Shear Wave Elastography Findings Research Articles

Multimodal ultrasonography evaluation in thyroid nodule characterization: what is the ideal algorithm?

The aim of this study is to investigate the diagnostic performances of Ultrasonography (US), Shear-wave Elastography(SWE), and Superb Microvascular Imaging (SMI) findings in the diagnosis of malignant thyroid nodules (MTNs) and todetermine the US algorithm with the best diagnostic performance. Eighty-one nodules in 77 patientswho had underwent multimodal US with biopsy results, were evaluated. Echogenicity, nodule components, contours, presenceand type of calcification, and size were analyzed with US. Nodule stiffness and vascular index (VI) measurements wereperformed via SWE and SMI. The power of the US algorithm in predicting malignancy was evaluated. Hypoechogenicity,irregular contour, aspect ratio (anteroposterior (AP)/transvers diameter) >1, and >43.9 kPa were the characteristicshad significant efficacy in the diagnosis of MTNs. Sensitivity, specificity, and AUC values were respectively 100%, 48.5%,and 0.742 for hypoechogenicity; 80%, 90.1%, and 0.855 for irregular contour; 60%, 71.2%, and 0.656 for aspect ratio >1;60%, 72.7%, and 0.671 for >43.9 kPa; and 93.3%, 90.9%, and 0.921 for the US algorithm. VI did not show significant efficacyin diagnosis. Some B-mode and SWE findings showed sufficient efficacy in differentiating benign and malignnodules on their own. However, diagnostic accuracy increased significantly when the US algorithm was applied.

Optical coherence tomography and shear wave elastography findings in Graves ophthalmopathy.

The main feature of Graves ophthalmopathy (GO) is revealed by determining the activity and severity of the disease. We aimed to evaluate the use of imaging methods can also provide additional information about the severity of this disease. Optical coherence tomography (OCT) and shear wave elastography (SWE) findings were compared in 32 patients with mild GO group and in the healthy control group. Measuring for TSH receptor antibody (TRAb) serum level is used third-generation assay. In Graves group, optic nerve sheath diameter (ONSD) values were increased in both eyes (p < 0.001, p < 0.001). SWE measurements showed a significant increase both eye optic nerve (ON) and right eye soft tissue elasticity values in GO group (p < 0.001, p < 0.001, p < 0.001, respectively). There was a significant thinning in left temporal retinal nerve fiber layer (RNFL) thickness and left RNFL peripapillary thickness in GO group (p < 0.001, p < 0.025, respectively). There was a correlation between left eye OCT and SWE findings. Also, there was a significant difference between the median left eye ON and soft tissue elasticity results in the TRAb-positive GO group (p = 0.049, p = 0.048, respectively). SWE measurements showed a significant increase both eyes ONSD, ON and right eye soft tissue elasticity values in GO group. GO group was significant thinning in some left eye regions in OCT measurements. There was a correlation between left eye OCT and SWE findings. In addition to clinical activity score and TRAb, SWE and OCT can be used to monitor in patients with GO.

Use of shear-wave elastography to distinguish complex and complicated fibroadenomas from simple fibroadenomas.

Simple fibroadenomas (SFAs), complex fibroadenomas (CFAs), and cellular fibroadenomas (CeFAs) are variants of fibroadenomas. Additionally, some degenerative, hyperplastic, and metaplastic changes may occur in fibroadenomas, forming complicated fibroadenomas. Distinctive ultrasonography (US) features in variants of fibroadenomas and complicated fibroadenomas have not been reported. Shear-wave elastography (SWE) can be applied to effectively discriminate between these variants and complicated fibroadenomas. In this study, we aimed to evaluate SWE findings to discriminate between SFAs and other variants. In total, 48 patients (26 with SFAs, 16 with CFAs, 3 with CeFAs, and 3 with complicated fibroadenomas) participated in this study. The lesions were classified into two groups according to histopathologic diagnoses. The SWE evaluation and lesion elasticity scores (Emax, Emean, and Emin) were both assessed in m/s and k/Pa, respectively. Two observers measured Emax, Emean, and Emin. Brightness (B)-mode US findings based on the Breast Imaging Reporting and Data System categorization and elasticity scores were recorded. In the statistical analyses, the chi-square test and non-parametric tests were performed. Fisher's exact test was used to compare independent groups, and Spearman's correlation coefficients were used to correlate the SWE data between the two observers. Additionally, receiver operating characteristic curves were analyzed to evaluate the diagnostic performance of the elasticity values. The B-mode US features in both groups showed no statistical significance. The set of SWE values of both observers demonstrated strong statistical significance in discriminating between group 1 (SFAs) and Group 2 (CFAs, CeFAs, and complicated fibroadenomas). As the fibroadenoma variants and complicated fibroadenomas have similar US findings, SWE in addition to a conventional B-mode examination can increase the diagnostic performance to discriminate SFAs from other complex and complicated forms of fibroadenomas.

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.

A nomogram incorporating clinical, conventional ultrasound and shear wave elastography findings for distinguishing pleomorphic adenoma from Warthin's tumor of the major salivary glands.

Pre-operative differentiation between pleomorphic adenoma (PA) and Warthin's tumor (WT) of the major salivary glands is crucial for treatment decisions. The purpose of this study was to develop and validate a nomogram incorporating clinical, conventional ultrasound (CUS) and shear wave elastography (SWE) features to differentiate PA from WT. A total of 113 patients with histological diagnosis of PA or WT of the major salivary glands treated at Fujian Medical University Union Hospital were enrolled in training cohort (n = 75; PA = 41, WT = 34) and validation cohort (n = 38; PA = 22, WT = 16). The least absolute shrinkage and selection operator (LASSO) regression algorithm was used for screening the most optimal clinical, CUS, and SWE features. Different models, including the nomogram model, clinic-CUS (Clin+CUS) and SWE model, were built using logistic regression. The performance levels of the models were evaluated and validated on the training and validation cohorts, and then compared among the three models. The nomogram incorporating the clinical, CUS and SWE features showed favorable predictive value for differentiating PA from WT, with the area under the curves (AUCs) of 0.947 and 0.903 for the training cohort and validation cohort, respectively. Decision curve analysis showed that the nomogram model outperformed the Clin+CUS model and SWE model in terms of clinical usefulness. The nomogram had good performance in distinguishing major salivary PA from WT and held potential for optimizing the clinical decision-making process.

The Diagnostic Role of Shear Wave Elastography and Superb Microvascular Imaging in the Evaluation of Suspicious Microcalcifications.

The aim of this study was to investigate the role of superb microvascular imaging (SMI) and shear wave elastography (SWE) in the prediction of malignancy and invasiveness of isolated microcalcifications (MC) that can be visualized by ultrasonography (US). Sixty-seven women with MC, who were considered suspicious on mammography were evaluated. Only those lesions that could be visualized by US and presented as non-mass lesion were included. They were evaluated by B-mode US, SMI, and SWE before US-guided core-needle biopsy. B-mode US, SMI (vascular index (SMIvi)), and SWE (E-mean, E-ratio) findings were compared with histopathologic features. Pathology confirmed 45 malignant (21 invasive and 24 in situ carcinomas) and 22 benign lesions. There was a statistically significant difference between malignant and benign groups in terms of size (P = .015), distortion (P = .028), cystic component (P < .001), E-mean (P < .001), E-ratio (P < .001), and SMIvi (P = .006). For differentiation of invasiveness E-mean (P = .002), E-ratio (P = .002), and SMIvi (P = .030) were statistically significant. According to ROC analysis E-mean (cut-off point at 38 kPa) was the most sensitive (78%) and the most specific (95%) value among four numeric parameters (size, SMI, E-mean, and E-ratio) with AUC = 0.895, PPV = 97%, and NPV = 68% in detecting malignancy. In the evaluation of invasiveness, the most sensitive (71.4%) method was SMI (cut-off point at 3.4) and the most specific (72%) method was E-mean (cut-off point at 91.5 kPa). Our study shows that adding SWE and SMI to the sonographic evaluation of MC would be an advantage for US-guided biopsy. Including suspicious areas according to SMI and SWE in the sampling area can help target the invasive part of the lesion and avoid underestimation of core biopsy.

’Shear-wave elastografi bulgularının meme kanseri moleküler alt tipleri ile ilişkisi ve diğer radyolojik görüntüleme teknikleri ile karşılaştırılması

Purpose: We aimed to evaluate the shear-wave elastography (SWE) findings of breast cancer and to compare their differences with other imaging techniques and to determine the rela-tionship between molecular subtypes. &#x0D; Methods: Radiological findings and histopathology results of patients who underwent biopsy due to breast mass and diagnosed as malignant were evaluated retrospectively. SWE findings, ultrasonography (US), mammography and magnetic resonance imaging (MRI) findings were evaluated. The histo-pathology results of the tru-cut biopsy performed under the guidance of US-SWE were analyzed. The findings of SWE and other radiological techniques were compared statistically and relationship with molecular subtypes was evaluated. &#x0D; Results: We had 51 patients with a median age of 58 years. In SWE, the mean tumor size was 20 mm, and the tumor elasticity was 105 kPa. Statistically signi-ficant correlation was found between the tumor size differences measured by B mode US-SWE and the tumor elasticity value. No correlation was found between SWE findings and molecular subtypes. SWE had significantly high positive correlation with mamography and MRI in terms of lesion size, with US very high positive correlation and with ER positivity weak negative correlation. &#x0D; Conclusion: In addition to conventional radiological imaging techniques the use of SWE provides useful insight to evaluation of breast cancer.

Clinical correlation of 2D shear wave elastography findings in children with type 1 diabetes mellitus without autoimmune thyroiditis.

The aim of study was to evaluate the 2D shear wave sonoelastography (SWE) findings of the thyroid gland in children with type 1 diabetes mellitus (T1DM) with normal gray-scale findings and without thyroid autoimmunity (AIT) and obtain data that will be useful for the early detection of glandular involvement. The study included 46 T1DM patients (mean age: 11.28±3.3years) and 46 healthy children (mean age: 12.01±3.8years) as the control group. The thyroid gland mean elasticity value was obtained as kPa and compared in groups. A correlation was investigated between elasticity values and age at diabetes, serum free T4, thyroid stimulating hormone (TSH), anti-thyroglobulin, anti-tissue peroxidase, and hemoglobin A1c values. No difference was found between T1DM patients and the control group in the thyroid 2D SWE evaluation (the median kPa value: 17.1 (10.2) in the study group and 16.8 (7.0) in the control group) (p=0.15). No significant correlation was found between 2D SWE kPa values and age at diagnosis, serum free T4, TSH, anti-thyroglobulin, anti-tissue peroxidase, and hemoglobin A1c levels in T1DM patients. Our study showed that the elasticity of the thyroid gland in T1DM patients without AIT was not affected differently from that of the normal population. If 2D SWE isused in routine follow-up in T1DM patients before the development of AIT, we think that it will be useful in the early detection of thyroid gland affections and AIT, and long-term comprehensive studies in this direction will contribute to the literature.

Varikosel ve İnfertilitenin Volumetri ve Shear-wave Elastografi Üzerindeki Etkilerinin Değerlendirilmesi

Aim: This study aims to compare the volumetry and shear-wave elastography findings in infertile and fertile patients and evaluate the effect of presence of varicoceles on the parameters. &#x0D; Materials-Methods: 40 infertile and 20 fertile patients (120 testes) (mean age 29,3±6,7) between January 2018-November 2018 were included in this prospective study. All patients underwent testicular B-mode and doppler ultrasonography (US) and shear-wave elastography (SWE). Patients were sub-grouped according to fertility status and presence or absence of varicoceles. &#x0D; Results: Testis stiffness was significantly higher in testes without varicoceles than those with varicoceles (p=0.021). It was also higher in fertile patients than infertile patients (p=0.015). Testes volumes were higher in fertile patients and patients with varicoceles (p=0.011 and p=0.028, respectively).&#x0D; Conclusion: SWE is a non-invasive, cheap and reproducible technique with promising results for diagnosis and follow-up in the evaluation of infertility.

Comparison of Shearwave Elastography and Apri Score for Liver Fibrosis in Patients of Chronic Liver Disease

Chronic liver disease of various etiologies is the major causes of mortality and morbidity globally. Liver biopsy is the most accurate and oldest method to determine the chronic liver disease progression and for liver histology. Shear wave elastography (SWE) is a new non-invasive technique that applies localized mechanical compression to the soft tissue with focused ultrasonography and obtains tension images showing the tissue response. Aspartate aminotransferase to platelets ratio (APRI) on the other hand is relatively less expensive test and can be done on outpatient basis. Objective: To find the relation between APRI aspartate and SWE for detection of liver fibrosis in patients with chronic liver disease. Study Design: A Cross Sectional study Setting: Medical Unit-1 Lahore General Hospital Lahore and Department of Gastroenterology &amp; Hepatology, Doctors Hospital and Medical Centre, Lahore. Study Duration: From July 2019 to December 2021. Methods: 180 patients met the criteria of inclusion were included, the blood samples were obtained and sent to the hospital laboratory for valuation of AST and Platelets. Reports were evaluated, APRI was calculated and patients were labeled as negative or positive. Then all patients underwent SWE by a senior radiologist for assessment of liver fibrosis. Patients were labeled as negative or positive. Agreement was noted, all data was entered on a specifically designed proforma, and data were analyzed and entered in SPSS version 20 statistical method. Agreement was calculated by generating 2x2 tables between APRI and SWE findings. Kappa statistics was calculated to measure the strength and significance of agreement. P-value ≤0.05 was taken as significant. Results: In this study, the patients mean age was 46.39 ± 16.02years. There were 119 (66.11%) males and 61 (33.89%) females. The mean BMI of patients was 24.70 ± 5.23kg/m2. The mean duration of CLD was 5.50 ± 2.672 years. The mean AST of patients was 73.98 ± 60.23IU/L while mean platelet count was 200.65 ± 92.47/cm3. The mean APRI was 1.41 ± 1.20. The mean SWE was 18.32 ± 23.85kPa. The APRI and SWE agreed on 73 (54.9%) cases and showed 66.7% agreement between them for diagnosis of liver fibrosis (p&lt;0.05). Conclusion: Thus, APRI and SWE showed strong agreement but further trials are required to confirm the evidence. Keywords: Agreement, APRI, Aspartate aminotransferase to platelets ratio, SWE, Shear-wave elastography, Chronic liver disease and Liver fibrosis.

Diagnostic performance of gray-scale ultrasound and shear wave elastography in assessing salivary gland involvement in patients with primary Sjögren's syndrome.

To investigate the diagnostic performance of gray-scale ultrasound (US) and shear wave elastography (SWE) for determining salivary gland involvement primary Sjögren's syndrome (pSS). In this prospective study, the salivary glands of 72 healthy volunteers and 74 participants with pSS were examined by two blinded radiologists with consensus using gray-scale US and SWE. SWE parameters were compared between groups. The area under the curve (AUC), sensitivity, and specificity of gray-scale US and SWE was analyzed. The correlation between SWE and clinical findings was investigated. The SWE parameters of the parotid and submandibular glands were significantly higher in the pSS group, but did not differ significantly based on serologic assays, Schirmer test, minor salivary gland biopsy, and comorbidities. The AUC values for gray-scale US of the salivary glands were significantly lower than the AUC values for SWE. The elasticity modulus (kPa) of parotid gland had the highest AUC value (0.937; 95% CI, 0.901-0.973), with a sensitivity of 93.2% and a specificity of 83.3%. SWE had no correlation with age, disease duration, laboratory values, or disease activity. SWE provides excellent diagnostic performance for submandibular and parotid gland involvement in pSS and can be used to complement gray-scale US.

Comparison of non-invasive imaging methods and laboratory findings on non-alcoholic fatty liver disease (NAFLD) in childhood

Aim: Diagnosis and follow-up of non-alcoholic fatty liver disease in children with practical and non-invasive methods have been researched for many years. Ultrasonography (USG), Shear wave elastography (SWE), and Magnetic Resonance (MR) are thought to help demonstrate the impairment which is also displayed in liver function tests. This study aims to identify the most effective imaging method among liver scanning methods in exhibiting the fatty condition of the liver and laboratory tests.&#x0D; Material and Method: This study was carried out on a population of 84 children who applied to the clinic. The relationship between the diagnostic performances of three different noninvasive methods [USG, MR, and SWE] and liver function tests in children with suspected NAFLD was analyzed. Age, BMI (body mass index), waist circumference, gender, liver function tests, total cholesterol, triglyceride, and Homeostasis Model Assesment-Insulin Rezistance (HOMA-IR) parameters of NAFLD and control group were put into comparison and their relationship with USG, MR, and SWE imaging methods were also analyzed.&#x0D; Results: There is no statistically significant relationship between hepatosteatosis grade and the mean SWE (p&gt;0.05) while there is a positive and statistically significant relationship between waist circumference and liver long axis values at 33.3% level (p: 0.036; p0.05).&#x0D; Conclusion: Abdominal USG, SWE, and dynamic MR examinations are very essential to demonstrate liver functions and liver pathology in children with non-invasive methods. It is also useful in patient follow-up. In this study, no difference was detected between SWE and MR findings, and we think that the SWE examination will be more suitable in estimating liver functions in follow-up as opposed to costly MR examination.

Comparing the clinical application of strain elastography and shear wave elastography for the evaluation of lateral epicondylitis.

This study aimed to compare the diagnostic performance of gray-scale ultrasound (GSU), strain elastography (SE), and shear wave elastography (SWE) for lateral epicondylitis (LE). From November 2018 to March 2021, 87 common extensor tendons (CETs) of 70 patients were evaluated using elbow ultrasound. Patients were divided into two groups: patients with LE and those without lateral elbow pain. GSU, SE, and SWE findings from the two groups were compared, and the diagnostic performance was compared for significant variables. Among the 70 patients, 41 with 44 CETs were clinically diagnosed with LE, and 29 with 43 CETs had no lateral elbow pain. Hypoechogenicity, calcification, and hyperemia were significantly different. Strain ratio (SR), stiffness, and shear wave velocity (SWV) were also significantly different. The diagnostic accuracy of stiffness and SWV was better than that of other significant findings. Furthermore, there were no superiorities in SR, stiffness, or SWV. Both SE and SWE can be valuable diagnostic tools for diagnosing LE. The diagnostic performances of both SE and SWE were similar in the detection of LE.

Analysis of Thyroid Gland Problems with Shear Wave Elastography in Children with Celiac Disease.

The rate of autoimmune thyroiditis in children with celiac disease (CD) is high relative to the normal population. Since the majority of these patients are also euthyroid, thyroid imaging methods are gaining significance in diagnosis and follow-up. This study examines the effectiveness of thyroid ultrasonography (US) and thyroid shear wave elastography (SWE) in diagnosing thyroid disease in children with CD. This cross-sectional controlled study analyzed thyroid US, SWE, serum thyroid function tests, and thyroid autoimmune antibodies of 106 CD patients and 103 control patients without CD. An Aplio 500 ultrasound device with a linear array transducer and elastography software was used for thyroid US and SWE measurement of all patients. Right lobe thyroid volume, left lobe thyroid volume, total thyroid volume, thyroid mean elasticity (m/s), right lobe elasticity (kPa), left lobe elasticity (kPa), and mean thyroid elasticity (kPa) levels of the CD group were higher than those of the control group (p < 0.001). The relationships between thyroid US and thyroid mean elasticity (m/s), thyroid mean elasticity (kPa), anti-thyroid peroxidase antibody, and thyroid-stimulating hormone were positive and moderate, respectively (r = 0.612, 0.612, 0.636, and 0.565, respectively; p < 0.001). In this study, SWE findings were compatible with laboratory findings, as they constituted a sensitive and useful method in the diagnosis and follow-up of autoimmune thyroid disease in children with CD.

Testes Parenchymal Shear Wave Elastography Findings in Varicocele.

To investigate the testicular parenchymal changes in patients with varicocele using shear wave elastography (SWE). Cross-sectional study. Department of Radiology, Hatay Mustafa Kemal, School of Medicine, Hatay, Turkey, between June and August 2021. The study was conducted on 124 testes of 62 patients who had undergone scrotal ultrasonography. Using the SWE technique, the mean velocity and stiffness values of each testis were measured and recorded, and varicocele volume was calculated by measuring testis volume and the Pampiniform plexus (pp) vein diameter on Doppler examination. After the exclusion criteria, 55 (44.3%) testes with varicocele and 69 (55.6%) testes without varicocele were examined. The relationship between the SWE values of testis volume and the presence and volume of varicocele was evaluated statistically. The mean velocity value was 0.76 ± 0.08 m/s in the varicocele group and 0.85 ± 0.13 m/s in the without varicocele group; the mean stiffness value was 1.76 ± 0.37 KPa in the varicocele group and 2.25 ± 0.54 KPa in the without varicocele group. The SWE values were found to be significantly lower in testes with varicocele than in those without (p<0.001). The mean testis volume was 13.5 ± 4.6 in the varicocele group and 13.8 ± 4.4 in the without varicocele group. No statistically significant relationship was determined between the presence of varicocele and testis volume (p=0.670). A significant negative correlation was found between plexus pampiniform diameter and velocity (rs=-0.405, p=0.002) and stiffness (rs =-0.399, p=0.003) values. SWE findings can provide information about testicular damage associated with varicocele. Furthermore comprehensive studies may be of importance in varicocele treatment. Shearwave elastography (SWE), Testis, Varicocele, Parenchymal stiffness.

Strain and shearwave sonoelastographic findings of quadriceps tendon in patients with chronic kidney disease. Are they reliable?

In this study, we aimed to compare the strain (SE) and shear wave elastography (SWE) findings of the quadriceps tendons (QT) of the patients with chronic kidney disease (CKD) and healthy volunteers (HV), and estimate the reliability of the evaluations. Twenty-nine HV and twenty-seven patients with CKD were enrolled. All sonoelastographic examinations were performed separately by two observers. The QT thickness (QTT), SWE, and SE findings including the tissue elastic modulus (EM), shear wave velocity (SWV), and the elasticity patterns were obtained and compared. Interobserver agreement was evaluated to test the reliability of the findings. The QT in CKD patients is thinner than HV (p= 0.001 for both observers). The elasticity patterns of QT were mostly intermediate stiffness for both observers (p< 0.05 for both observers). The mean EM values in the patient group were significantly higher than HV for both observers (p< 0.05 for both observers). The mean SWVs were significantly higher in the patient group (p< 0.05 for both observers). SWV showed weak, significant, and negative correlations with the hemodialysis (HD) duration (p< 0.05 for both observers). The interobserver agreements were moderate to excellent for QTT, EM, SWS, and SE patterns (p< 0.01 for all parameters). QTT and its elasticity are decreased in patients with CKD. The QTT and SE patterns may be the choice to determine the elasticity in CKD patients with good reliability values rather than SWE. But, there is still debate on the reliability of sonoelastographic findings, to ensure standardization of the factors affecting reliability, they should be well understood.

Preoperative and postoperative ultrasound elastography findings of the sciatic nerve in patients with unilateral lumbar foraminal disc herniation: a pre-test and post-test design.

The aim of this study was to compare preoperative and postoperative findings of the sciatic nerve by using B-mode ultrasound, strain elastography (SE), and shear wave elastography (SWE) in patients with unilateral lumbar foraminal disc herniation. In this prospective study group, patients with complaints of foraminal disc herniation due to one level (L4-5 or L5-S1) were included. Preoperative and postoperative (one month after surgery) B-mode ultrasound, SE, and SWE findings of the affected sciatic nerve in patients who underwent unilateral spinal decompression surgery were compared. Evaluations were performed on the axial plane from the gluteal region using a convex probe of 5-9L MHz. The reference method used to assess nerve root compression was 1.5-T Magnetic Resonance Imaging (MRI). A total of 20 patients (9 males, 11 females) with a mean age of 46.2±13.1 years were included. The cross-sectional area (CSA), diameter, SWE values of the sciatic nerve were significantly higher in the affected side compared to those of the non-affected side (all for p<0.05). Blue and blue-green were the most common color codes in the affected side while green and green-yellow-red were the most common color codes in the non-affected side. The CSA, diameter, and SWE values of the sciatic nerve decreased after the surgery in the affected side (all for p<0.05), nonetheless. those did not differ in the non-affected side (all for p>0.05). Lumbar decompression surgery decreases the sciatic nerve diameter, CSA, and stiffness of the sciatic nerve.

Magnetic resonance imaging and shear wave elastography comparison in the evaluation of breast lesions

This study aims to compare the Magnetic Resonance Imaging (MRI) and Shear Wave Elastography (SWE) data and investigate their contribution to diagnosis when both are individually used and combined. This study included the consent of 46 diagnostic biopsy patients after their breast MRI examination was performed. Mass appearance patients in the sonographic evaluation were SWE examined before the biopsy. In MR examination, lesion localization, size, contrast curves, contrast enhancement features, intensity in the fat-suppressed T2A sequence, Emean value in SWE examination, and histopathological results were examined. Individual and combined use of MRI and SWE findings were evaluated with histopathological results. The diagnosis consistency was compared according to the histopathological results of the malignant-benign defined lesions. Higher sensitivity in MRI; higher specificity and accuracy in SWE were acquired when both methods were compared. The accuracy of MRI improved when MRI use is combined with SWE. The combined use of SWE with MRI increases the diagnostic accuracy in breast lesion characterization. We observed that lesions showing a type 3 enhancement curve and iso-hypointense on the T2W sequence in breast MRI could be predicted to show a stiff elasticity pattern on SWE due to higher elastography values.

The role of penile elastography in the evaluation of erectile dysfunction in patients with chronic obstructive pulmonary disease

IntroductionIn this study, we aimed to measure the change in penile stiffness by evaluating corpus cavernosum (CC) with shear wave elastography (SWE) in patients with chronic obstructive pulmonary disease (COPD).Material and methodsSeventy outpatient patients aged 50–80 years who were diagnosed with COPD were evaluated using SWE. Patients were divided into 2 groups according to the International Index of Erectile Function-5 (IIEF-5) questionnaire (IIEF-5 >17: Group A, IIEF-5 <17: Group B). The measurements were made in both transverse and longitudinal sections.ResultsThe mean age of the patients was 60 ±7.9 years. The duration of COPD was significantly higher in Group B than in Group A (p = 0.003). The mean SWE values of right transverse mid-portion of corpus penis (RTM) and left transverse mid-portion of corpus penis (LTM) in Group B (21.1 ±5.6 kPa and 20.8 ±4.8 kPa, respectively) were significantly higher than in Group A (15.2 ±2.3 kPa and 15.8 ±2.7 kPa, respectively); (p <0.001 and p <0.001, respectively). There was a significant negative correlation between IIEF-5 scores and the duration of COPD (p <0.05). There was a significant negative correlation between IIEF values and RTM and LTM values of the patients (p <0.05 and p <0.05, respectively). There was a significant positive correlation between the duration of COPD and both RTM and LTM values (p <0.05 and p <0.05, respectively).ConclusionsIn our study, according to the SWE findings, we showed the effect of systemic changes created by COPD on penile tissue and the negative effect of this on erectile function in patients.

Elastography and Doppler May Bring a New Perspective to TIRADS, Altering Conventional Ultrasonography Dominance

The main aim of ultrasonography (US) examining thyroid nodules is to differentiate malignant nodules from benign nodules. Several professional societies and groups of investigators have defined guidelines such as Thyroid Imaging Reporting and Data System (TIRADS) to provide the standardized language and approach to thyroid nodules. This study is aimed to investigate the compatibility of such classification systems with the pathological diagnosis of nodules and evaluate the contribution of the Shear-wave elastography (SWE) and Doppler ultrasonography (DUS) findings. This is a prospective study. Patients with thyroid US exams between December 2017 and April 2019 were included. In the study, eligible 210 nodules from 210 patients were enrolled. For stratification, the conventional B-mode US, SWE and DUS were performed. According to Kwak, American College of Radiology (ACR), and European (EU)-TIRADS, Nodules were classified separately, and a new scoring system whose the criteria was put defined in the study has developed. For SWE; Emean cut-off value was 33 kPa with a sensitivity and specificity of 95,6% (95% CI: 0,85-0,98) and 95% (95% CI:0,90-0,97) respectively (p <0.001). For spectral DUS; resistivity index (RI) cut-off value was 0.64 with a sensitivity and specificity of 73,3% (95% CI:0,59-0,83) and 80% (95% CI:0,73-0,85) respectively (p <0.001). Kwak TIRADS, American College of Radiology TIRADS, EU-TIRADS, and new system were compared by ROC curve analysis. The new system has the highest sensitivity, specificity, PPV, NPV, accuracy, and AUC compared to others. The new scoring system has shown that SWE and DUS findings may alter the categorization in TIRADS and increase sensitivity and specificity.