Share Wave Elastography Research Articles

Integrated Difference Autocorrelation: A Novel Approach to Estimate Shear Wave Speed in the Presence of Compression Waves.

In share wave elastography (SWE), the aim is to measure the velocity of shear waves, however unwanted compression waves and bulk tissue motion pose challenges in evaluating tissue stiffness. Conventional approaches often struggle to discriminate between shear and compression waves, leading to inaccurate shear wave speed (SWS) estimation. In this study, we propose a novel approach known as the integrated difference autocorrelation (IDA) estimator to accurately estimate reverberant SWS in the presence of compression waves and noise. The IDA estimator, unlike conventional techniques, computes the subtraction of velocity between neighboring particles, effectively minimizing the impact of long wavelength compression waves and other wide-area movements such as those caused by respiration. We evaluated the effectiveness of IDA by: (1) using k-Wave simulations of a branching cylinder in a soft background, (2) using ultrasound elastography on a breast phantom, (3) using ultrasound elastography in the human liver-kidney region, and (4) using magnetic resonance elastography (MRE) on a brain phantom. By applying IDA to unfiltered contaminated wave fields of simulation and elastography experiments, the estimated SWSs are in good agreement with the ground truth values (i.e., less than 2% error for the simulation, 9% error for ultrasound elastography of the breast phantom and 19% error for MRE). Our results demonstrate that IDA accurately estimates SWS, revealing the existence of a lesion, even in the presence of strong compression waves. IDA exhibits consistency in SWS estimation across different modalities and excitation scenarios, highlighting its robustness and potential clinical utility.

Assessment of hepatic fibrosis, portal hemodynamic changes, and disease severity in patients with HCV-related liver cirrhosis after sustained virologic response to direct-acting antiviral drugs (DAAs)

BackgroundRegression of fibrosis and improvement of portal hemodynamics after achievement of sustained viral response (SVR) in patients with chronic hepatitis C (HCV) is a subject of debate in different studies. Some studies reported improvement in the degree of fibrosis, while others did not find significant changes.ObjectiveWe aimed to evaluate changes in liver fibrosis, portal hemodynamics and clinical outcomes in patients with chronic HCV-related liver cirrhosis after the achievement of SVR with direct-acting antiviral drugs (DAAs).Patients and methodsIn our prospective longitudinal study, a total of 100 patients with chronic HCV infection-related liver cirrhosis were recruited, received DAAs, and completed the follow-up period. Clinical evaluation for assessment of liver disease severity using MELD and Child–Pugh class and scores were done. A noninvasive assessment of liver fibrosis using serum biomarkers (APRI index & FIB4 score) and share wave elastography (SWE) was done. Portal hemodynamic evaluation using Doppler ultrasound was done. All were done at baseline and 3 and 12 months after the end of therapy.ResultsA significant reduction in the degree of fibrosis was observed. Share wave elastography (SWE) readings showed 19.79% and 30.45% reduction 3 and 12 months after the end of therapy respectively (P < 0.001). Regarding the FIB4 score, the percentage of score reduction was 19.8% and 26.46% 3 and 12 months after the end of therapy, respectively (P < 0.01). APRI scores showed 22.6% and 41.09% reduction 3 and 12 months after the end of therapy respectively (P < 0.001). Significant improvement in Child–Pugh scores 3 and 12 months after the end of treatment was observed. Doppler ultrasound showed a significant increase in portal vein flow velocity, a significant decrease in time average mean velocity, and cross-section area 12 months after the end of treatment.ConclusionThere was a considerable degree of reduction of liver fibrosis, improvement of portal hemodynamics, and Child–Pugh score in cirrhotic HCV patients who achieved SVR after DAAs.Trial registrationClinicalTrials.gov, ID: NCT03241823. Registered on 08 May 2017.

Valutazione degli effetti a lungo termine di un regime alimentare iperproteico sulla funzionalità renale mediante elastografia a ultrasuoni e test di funzionalità renale nei culturisti

BACKGROUND: Bodybuilding athletes are more prone than other athletes to use high-protein diets. It is considered that a high-protein diet considerably affects renal functioning. This study examined the effects of a high-protein diet on the kidney function and morphology of bodybuilders over time.METHODS: Thirty-six male bodybuilders who trained an average of 3.5-6.5 hours a week for the previous two years participated in the study. Participants were separated into three groups based on their daily protein intake/body weight: group 1 (N.=8): 1.5-1.9 g/kg/day, group 2 (N.=16): 2-2.9 g/kg/day, and group 3 (N.=12): 3-4.5 g/kg/day. Blood urea nitrogen (BUN), serum creatinine (Cr), and estimated glomerular filtration rate were measured (eGFR). In urine samples, the amounts of microalbumin, calcium, sodium, chloride, and potassium were analyzed. Sonography was employed in order to assess renal parameters, cortical thickness, and cortical echogenicity. Share wave elastography was used to calculate share wave velocity for each kidney (SWV).RESULTS: In all protein intake groups, kidney volume, cortical echogenicity, and cortical thickness were shown to be significantly increased (P<0.005). The group with the highest protein consumption had sonographic measurements that were considerably greater than the other groups (P<0.005). All protein intake groups had significantly higher levels of eGFR, BUN, and the BUN/cr ratio than the control group and the reference values. None of the athletes had symptoms and indicators of renal failure. There were no statistically significant differences in SWV across all comparisons (P>0.005).CONCLUSIONS: This study suggests that a high-protein diet has dose-dependent structural and functional effects on the kidneys. Traditional kidney function tests and ultrasound findings are nonspecific because they cannot distinguish between metabolic adaptation and the onset of a pathological process. Radiologists should be aware of the kidney effects of high protein diet and should guide the athletes about the importance of follow-up.

Elastography of the Liver in Wilson's Disease.

Staging of liver fibrosis is of special significance in Wilson's disease as it determines the patient's prognosis and treatment. Histopathological examination is a standard method for fibrosis assessment; however, non-invasive methods like transient elastography and share wave elastography are believed to be reliable and repetitive and are expected to replace liver biopsy in Wilson's disease. This article presents a short description of available elastography techniques and the results of the most recent studies on elastography of the liver in patients with Wilson's disease.

The Power of Share Wave Elastography in Evaluating Portal Hypertension Signs in Children

The Power of Share Wave Elastography in Evaluating Portal Hypertension Signs in Children

Role of Multiparametric Intestinal Ultrasound in the Evaluation of Response to Biologic Therapy in Adults with Crohn’s Disease

Crohn’s disease is one of the two most common types of inflammatory bowel disease. Current medical therapies are based on the use of glucocorticoids, exclusive enteral nutrition, immunosuppressors such as azathioprine and methotrexate, and biological agents such as infliximab, adalimumab, vedolizumab, or ustekinumab. International guidelines suggest regular disease assessment and surveillance through objective instruments to adjust and personalize the therapy, reducing the overall rates of hospitalization and surgery. Although endoscopy represents the gold-standard for surveillance, its frequent use is strongly bordered by associated risks and costs. Consequently, alternative non-invasive tools to objectify disease activity and rule active inflammation out are emerging. Alongside laboratory exams and computed tomography or magnetic resonance enterography, intestinal ultrasonography (IUS) shows to be a valid choice to assess transmural inflammation and to detect transmural healing, defined as bowel wall thickness normalization, no hypervascularization, normal stratification, and no creeping fat. Compared to magnetic resonance imaging (MRI) or computed tomography, CT scan, IUS is cheaper and more widespread, with very similar accuracy. Furthermore, share wave elastography, color Doppler, and contrast-enhanced ultrasonography (CEUS) succeed in amplifying the capacity to determine the disease location, disease activity, and complications. This review aimed to discuss the role of standard and novel ultrasound techniques such as CEUS, SICUS, or share wave elastography in adults with Crohn’s disease, mainly for therapeutic monitoring and follow-up.

THE VALUE OF SHEAR-WAVE ELASTOGRAPHY IN THE DIAGNOSIS AND FOLLOW-UP OF POST COVID-19 SUBACUTE THYROIDITIS

ObjectivesSubacute thyroiditis is a self-limited inflammatory thyroid disease, following or coexisting with a viral infection.COVID-19 has numerous multi-systemic effects, including thyroid disorders. Possible mechanisms involved in thyroid dysfunction associated with COVID-19 infection include apoptosis, inflammatory reaction and follicular cells damage; direct effect of the virus (SARS-CoV-2 genomes were found in patients serum); the interaction with thyroid angiotensin-converting enzyme 2 (ACE2) receptors, respectivelyMaterialsIn the period of November 2021-February 2022, five patients with subacute thyroiditis associated with COVID-19 were evaluated in our department (4 women, one man); mean age 42.1±11.3 years. The mean time between COVID-19 infection and onset of subacute thyroiditis was 23±10.2 days.ResultsThe most common symptoms presented by the affected patients were represented by fever, painful thyroid, and thyrotoxicosis associated complaints. All the patients presented severe inflammatory syndrome, but the thyrotoxicosis clinical and biochemical picture was more severe as compared to other viral subacute thyroiditis. In 60% of the cases, 2D-ultrasonography was suggestive for subacute thyroiditis, but Share-Wave Elastography (SWE) parameters confirmed the diagnostic in 100% of cases (mean thyroid stiffness 234.2±34.5 kPa). Under steroid therapy, during follow-up, the thyroid stiffness decreased gradually at 4 weeks (65.9±15.4 kPa), respectively at 10 weeks (21.6±5.3 kPa).The clinical outcome was favorable in all cases. Two patients developed hypothyroidism and were treated accordingly.Discussions: Subacute thyroiditis are characterized by significantly increased thyroid stiffness. The results of this study documented a significant difference in thyroid tissue stiffness between SAT at baseline and values recorded at the follow-up visit. It is noteworthy that changes in the elastic properties of thyroid parenchyma were associated with a gradual normalization of biochemical parametersConclusionsEarly diagnosis of subacute thyroiditis associated with COVID-19 is crucial, as prompt treatment with glucocorticoids leads to complete resolution of the disease. Sonoelastography SWE is useful in the positive diagnosis of subacute thyroiditis

The role of elastography in the assessment of chronic liver disease in children.

Conventional ultrasonography is a method preferred for the investigation of chronic liver diseases in pediatric groups, as it is non-invasive, cheap, feasible and available. The purpose of this study is to present the role of Share-wave Elastography (SWE) in terms of diagnostic value in children diagnosed with "chronic liver disease." We studied patients who had been diagnosed with chronic liver disease between March 2012-September 2015, and who had undergone liver biopsy and had their pathology results, compared with 26 healthy subjects. Statistical analysis was performed with IBM SPSS Statistics for Windows, Version 20.0. "Pearson Correlation Analysis" was performed in order to measure the relationship between elastography values and Brunt level. This study had 107 subjects in total, consisting of 81 patients between 0-204 months of age Pearson correlation coefficient level was determined as r = 0.644. Since the correlation coefficient is positive, there is a same-directional relationship between Elastography level and Brunt degree. This means that while one of the variables is increasing, the other one will also increase. Since it is known that development of hepatic fibrosis is a dynamic process, and that many hepatic fibrosis etiologies are known to continue throughout the course of life, the application of Real time SWE method instead of repeated liver biopsies on patients is a much simpler and smart method. Increasing the clinical use of Real Time SWE method with future studies might provide an opportunity for preventing unnecessary liver biopsies since the patients are evaluated in a shorter time and in a cost-effective manner.

Correlation of polymorphous variants (ApaI, TagI, BsmI) of the VDR receptor gene with the vitamin D level and liver fibrosis in children with autoimmune hepatitis

The aim. To study the correlation of the frequency distribution of alleles, genotypes and their combinations for the allelic variants of ApaI, TagI, BsmI of the Vitamin D receptor gene (VDR) with the vitamin D levels and the stage of fibrosis in children with autoimmune hepatitis.Materials and methods. 51 children with autoimmune hepatitis were examined between 2016 and 2018. In all children, the diagnosis was confirmed in accordance with the International Guidelines for the study of liver diseases (European Association for the Study of Liver (EASL) Clinical Practice Guidelines: Autoimmune Hepatitis, 2015). In the examined children, the elastography of the liver parenchyma was performed by the shear wave method. Needle biopsy of the liver with histological examination of the specimens was performed in 42 children. The disease activity was determined using the histological activity index (HAI) by Knodell based on the results of a morphological study of the liver biopsy and biochemical parameters. The stage of the disease was evaluated by the histological index of fibrosis using the METAVIR scoring system and semi-quantitatively using the share wave elastography of liver parenchyma. A level of 25(OH)D was determined in the blood serum. The determination of the ApaI, TagI, BsmI polymorphic loci of vitamin D receptor (VDR) was carried out using the molecular-genetic method. The association of polymorphic variants of the VDR gene with the level of vitamin D and the stage of liver fibrosis in children with autoimmune hepatitis has been evaluated.Results. 72.0 % of the examined children had advanced severe liver fibrosis (F3-4 by the METAVIR score), among them 34.0 % of children had signs of liver cirrhosis. Children with advanced severe fibrosis (F3–4 by the METAVIR score) had the CC genotype of the polymorphic version of the TagI of the VDR gene significantly more often (χ2 = 3.953; P &lt; 0.05), and the genotype AA/CC/AA according to the investigated allelic variants of the VDR gene (χ2 = 3.953; P &lt; 0.05). In 72.5 % of the examined children, there was a deficiency of vitamin D. In children with severe fibrosis (F3–4 by the METAVIR score) vitamin D deficiency was significantly more frequent as compared to children with less severe fibrosis (F1–2 by the METAVIR score) (χ2 = 5,207; P = 0.023). The genotype GA of the BsmI polymorphic variant was associated with a decrease in serum vitamin D levels (P &lt; 0.05). At the AC/TC/GA combination of the ApaI, TagI and BsmI allelic variants of the VDR gene, vitamin D deficiency was registered significantly more frequently (P &lt; 0.05).Conclusions. The level of vitamin D in children with autoimmune hepatitis was dependent on the stage of fibrosis. Children with severe fibrosis had a genetically determined vitamin D deficiency significantly more often. Vitamin D deficiency was associated with the CC genotype presence of the TagI polymorphic variant of the VDR gene in patients as well as the GA genotype of the BsmI polymorphic variant and the AC/TC/GA genotype of the three allelic variants of the gene studied.

Estimation of Elastography Parameters of the Pancreas and the Liver with Comorbidity of Chronic Biliary Pancreatitis and Obesity

The objective: is to evaluate the structural state of the liver and the pancreas, and their dependence on the etiology of the biliary factor and obesity, to analyze the relationship between them.Materials and methods. The results of the study of shear wave elasticity indices in 137 patients with chronic biliary pancreatitis (CBP) are presented in the article. Among them are 115 patients with CBP and adiposity (main group) and 22 patients with CBP (comparison group).Results. The increase of the stiffness of both the liver and the pancreas to steatosis was established using share wave elastography. It should be noted that the indicators of the liver and the pancreas were increased with increasing of obesity. The rating of the influence the etiological factor on the structure state of the liver and the pancreas was established in the direction of reducing the level of stiffness: laparotomy cholecystectomy &gt; noncalculous cholecystitis = functional disorders of the hepatobiliary system &gt; noninvasive cholecystectomy.Conclusion. The strong direct correlation link between the stiffness index of the liver and the pancreas (r=0,879; p&lt;0,05) demonstrated the fact that the deterioration of the structural state the liver causes similar changes in the structural state of the pancreas, and was established their interrelatedness. It also proved the systematic of steatosis of the liver and the pancreas in patients with CBP in combination with obesity.

Pancreatic stiffness values using a point shear wave elastography technique in patients with healthy pancreas

Background In the current literature, there is only a small number of studies that have evaluated the utility of point share wave elastography for pancreatic assessment. Objective To assess the feasibility of Virtual Touch Quantification (VTQ) elastography for pancreas assessment, as well as the mean pancreatic stiffness values in healthy subjects. Material and Method We included 70 subjects (52.8% women, 47.2% men, average BMI = 25.9 ± 4.9 kg/m2, average age 46.8 ± 18.4 years) with a normal pancreatic ultrasound aspect and with no history of pancreatic disease or diabetes, in whom elastography measurements were performed with a Siemens Acuson S2000 Virtual Touch ultrasound system (Siemens AG, Erlangen, Germany) using a 4CI transducer. For each patient, 10 valid VTQ measurements of the pancreatic parenchyma were performed under fasting conditions. Reliable measurements were defined as a median value of ten pancreas stiffness measurements with a success rate ≥ 60% and an interquartile range interval Results Out of 70 subjects, reliable measurements were acquired in 61 subjects (87.1%) by means of VTQ elastography. The mean pancreas stiffness values in healthy subjects was 1.26 m/s ± 0.1 m/s, CI 95% (1.24-1.28). There were no significant differences between the mean pancreas stiffness in men vs. women 1.25 m/s ± 0.09 m/s, CI 95% (1.21-1.28) vs. 1.28 m/s ± 0.1 m/s CI 95% (1.25-1.31) (p = 0.103). Conclusion VTQ can be a useful tool for pancreas quantification characterized by a good feasibility (87.1%) in healthy subjects. The mean pancreas stiffness values in healthy individuals was 1.26 m/s ± 0.1m/s.

The application of conventional us and transthoracic ultrasound elastography in evaluating peripheral pulmonary lesions.

The aim of the present study was to evaluate the diagnostic value of ultrasound (US) elastography in differentiating between benign and malignant peripheral lung lesions (PLLs). This retrospective study included 91 consecutive patients with 91 PLLs. Conventional US, strain elastography (SE), acoustic radiation force impulse imaging (ARFIimaging) and point share wave elastography (p-SWE) were performed. All of the pathological results were confirmed by US-guided biopsies or surgeries. There were 36 benign PLLs and 55 malignant PLLs on pathology. For conventional US, a lesion diameter ≥5 cm, irregular contour, presence of air bronchogram and non-abundant vascularity were predictive factors of malignancy (P<0.05). SE scores were observed to be invalid in differentiating between malignant and benign PLLs (P=0.542). For ARFIimaging scores, an elasticity score of 3 or greater was predictive of malignancy, with a sensitivity of 83.6% (46/55) and a specificity of 52.8% (19/36). For p-SWE, the share wave velocity of malignant PLLs was higher than benign ones (2.47±0.92 vs. 1.85±0.92 m/sec; P=0.0022). When 1.951 m/sec was selected as the cut-off value, a sensitivity of 70.9% (39/55) and a specificity of 69.4% (25/36) were obtained. Thus, US, particularly US elastography, is helpful in distinguishing malignant PLLs from benign PLLs.

Value of adding shear wave elastography to routine breast ultrasound examination in assessment of solid breast lesions

PurposeTo assess the additional diagnostic value of share wave elastography in combination with B-mode ultrasound versus B-mode ultrasound alone in characterization of solid breast lesions. Patients and methodsprospective study included women with a single undiagnosed solid breast lesion, between May 2016 and May 2017. All patients underwent B-mode ultrasound and (SWE), and histopathology was performed on all lesions. Results150 women included in this study. 87 breast lesions were malignant & 63 were benign. B-mode ultrasound was performed and the lesions were categorized according to the (BI-RADS). With a sensitivity of 89.7%, specificity of 76.2%, overall accuracy of 84%. Using SWE alone based on elasticity, speed and color pattern, the cut-off values were ≥46 kPa and ≥3.25 m/s. These values demonstrated a sensitivity of 96.6%, specificity of 90.47%, and overall accuracy of 94%. The color pattern had a better sensitivity of 96.8%, specificity of 92%, and overall accuracy of 94.5%.The combination of SWE and B-mode ultrasound results using logistic regression modeling improved diagnostic performance, with an overall accuracy of 96%. ConclusionCombined B-mode ultrasound with shear-wave elastography will improve the overall diagnostic performance for the differentiation of benign and malignant breast lesions.

The role of ultrasonography in the investigation of male infertility

Unintended childlessness affects approximately 9-15% of couples in the reproductive age. It is known that a remarkable proportion of infertility is caused by the disorders of the male reproductive functions. Diagnostic imaging methods and especially ultrasonography play a crucial role in the infertility work-up, the ultrasound examination has become the method of choice for imaging in diseases affecting the testis. With the development of high resolution transducers and technology using colour Doppler, pulsed Doppler, share wave elastography and strain elastography, it is now possible to make accurate diagnoses. However, the place of the new imaging methods in the algorithm of infertility check-up should be clearly defined. Orv Hetil. 2018; 159(21): 815-822.

298 (PB-093) - Share Wave Elastography as a method of assessing the response to neoadjuvant chemotherapy treatment for women with breast malignancy

298 (PB-093) - Share Wave Elastography as a method of assessing the response to neoadjuvant chemotherapy treatment for women with breast malignancy

THU-494 - Non-invasive assessment of liver fibrosis by point share wave elastography in primary biliary cholangitis: comparison with fibroscan® and fibrosis scores

THU-494 - Non-invasive assessment of liver fibrosis by point share wave elastography in primary biliary cholangitis: comparison with fibroscan® and fibrosis scores

Diagnostic performance of point share wave elastography (pSWE) in comparison with transient elastography performed by Fibroscan® (TE) and non-invasive scores of fibrosis in primary biliary cirrhosis (PBC)

Introduction: The reliability of Fibroscan in the assessment of liver fibrosis is well established. The newer pSWE has been successfully applied in viral hepatitis and non-alcoholic liver disease. pSWE performance in PBC has been evaluated only once and a direct comparison with Fibroscan in PBC has never been investigated.

Корекція ендотоксикозу і синдрому пероксидації у хворих на подагру в поєднанні з неалкогольним стеатогепатитом = Lipid peroxidation and endotoxemia syndrome сorrection in patients with gout combined with nonalcoholic steatohepatitis

Smiyan S . I ., Danchak S . V . Корекція ендотоксикозу і синдрому пероксидації у хворих на подагру в поєднанні з неалкогольним стеатогепатитом = L ipid peroxidation and endotoxemia syndrome сorrection in patients with gout combined with nonalcoholic steatohepatitis . Journal of Education, Health and Sport. 2015;5(10):191-198. ISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.32608 http://ojs.ukw.edu.pl/index.php/johs/article/view/2015%3B5%2810%29%3A191-198 https://pbn.nauka.gov.pl/works/661416 Formerly Journal of Health Sciences. ISSN 1429-9623 / 2300-665X. Archives 2011–2014 http://journal.rsw.edu.pl/index.php/JHS/issue/archive Deklaracja. Specyfika i zawartośc merytoryczna czasopisma nie ulega zmianie. Zgodnie z informacją MNiSW z dnia 2 czerwca 2014 r., ze w roku 2014 nie bedzie przeprowadzana ocena czasopism naukowych; czasopismo o zmienionym tytule otrzymuje tyle samo punktow co na wykazie czasopism naukowych z dnia 31 grudnia 2014 r. The journal has had 5 points in Ministry of Science and Higher Education of Poland parametric evaluation. Part B item 1089. (31.12.2014). © The Author (s) 2015; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland and Radom University in Radom, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 05.08.2015. Revised 05.09.2015. Accepted: 20.10.2015. Корекція ендотоксикозу і синдрому пероксидації у хворих на подагру в поєднанні з неалкогольним стеатогепатитом L ipid peroxidation and endotoxemia syndrome сorrection in patients with gout combined with nonalcoholic steatohepatitis S . I . Smiyan , S . V . Danchak Department of Internal Medicine №2 (Head of Department. - MD, prof. Smiyan S.I.) State Medical University named after I. Gorbachevsk y , Communal establishment Regional Council Ternopil University Hospital, Ternopil, Ukraine. Aim. Patients with gout in 25% cases has signs of liver damage (clinical and instrumental data) and it’s proved that metabolic disorders plays main role in this process. Methods and results. A 120 patients with gout were examined, the diagnosis of nonalcoholic fatty liver disease confirmed by share wave elastography. Level of superoxide dismutase, catalase, ceruloplasmin, reduced glutathione and malonic dialdehyde where determined to assess the activity of antioxidant protection system and lipid peroxidation. Middle mass molecules indicated endogenous intoxication. Conclusion. Patients with gout in combination with nonalcoholic steatohepatitis is characterized by intensification of lipid peroxidation and decrease of antioxidant protection system, accompanied by of endotoxemia syndrome, which manifests with accumulation of lipid peroxidation products with high activity of free radical processes. Influenced by complex of treatment with fortified soy phospholipids and L-glutathione, significantly (p <0.001) reduced lipid peroxidation activity, appeared tendency to normalization of antioxidant protection and reduced the intensity of endotoxemia syndrome. Key words : gout, l ipid peroxidation , endotoxemia, steatohepatitis .

Value of real-time sharewave elastography in Achilles tendinopathy: Ultrasound technology of the future?

To determine if the viscoelastic properties of Achilles tendon assessed by real-time sharewave elastography (SWE) are modified in tendinopathy and provide informations for subsequent applications of this technique. Twenty-six abnormal tendons (16 unilateral and 5 bilateral tendinopathy) from 21 patients with Achilles tendinopathy and 176 normal tendons (from 16 patients and 80 healthy volunteers) were prospectively included and compared. Mean sharewave velocity (Vmean) was measured on axial and sagittal SWE images at two degrees of passive ankle flexion (position 1: complete plantar flexion? and position 2: 0 degree flexion). Tendon maximum anteroposterior and lateral diameters, cross sectional area and the presence of tears were also noted. In position 1, the abnormal tendons Vmean was significantly lower than for contralateral normal tendons on sagittal ( Δ = 1.23 m/s, P = 0.004) and axial elastograms ( Δ = 0.68 m/s, P = 0.03)? and significantly lower than for normal tendons only on axial images ( Δ = 0.49 m/s, P = 0.01). In position 2 and on axial elastograms, the abnormal tendons Vmean was 1.14 m/s lower than for contralateral normal tendons however without reaching statistical significance ( P = 0.07). In position 2, the abnormal tendons Vmean was significantly lower than for normal tendons on sagittal ( Δ = 1.26 m/s, P < 0.001) and axial elastograms ( Δ = 0.52 m/s, P = 0.05). In tendon with complete tears Vmean was significantly lower than for normal tendons on both sagittal and axial images and in both positions ( P < 0.001). All tears ( n = 4) appeared as signal void areas. Abnormal Achilles tendons have lower Vmean and are therefore softer than normal tendons. There is no SWE signal into tendon tears. Tendon softening, assessed by realtime SWE, is a new helpful tool in the evaluation of Achilles tendinopathy. SWE may also provide quantitative parameters to assess the severity of tendinopathy to monitor the effect of therapeutics.

2082791 Difficulties In The Performance Of Ultrasound Elastography Of Thyroid Malignancies

to analyze disadvantages, difficulties, and artifacts during ultrasound elastography of thyroid cancer. Ultrasound examinations with elastography of 141 patients with verified thyroid cancer were analyzed. The reference group with verified benign nodules included 432 persons. The scanners S2000 (Siemens-Acuson), SonixSP (Ultrasonix), DC-8 (Mindray) with linear 7.5-15MHz probes were utilized. The efficacy of the combination of compression and share-wave elastography in diagnosis of thyroid cancer was characterized with sensitivity of 96.4% and specificity of 90.1%. Compression elastography was accompanied with difficulties in interpretation in 13 cases (9.2%). In 4 cases (2.8%) the artifact of excessive color pattern within the malignant lesion was observed, while 9 cases (6.4%) had the artifact of poor (deficiency or absence) color pattern or absence of difference between the color of the lesion and the surrounding thyroid parenchyma. However, all lesions were well visualized in other ultrasound regimens. Artifacts during compression elastography resulted from inadequate adjustments of equipment, “noise” due to thyroid lesion location, different approaches in image processing in scanners of different manufacturers, significant operator-dependency of the technology. Difficulties in the performance of share-wave elastography were experienced in 12 (14.9%) cases. They were the consequence of substernal thyroid location, subcentimetric or large (>3cm) lesions, prominent heterogeneity of lesions, and severe background changes in thyroid parenchyma. In 9 cases (6.4%) compression elastography and share-wave elastography exhibited discordant results. Effective acquisition and interpretation of elastographic images demands certain knowledge, skills, and experience with complex analysis of quantitative and qualitative data.