values and histologic scores were correlated (r = -0.792, p<0.01). The average thickness decreased in the three groups but did not show significant differences. Conclusions2D ultrasound is beneficial to the diagnosis of Achilles tendinopathy. SWE could quantify changes in Achilles tendon stiffness noninvasively during LIPUS treatment, enabling the study of early Achilles tendon healing after LIPUS treatment.

Association of renal elasticity evaluated by real-time shear wave elastography with renal fibrosis in patients with chronic kidney disease.

Renal fibrosis is a final common pathological hallmark in the progression of chronic kidney disease (CKD). Non-invasive evaluation of renal fibrosis by mapping renal stiffness obtained by shear wave elastography (SWE) may facilitate the clinical therapeutic regimen for CKD patients. A cohort of 162 patients diagnosed with CKD, who underwent renal biopsy, was prospectively and consecutively recruited between April 2019 and December 2021. The assessment of renal cortex stiffness was performed using SWE imaging. The patients were classified into different groups based on pathological renal fibrosis (mild group: n = 74; moderate-to-severe group: n = 88). Binary logistic regression model and generalized additive model were conducted to investigate the association of renal elasticity with renal fibrosis. Compared with the mildly impaired group, the moderate-to-severe group showed a significant decline in renal elasticity (P < .001). In the fully adjusted model, each 10 kPa drop in renal elasticity was associated with a 3.5-fold increment in the risk of moderate-to-severe renal fibrosis (fully adjusted odds ratio, 4.54; 95% CI, 2.41-8.57). Particularly, participants in the lowest elasticity group (≤29.92 kPa) had a 20-fold increased chance of moderate-to-severe renal fibrosis than those in the group with highest elasticity (≥37.93 kPa). An inverse linear association was observed between renal elasticity increment and moderate-to-severe renal fibrosis risk. There is a negative linear association between increased renal elasticity and moderate-to-severe renal fibrosis risk among CKD patients. Patients with diminished renal stiffness have a higher risk of moderate-to-severe renal fibrosis. CKD patients with reduced renal stiffness have a higher likelihood of moderate-to-severe renal fibrosis.

Retracted: Evaluation of Achilles Tendon in Patients with Diabetic Foot Ulcer by High-Frequency Ultrasound Combined with Real-Time Shear-Wave Elastography

Retracted: Evaluation of Achilles Tendon in Patients with Diabetic Foot Ulcer by High-Frequency Ultrasound Combined with Real-Time Shear-Wave Elastography

Real-time Shear Wave Elastography Assessment of Muscle Elasticity in Patients with Renal Failure

Objective: To explore the value of real-time elastic shear wave in evaluating muscle elasticity in patients with renal failure. Methods: 50 patients with chronic renal failure from January 2019 to December 2022 were randomly selected as the experimental group, and 50 healthy patients aged 21–61 during the same period were selected as the control group, and the basic information of the patients, including age, gender, body mass index, etc., were collected. Besides, the Young’s modulus of the two groups of patients were observed and analyzed. Results: The Young’s modulus values of left and right gastrocnemius muscles in the experimental group were significantly lower than those in the control group (P &lt; 0.05), and there was no statistical difference between the left and right sides of the experimental group and the control group (P &gt; 0.05). Conclusion: Real-time shear wave elastography provides a non-invasive, real-time and effective tool for the assessment of muscle elasticity in patients with renal failure. Through further research and optimization, real-time shear wave elastography will play a greater role in the prevention and treatment of patients with renal failure, improvingthe quality of life and prognosis of patients.

Application of real time shear wave elastography to the differential diagnosis of secondary parathyroid hyperplasia and adenoma.

We aimed to explore the value of ultrasonic elastic imaging in the diagnosis of parathyroid hyperplasia and adenoma in patients with secondary hyperparathyroidism and provide more evidence for clinical treatment. Forty patients who were on dialysis and underwent parathyroid surgery were selected All patients underwent routine ultrasound, ultrasound elasticity examination and blood biochemical examination before surgery, including calcium, phosphorus, parathyroid hormone (PTH), etc. According to postoperative results, adenoma group and hyperplasia group were divided into 2 groups. Receiver operating characteristic curve was drawn to evaluate the diagnostic efficacy and combined diagnostic efficacy of each index. The PTH levels significantly differed between the adenoma and hyperplasia groups (P < .001). The volume and blood flow grades significantly differed between the adenoma and hyperplasia groups (P < .001) The minimum of the adenoma group was 14.62 ± 6.79 kPa, mean was 19.42 ± 6.29 kPa, and maximum was 24.25 ± 6.35 kPa which were significantly different from those in the hyperplasia group (P < .05). The combinations of more than 6 indicators in the diagnosis of parathyroid adenoma resulted in an area under the curve of 0.892 (P < .001), and the sensitivity and specificity were 78.9% and 97.4%, respectively. Shear wave elastography can be used as an effective tool to distinguish secondary parathyroid hyperplasia from adenoma. When combined with PTH, conventional ultrasound blood flow grading and volume measurement, it has higher diagnostic efficacy.

Clinical value of grayscale ultrasound combined with real-time shear wave elastography nomogram in risk prediction of thyroid cancer

ObjectivesThis study constructed a nomogram based on grayscale ultrasound features and real-time shear wave elastography (SWE) parameters to predict thyroid cancer.MethodsClinical data of 217 thyroid nodules of 201 patients who underwent grayscale ultrasound, real-time SWE, and thyroid function laboratory examination in Ma’anshan People’s Hospital from January 2019 to December 2020 were retrospectively analyzed. The subjects were divided into a benign nodule group (106 nodules) and a malignant nodule group (111 nodules). The differences in grayscale ultrasound features, quantitative parameters of real-time SWE, and laboratory results of thyroid function between benign and malignant thyroid nodules were analyzed. We used a chi-square test for categorical variables and a t-test for continuous variables. Then, the independent risk factors for thyroid cancer were analyzed using multivariate logistic regression. Based on the independent risk factors, a nomogram for predicting thyroid cancer risk was constructed using the RMS package of the R software.ResultsMultivariate logistic regression showed that the grayscale ultrasound features of thyroid nodules were the shape, margin, echogenicity, and echogenic foci of the nodules,the maximum Young’s modulus (SWE-max) of thyroid nodules, and the ratio of thyroid nodule and peripheral gland (SWE-ratio) measured by real-time SWE were independent risk factors for thyroid cancer (all p < 0.05), and the other variables had no statistical difference (p > 0.05). Based on the shape (OR = 5.160, 95% CI: 2.252–11.825), the margin (OR = 9.647, 95% CI: 2.048–45.443), the echogenicity (OR = 6.512, 95% CI: 1.729–24.524), the echogenic foci (OR = 2.049, 95% CI: 1.118–3.756), and the maximum Young’s modulus (SWE-max) (OR = 1.296, 95% CI: 1.140–1.473), the SWE-ratio (OR = 2.001, 95% CI: 1.403–2.854) of the thyroid nodule to peripheral gland was used to establish the related nomogram prediction model. The bootstrap self-sampling method was used to verify the model. The consistency index (C-index) was 0.979, ROC curve was used to analyze the nomogram scores of all patients, and the AUC of nomogram prediction of thyroid cancer was 0.976, indicating that the nomogram model had high accuracy in the risk prediction of thyroid cancer.ConclusionsThe nomogram model of grayscale ultrasound features combined with SWE parameters can accurately predict thyroid cancer.

Viscoelasticity in trapezius myofascial pain syndrome: quantitative assessment using Real-Time Shear-Wave Elastography

Objective To investigate the differences in the viscoelastic properties between normal trapezius muscles and those in patients with trapezius myofascial pain syndrome (MPS) using real-time shear-wave elastography (SWE). Materials and Methods This study included 31 patients with trapezius MPS and 31 volunteers. Sixty-one trapezius muscles (41 and 20 on the affected and non-affected side, respectively) of patients with MPS and 62 normal trapezius muscles in volunteers were assessed. Conventional ultrasonic parameters, including skeletal muscle thickness, resistance index (RI), and mean shear wave velocity (SWVmean) of trapezius muscles, were obtained in the seated position with the shoulders and neck relaxed. The daily neck leaning time (unit:hours) of all participants was obtained using a questionnaire. Results Ultrasound showed no statistically significant differences in thickness or RI of the trapezius muscles of the affected and non-affected sides in MPS patients versus normal trapezius muscles (p = 0.976 and 0.106, respectively). In contrast, the SWVmean of trapezius muscles in patients with MPS was significantly higher than that of normal trapezius muscles in both the affected and non-affected sides (4.41 ± 1.02 m/s vs. 3.35 ± 0.79 m/s, p < 0.001; 4.05 ± 0.63 m/s vs. 3.35 ± 0.79 m/s, p = 0.002). There was no significant difference between the SWVmean of the trapezius muscles on the affected and non-affected sides in patients with MPS (4.41 ± 1.02 m/s vs. 4.05 ± 0.63 m/s, p = 0.225). Correlation analysis showed that daily neck forward time was positively correlated with the SWVmean of the trapezius muscles on the affected and non-affected sides in patients with MPS (r = 0.635, p < 0.001; r = 0.576, p = 0.008). Conclusion SWE can quantitatively evaluate stiffness of trapezius muscles in patients with trapezius MPS. The stiffness of both affected and non-affected trapezius muscles increased in patients with trapezius MPS, and the degree of increase positively correlated with the time of cervical forward leaning.

Evaluation of fatty liver with grey scale 2D ultrasonography and ultrasound elastography and co-relation with lipid profile in adult patient in the state of Chhattisgarh attending Dr. Bhim Rao Ambedkar memorial hospital tertiary care centre Raipur

Background: Several noninvasive imaging techniques have been introduced for the assessment of liver fibrosis. Among these techniques real-time Point shear wave elastography has become a promising imaging modality for the measurement of liver stiffness. The advantage of this technique is that the elasticity displayed using a B-mode image, also a quantitative estimation of liver stiffness is performed. The present study evaluates the fatty liver in patients above 18 years age with grey scale 2D ultrasonography and ultrasound elastography and also study the correlation with lipid profile in patients attending Dr B.R.A.M hospital tertiary care center Raipur, Chhattisgarh. Methods: This was a hospital based observational study conducted in Department of Radio-diagnosis, Dr BRAM Hospital and Pt JNM Medical College, Raipur (C.G). A sample of 198 patient above 18-year age with fatty liver were taken. Grading and quantification of fatty liver was also done by Shear wave elastography. A p-value &lt;0.05 was considered statistically significant. Results: Mean age of study subjects was 48.47±15.21 years and 52.02% were female. 2D ultrasound technique diagnosed 75.25% grade-1 and 24.24% were in grade-II. Elastography technique diagnosed 57.58% with dysfunction (F1) liver stiffness, 28.28% fibrosis present (F2 or F3) and 13.64% normal. Increasing liver stiffness stages was significantly associated with increasing levels of serum VLDL (p=0.04). Conclusions: Ultrasound used in conjunction with elastography has shown utility in diagnosing and follow up of fatty liver patients. Liver stiffness was significantly associated with increasing levels of serum VLDL.

Real-Time Shear Wave Elastography for Determining the Ideal Site of Liver Biopsy in Diffuse Liver Disease.

Objectives The objective of the study was to identify accurate site of liver biopsy under ultrasound and elastography guidance and compare the shear wave elastography (SWE) and transient elastography (TE) diagnostic accuracy with histopathological correlation. Methods This was a prospective single-center study where patients scheduled for nonfocal liver biopsy were divided into two groups (group U: ultrasound; group E elastography) by sequential nonrandom selection of patients. Elastography was performed before the biopsy and biopsies from the maximum stiffness segment were taken. Results There was no significant difference of intersegmental liver stiffness with mean velocity; however, biopsy segment velocities show significant difference with mean liver stiffness suggestive of heterogenous distribution of fibrosis. The rho ( r ; Spearman's correlation) value between biopsy segments and mean velocities shows excellent correlation. The diagnostic performance of TE was good for fibrosis stages F2, F3, and F4, while SWE was fair for the diagnosis of fibrosis stages F1 and F2 and fairly equal for the diagnosis stages F2 and F3. Area under the curve (AUC) values in differentiating mild (F1) or no fibrosis from significant fibrosis (≥F2) were 95.5 with cutoff value of at least 1.94 m/s. Conclusions The diagnostic performance of SWE is comparable with TE in liver fibrosis staging and monitoring. Fibrosis is heterogeneously distributed in different segments of the right lobe liver. Therefore, elastography at the time of biopsy may help in defining the accurate site for biopsy and improve histopathological yield in detecting liver fibrosis in patients with chronic liver disease. Advances in Knowledge Elastography-guided biopsy is helpful to determine the ideal site of biopsy.

Monitoring Methotrexate-induced Increased Liver Stiffness and Significant Liver Fibrosis in Rheumatoid Arthritis Patients: A Cross-sectional Controlled Study with Real-time Two-dimensional Shear Wave Elastography

Monitoring Methotrexate-induced Increased Liver Stiffness and Significant Liver Fibrosis in Rheumatoid Arthritis Patients: A Cross-sectional Controlled Study with Real-time Two-dimensional Shear Wave Elastography

A different approach to cystinosis: ultrasound, doppler, and shear wave elastography findings of thyroid gland

BackgroundWhile thyroid dysfunction develops in about 50% of untreated children with cystinosis, there is no data about how the sonography of thyroid tissue appears in this disease. Therefore, the purpose of this study was to assess the sonographic appearance, color doppler findings in this disease and to evaluate how cystine crystal accumulation affect tissue stiffness using shear wave elastography (SWE).MethodsSixteen children diagnosed with cystinosis and a control group consisting of 34 healthy children were included in this study. B mode ultrasound, color doppler imaging and real-time SWE of thyroid tissue were performed.ResultsUltrasound imaging revealed lower echogenicity and diffuse heterogeneous echotexture in 7 of the 16 cystinosis patients. Thyroid gland volumes were lower in cystinosis patients (p 0.005). Doppler ultrasound demonstrated increased flow in 8 patients. On SWE, the thyroid tissue stiffness was established to be lower in patients compared to healthy children (p 0.003).ConclusionsThis is the first study evaluating thyroid gland B mode, color doppler ultrasonography, and SWE findings in cystinosis. Our findings indicate that cysteamine treatment still cannot completely prevent the disease infiltration process of thyroid gland. The other important finding—that thyroid tissue stiffness was established to be lower than that of the controls—also demonstrates the ongoing disease infiltration process.

Using elastography-based multilayer perceptron model to evaluate renal fibrosis in chronic kidney disease

Background Given its progressive deterioration in the clinical course, noninvasive assessment and risk stratification for the severity of renal fibrosis in chronic kidney disease (CKD) are required. We aimed to develop and validate an end-to-end multilayer perceptron (MLP) model for assessing renal fibrosis in CKD patients based on real-time two-dimensional shear wave elastography (2D-SWE) and clinical variables. Methods From April 2019 to December 2021, a total of 162 patients with CKD who underwent a kidney biopsy and 2D-SWE examination were included in this single-center, cross-sectional, and prospective clinical study. 2D-SWE was performed to measure the right renal cortex stiffness, and the corresponding elastic values were recorded. Patients were categorized into two groups according to their histopathological results: mild and moderate-severe renal fibrosis. The patients were randomly divided into a training cohort (n = 114) or a test cohort (n = 48). The MLP classifier using a machine learning algorithm was used to construct a diagnostic model incorporating elastic values with clinical features. Discrimination, calibration, and clinical utility were used to appraise the performance of the established MLP model in the training and test sets, respectively. Results The developed MLP model demonstrated good calibration and discrimination in both the training [area under the receiver operating characteristic curve (AUC) = 0.93; 95% confidence interval (CI) = 0.88 to 0.98] and test cohorts [AUC = 0.86; 95% CI = 0.75 to 0.97]. A decision curve analysis and a clinical impact curve also showed that the MLP model had a positive clinical impact and relatively few negative effects. Conclusions The proposed MLP model exhibited the satisfactory performance in identifying the individualized risk of moderate-severe renal fibrosis in patients with CKD, which is potentially helpful for clinical management and treatment decision-making.

Evaluation of muscle elasticity in patients with end-stage renal disease complicated with sarcopenia by real-time shear wave elastography multipoint measurement

Abstract Background To analyze the value of real-time shear wave elastography (SWE) multi-point measurement in the evaluation of muscle elasticity in patients with end-stage renal disease (ESRD) complicated with sarcopenia. Methods We enrolled 169 ESRD patients treated as the research objects from January 2019 to February 2022. According to whether they were complicated with sarcopenia, the patients were divided into sarcopenia group (n=63) and non-sarcopenia group (n=106). The Young’s modulus and shear wave velocity (SWV) of muscles in relaxed and contracted states were measured by SWE technology in the two groups. Results Logistic regression analysis showed that age and hs-CRP were independent risk factors for sarcopenia in ESRD patients (P&lt;0.05), while BMI, muscle thickness, Young’s modulus in stretched state and SWV in stretched state were protective factors for sarcopenia in ESRD patients (P&lt;0.05). BMI, muscle thickness, Young’s modulus in extended state, SWV in extended state and Young’s modulus in rest state were all negatively correlated with age and hs-CRP (P&lt;0.05), while there was a significant positive correlation between age and hs-CRP (P&lt;0.05). Independent influencing factors were used to construct the prediction model of nomogram. The consistency index (C-index) was 0.845 (95% CI: 0.830~0.857), and the AUC of ROC curve was 0.852 (95% CI: 0.836~0.871), which had good discrimination. Conclusion SWE could accurately evaluate the muscle elasticity of ESRD patients, so as to reflect the changes of muscle mass and stiffness of patients, and could provide the important imaging indicator for the prediction of sarcopenia.

Real-Time Elastography versus Shear Wave Elastography on Evaluating the Timely Radiofrequency Ablation Effect of Rabbit Liver: A Preliminary Experimental Study

to evaluate and monitor the timely thermal ablation changes of rabbit liver by using two elastographic methods-real-time elastography (RTE) and shear wave elastography (SWE)-as compared to contrast-enhanced ultrasound (CEUS) and physical specimens. 20 ablation zones were created in the livers of 20 rabbits using radiofrequency ablation (RFA). After the ablation, RTE and SWE were used to measure the elastic properties of the twenty ablation zones. The consistency of efficacy evaluation for RTE and SWE measurements was analyzed using the Bland-Altman test. The areas of the thermal ablation zones were also measured and compared according to the images provided by RTE, SWE, CEUS, and gross physical specimen measurement. RTE and SWE could clearly display the shape of RFA ablation zones within one hour after the ablation. The average elasticity ratio for the ablation zone measured by RTE was 3.41 ± 0.67 (2.23-4.76); the average elasticity value measured by SWE was 50.7 ± 11.3 kPa (33.2-70.4 kPa). The mean areas of the ablation zones measured with RTE, SWE, gross specimen, and CEUS were 1.089 ± 0.199 cm2, 1.059 ± 0.201 cm2, 1.081 ± 0.201 cm2, and 3.091 ± 0.591 cm2, respectively. The Bland-Altman test showed that RTE and SWE have great consistency. Area measurements by CEUS were significantly larger than those of the other three methods (p < 0.05). RTE and SWE are both able to accurately confirm the range of ablation zones shortly after the ablation for rabbit livers.