This study intends to assess the salivary glands of individuals with hypothyroidism and healthy controls using B-mode ultrasonography (US) parameters, shear wave elastography (SWE) values, and colour Doppler characteristics. Additionally, the study aims to compare salivary flow rates between the patient groups. A total of 160 submandibular glands and 160 parotid glands from 80 patients (40 hypothyroidism individuals and 40 controls) were assessed using ultrasonography. Echogenicity, internal parenchymal structure, margin characteristics, dimensional measures, and colour Doppler and SWE assessments were conducted using a linear probe. Furthermore, the stimulated and unstimulated salivary flow rates of each subject were quantified in millilitres per minute (mL/min). A statistically significant difference was identified between the hypothyroidism and control groups regarding echogenicity, margin characteristics, parenchymal homogeneity, colour Doppler metrics, medio-lateral dimension, and mean values of SWE (kPa) and SWE (m/Sn) in the right submandibular gland; margin characteristics, parenchymal homogeneity, colour Doppler metrics, and mean values of SWE (kPa) and SWE (m/Sn) in the left submandibular gland; as well as echogenicity, margin characteristics, parenchymal homogeneity, and mean values of SWE (kPa) and SWE (m/Sn) in both the right and left parotid glands (p < 0.05). The patient group had significantly reduced stimulated and unstimulated salivary flow rates (p < 0.05). Hypothyroidism has been shown to be associated with structural and functional changes in the salivary glands, including decreased salivary flow and increased gland stiffness. US and SWE are reliable imaging methods for evaluating the salivary glands in individuals with hypothyroidism.

Evaluation of Diabetic Retinopathy in Patients With Diabetes Mellitus Using 2D-Shear Wave Elastography (SWE), Ultra-Microangiography (UMA), and Doppler Imaging.

In chronic diseases, accelerated muscle mass loss is associated with poor clinical outcomes. Computed tomography (CT) is considered a reference standard for assessing muscle mass, but it is limited for longitudinal assessment. Ultrasound (US) is more suitable for longitudinal measurements, but limited reliability data or reference values exist to inform clinical adoption. This pilot study evaluated the reliability of rectus femoris (RF) muscle US measurements [cross-sectional area (CSA) and shear-wave elastography (SWE) stiffness] and investigated their relationship with CT-derived truncal muscle mass. Forty healthy living liver donors undergoing abdominal CT were included. CT-derived skeletal muscle area and skeletal muscle index at T12 and L3 were quantified using deep learning. US B-mode and SWE RF images obtained with manual and automated measurements. Reliability was assessed using intraclass correlation (ICC). Agreement between manual and automated methods was evaluated using the Dice coefficient. US and CT measurements associations were evaluated using Pearson correlation and multiple linear regression. Inter-reader agreement for manual US CSA was excellent (ICC=0.95, 95% CI: 0.88-0.97). Test-retest reliability of SWE was good (ICC=0.78, 95% CI: 0.67-0.87). Automated and manual methods showed strong agreement (Dice coefficient 0.94) and good reliability (ICC=0.85, 95% CI: 0.75-0.91). RF CSA demonstrated weak but significant correlations with CT-derived skeletal muscle area at both T12 and L3 levels (r=0.37 to 0.40, P<0.05). US parameters showed moderate predictive value for CT-derived skeletal muscle index at L3 (adjusted R²=0.70). In conclusion, RF US measurements are reliable, and automated measurements are feasible but show a modest correlation with CT-derived muscle mass measurements.

Acoustic guide pad: a simple innovation that dramatically reduces the risk of misdiagnosis in respiratory muscle ultrasound examinations.

Achilles tendon (AT) plays a crucial role during walking. In cerebral palsy (CP), altered neuromuscular development appears to affect AT morphology and stiffness, disrupting muscle-tendon interaction and gait. This study quantified differences in static AT morphology and passive mechanical properties in children and young adults with CP and examined whether these properties are related to AT function during walking. Twelve young individuals with CP and 12 typically developing (TD) peers underwent three-dimensional freehand ultrasonography to obtain AT datasets from which cross-sectional area (CSA) and lengths were extracted. Shear wave elastography was used to estimate the shear modulus of the free AT. Three-dimensional gait analysis was synchronized with ultrasound during overground walking, enabling estimation of AT length changes during stance along with lower-limb kinematics and kinetics. Free AT was 86.7±34.6mm longer in CP than TD (p=0.015) and remained longer after normalization to tibia length (p=0.025). No significant differences were observed in medial gastrocnemius AT length and CSA. Within CP, CSA was correlated negatively with walking speed (r=-0.66, p=0.026) and positively correlated with AT length changes during walking (r=0.79, p=0.002). This study shows that the free AT length is longer in CP than in TD peers, with no differences in AT CSA. Only limited structure-function associations were observed, suggesting altered involvement of AT stretch-recoil during walking in CP. These explorative results require further evaluation with larger samples and homogenous CP groups.

Effect of heel drop static stretching on triceps surae stiffness through shear wave elastography.

The long head of the biceps brachii muscle is lengthened by compression in the proximal and distal regions.

Changes in forearm muscle stiffness in relation to grip strength.

Diagnostic accuracy of liver and spleen stiffness measured by two-dimensional shear wave elastography and transient elastography for high-risk varices: A prospective cross-sectional study.

Elastographic data regarding thyroid involvement in systemic sclerosis (SSc) are limited. This study aimed to evaluate thyroid parenchymal stiffness in patients with SSc using two-dimensional shear wave elastography (2D-SWE) and to investigate its relationship with clinical parameters. This single-center, cross-sectional case-control study included 36 SSc patients and 36 age- and gender-matched healthy controls. All participants underwent thyroid ultrasonography and 2D-SWE. Thyroid volume was calculated using the ellipsoid formula, and elasticity values were recorded in kilopascals (kPa). Clinical characteristics, laboratory parameters, and disease severity indices were recorded, and correlation analyses were performed. Thyroid volume and isthmus thickness were similar between groups (all p > 0.05; d = 0.10-0.35). Right, left, and total thyroid elasticity values were significantly higher in SSc patients than in controls before and after smoking adjustment (all unadjusted p ≤ 0.001; all adjusted p ≤ 0.007; d = 0.83, 0.79, and 0.90, respectively). Right lobe elasticity correlated weakly with erythrocyte sedimentation rate (r = 0.355; p = 0.034), while left and total thyroid elasticity correlated moderately with ejection fraction (r = 0.423; p = 0.010 and r = 0.390; p = 0.019, respectively). No significant associations were found with disease duration, modified Rodnan skin score, EUSTAR Activity Index, Medsger Disease Severity Score, autoantibody status, or major organ involvement. In SSc, thyroid parenchymal stiffness increases without volume change. This suggests that the fibrotic process may be reflected in the thyroid tissue at a subclinical level. Thyroid elastography may be a potential method for evaluating organ-specific fibrotic changes in SSc; further large-scale and prospective studies are needed to clarify its clinical significance.

Systemic sclerosis-associated interstitial lung disease (SSc-ILD) is characterized by microvascular injury and progressive fibrosis leading to respiratory impairment. This study aimed to evaluate the effect of anti-fibrotic therapy on intercostal and diaphragmatic shear wave elastography (SWE) measurements in patients with SSc-ILD and to assess their relationship with pulmonary function tests and Borg dyspnea scores. 30 patients with SSc-ILD receiving stable background therapy and 30 healthy controls were evaluated prospectively between January and August 2025. Intercostal and diaphragmatic SWE, pulmonary function tests, and Borg dyspnea scores were obtained before and three months after initiation of anti-fibrotic therapy. At three months, SSc-ILD patients showed significant improvement in FVC and FEV₁ (p = 0.009 and p = 0.02), while Borg scores and intercostal and diaphragmatic SWE values decreased (all p < 0.001). Elastography measurements regressed to levels comparable with controls. Changes in intercostal SWE correlated with ΔFVC and ΔFEV₁ (R = -0.769, p < 0.001 and R = -0.492, p = 0.007), and ΔBorg correlated with both intercostal and diaphragmatic SWE (R = 0.89 and R = 0.793, both p < 0.001). In multivariable analysis, elastographic improvement was the strongest determinant of dyspnea reduction (p < 0.001). Anti-fibrotic therapy initiation was associated with early reductions in respiratory muscle elastographic stiffness parameters and dyspnea in SSc-ILD. These short-term changes may reflect early biomechanical or functional alterations rather than definitive structural remodeling.

Chronic liver diseases are a major global health burden, with cirrhosis and portal hypertension driving morbidity and mortality. Non-invasive assessment of portal hypertension is critical for risk stratification and clinical decision-making. Spleen stiffness measurement (SSM) has emerged as a novel elastography-based biomarker reflecting the hemodynamic consequences of portal hypertension. This review summarizes current evidence on SSM across major chronic liver disease etiologies, including viral hepatitis, metabolic-associated fatty liver disease, and autoimmune liver diseases. We outline the principles and technical evolution of SSM across elastography platforms, including transient elastography, shear-wave elastography, and magnetic resonance elastography. Emerging data indicate that SSM provides incremental value beyond established non-invasive markers such as liver stiffness measurement and platelet count, particularly in refining risk stratification for clinically significant portal hypertension and high-risk varices. SSM may reduce unnecessary endoscopic screening and improve patient selection for therapeutic interventions. This review is based on a structured literature search of PubMed and Web of Science. SSM is a promising non-invasive biomarker with increasing translational relevance in the management of chronic liver diseases. With further standardization and prospective validation, SSM has the potential to support precision risk stratification and guide individualized clinical decision-making.

This study investigated the comparative acute effects of 3 × 30 s of vibration foam rolling (VFR) or percussive massage (PM) on the hamstring muscles, specifically range of motion (ROM), maximum voluntary isometric contraction (MVIC), and muscle stiffness, using shear wave elastography (SWE), tensiomyography (TMG), and the MyotonPro. Further, the correlation between the three stiffness measures was examined. Seventeen participants (27.1 ± 3.1 years; 7 females) were randomized to VFR or PM on two occasions. Muscle stiffness of the biceps femoris (BF) was assessed at baseline and immediately post-intervention with SWE, TMG, and the MyotonPro. A sit-and-reach test was conducted and MVIC of the hamstring muscles was measured unilaterally. A significant time effect was observed for MVIC torque (p = 0.01, ƞ² = 0.319). ROM and BF muscle stiffness were unaffected by either intervention. No significant associations were found between the stiffness measurements from the three techniques. The acute application of 3 × 30 s of VFR or PM did not enhance ROM or alter BF muscle stiffness. However, both interventions reduced MVIC torque, with no significant difference between them. The lack of correlation between the SWE, TMG, and MyotonPro measurements suggests that these techniques cannot be used or interpreted interchangeably.

Limited Utility of Serum Scores vs. Shear Wave Elastography for Graft Fibrosis in Adult and Pediatric Liver Transplant Recipients.

Shearwave elastography (SWE) to detect hyperglycaemic changes in the placenta (a pilot feasibility study).

Inspiratory effort is associated with the recruitment of extra-diaphragmatic muscles, including parasternal intercostal muscles (PIM). The mechanical behavior of PIM and its relationship to indices of inspiratory effort in humans remains poorly characterized. We investigated whether PIM stiffening, assessed using ultrafast ultrasound shear wave elastography (SWE), tracks inspiratory effort breath-by-breath during graded inspiratory loading. Fourteen healthy adults (9 men, 5 women) were studied during quiet breathing and inspiratory threshold loading at 10, 20, 30, and 40% of maximal inspiratory pressure. Inspiratory changes in PIM shear modulus (Δµ) were quantified from SWE and related to esophageal (ΔP̄es) and transdiaphragmatic (ΔP̄di) pressure swings, pressure-time products (PTP̄es, PTP̄di), and crural diaphragm EMG (EAdi). The ability of Δµ to detect increased inspiratory effort was evaluated per breath using ROC analysis. Inspiratory loading induced progressive increases in PIM stiffening (Δµ: 10.2 ± 7.4 to 24.0 ± 15.9 kPa, P < 0.001). Δµ showed strong within-subject correlations with ΔP̄es and ΔP̄di (R = 0.72 and R = 0.68, respectively; both P < 0.0001) and moderate correlations with PTP̄es and PTP̄di (R = 0.50 and R = 0.49, respectively; both P < 0.001). Δµ was also moderately correlated with EAdi (R = 0.45, P < 0.001). Breath-by-breath Δµ discriminated breaths with increased inspiratory effort with a pooled ROC AUC of 0.78. PIM stiffening increased proportionally with inspiratory load and was correlated with established pressure- and activation-based indices of inspiratory effort. These findings define the mechanical behavior of the PIM during loaded breathing and identify PIM stiffening as a non-invasive mechanical readout of increased inspiratory effort in humans.

To determine whether shear-wave elastography (SWE) can detect subclinical parenchymal changes related to chronic inflammation and AA amyloid risk by measuring liver, spleen, and thyroid stiffness in children with Familial Mediterranean Fever (FMF) in remission compared with healthy controls. In this prospective case-control study, 43 children with FMF and 50 age- and sex-matched healthy controls underwent SWE of the liver, spleen, and thyroid using a standardized protocol. All FMF patients were evaluated during clinical remission. Clinical characteristics and laboratory parameters, including inflammatory markers, were recorded. Measurements were performed by two blinded radiologists. For the liver and spleen, five technically valid ROIs were obtained from each organ; for the thyroid gland, five ROIs were obtained from each lobe. The arithmetic mean of technically valid ROI measurements was used as the final stiffness value for each organ. AST, ALT, ESR, and CRP levels were higher in the FMF group (all p < 0.001). However, liver, spleen, and thyroid stiffness values did not differ between groups (all p > 0.05). Thyroid stiffness showed a weak, non-significant association with ESR (Spearman's rho = 0.376, p = 0.013). SWE-derived stiffness values were similar between children with FMF in remission and controls, suggesting limited sensitivity for detecting subclinical organ involvement. This study demonstrates that SWE-derived organ stiffness remains unchanged in children with FMF in remission despite biochemical evidence of low-grade inflammation, highlighting the need for further studies across different disease states and longitudinal settings.

Background: EUS point shear‑wave elastography (EUS‑pSWE) permits near‑field, intraluminal assessment of liver stiffness. Objective: We examined its concordance with vibration-controlled transient elastography (VCTE) and its diagnostic accuracy for advanced fibrosis (F ≥ 3) in an expanded mixed cohort. Methods: One hundred twenty adults (57% men; mean age: 61 ± 10 years; body mass index: 28.9 ± 4.0) undergoing routine endoscopic ultrasound were prospectively enrolled. VCTE stratified fibrosis as F0–1 (&lt;7.0 kPa, n = 96), F2 (7–9.4 kPa, n = 11) and F3‑4 (≥9.5 kPa, n = 13). In all the patients, 10 EUS‑pSWE measurements were performed in each lobe, and the liver stiffness result was the median value of the 10 measurements. Correlation (Pearson’s r ), Bland–Altman agreement, and diagnostic indices for F ≥3 were calculated. Results: Median EUS‑pSWE increased with fibrosis (left lobe: 5.0 ± 0.9, 7.8 ± 1.0, 15.1 ± 3.4 kPa for F0–1, F2, F3–4; P &lt; 0.001). EUS-pSWE correlated strongly with VCTE ( r = 0.89, left; r = 0.88, right; P &lt; 0.0001). AUROC for detecting F ≥3 reached 0.91 (95% confidence interval: 0.85–0.96) for the left and 0.89 (0.83–0.95) for the right lobe. A 10.2 kPa cutoff value for F3 afforded 85% sensitivity, 84% specificity, positive predictive value 72%, and negative predictive value 93%. EUS-pSWE provided lobe-independent stiffness estimates that tracked VCTE closely to recognize advanced fibrosis. Conclusions: Its high diagnostic accuracy across fibrosis stages and ability to integrate seamlessly into routine EUS make EUS-pSWE a valuable tool for comprehensive liver assessment.

Role of shear wave elastography in the evaluation of cervical lymph nodes during follow-up of differentiated thyroid carcinoma.

In ultrasound time-harmonic elastography, tissue elasticity is estimated from the ultrasound-measured shear-wave displacement fields, generated by an external vibrator. Commonly used techniques to map from the ultrasound pulse-echo data to tissue elasticity maps, such as the phase-gradient and local-frequency estimation methods, base their estimates on a set of displacement field data and do not involve direct numerical modeling of the underlying shear-wave propagation. In the current proof-of-concept study, the objective is to develop a Full-Waveform Inversion (FWI) approach to ultrasound-based time-harmonic elastography, providing a physics-driven framework for improved tissue elasticity estimation. FWI is a methodology commonly applied in geophysics. It relies on simulating the wave propagation and scattering in heterogeneous media to model the intricate relationship between the observed wavefield and the propagation medium properties. Our FWI-based tissue-harmonic elastography approach is based on minimizing a cross-correlation based objective function that quantifies phase mismatches between measured and simulated shear waves. Experiments on synthetic phantom data obtained from the fractional Kelvin-Voigt wave model demonstrate that our approach accurately reconstructs the shear wave speed of the medium, even in the presence of significant noise, and without relying on pre-filtering steps such as directional filtering, which selects waves based on their propagation direction. An improvement of approximately 0.4 m.s -1 within the inclusion region, compared to an established method, is observed for a noisy wavefield with decreasing signal-to-noise ratio, ranging from 20 to -10 dB from top to bottom of the ultrasound image. In addition, the reconstructed shear-wave speed map achieved a 50% reduction in standard deviation. This work demonstrates the potential for enhanced elasticity mapping using FWI-based reconstruction in time-harmonic elastography with prospective impacts for future clinical applications.