Shear Wave Imaging Research Articles

Suppression of the influence of surface waves on shear wave imaging for buried pipe location

Shear wave imaging has been proposed to detect shallow buried target objects in recent years. However, moderate results have been achieved with limited success since the resultant surface waves hinder the practical applicability of the method. In this paper the influence of surface waves is reduced prior to the image fusion for pipe localization. Field tests were carried out in the Hefei Institute of Public Safety, Tsinghua University. A sensor array was adopted to measure the ground surface vibration in response to the shear wave excitation. The method of connected subgraph traversal is applied to each image to show the suspected depth region of the target pipe. The fused image is subsequently obtained by extracting and fusing the suspected feature regions from the sequence imaging results and attenuating them with equal weighting. The image is finally analyzed to identify the burial depth. Furthermore, the effect of different sensor types and the interference effect of ambient noise on the imaging results are investigated experimentally. Test results show good agreement between the detected and actual depth of the buried pipeline.

Efficacy of shear wave elasticity for evaluating myocardial hypertrophy in hypertensive rats

Shear wave (SW) imaging is a novel ultrasound-based technique for assessing tissue characteristics. SW elasticity may be useful to assess the severity of hypertensive left ventricular (LV) hypertrophy. This study aimed to evaluate the efficacy of SW elasticity for assessing the degree of myocardial hypertrophy using hypertensive rats. Rats were divided into hypertension group and control group. SW elasticity was measured on the excised heart. Myocardial hypertrophy was assessed histologically. LV weight was greater in hypertension group. An increase in interventricular septum and LV free wall thicknesses was observed in hypertension group. SW elasticity was significantly higher in hypertension group than in control group (14.6 ± 4.3 kPa vs. 6.5 ± 1.1 kPa, P < 0.01). The cross-sectional area of cardiomyocytes was larger in hypertension group than in control group (397 ± 50 μm2 vs. 243 ± 14 μm2, P < 0.01), and SW elasticity was positively correlated with the cross-sectional area of cardiomyocytes (R = 0.96, P < 0.01). This study showed that SW elasticity was higher in hypertensive rats and was closely correlated with the degree of myocardial hypertrophy, suggesting the efficacy of SW elasticity for estimating the severity of hypertensive LV hypertrophy.

Abstract 10693: Noninvasive Assessment of Contractility and Compliance of the Left Ventricle in Children: Myocardial Stiffness Measured Throughout the Cardiac Cycle by Shear Wave Imaging

Background: Intrinsic myocardial stiffness (MS) is load-independent, unlike most parameters to assess LV systolic and diastolic function. Pre-clinical studies have found good correlation between 1) peak-systolic MS and contractility (or ESPVR); 2) end-diastolic MS and compliance (or EDPVR). Shear wave imaging (SWI) by ultrafast ultrasound imaging allows MS measurement throughout the cardiac cycle. Methods (Fig 1): Five children with LV pressure-overload (LV-PO; 2 aortic stenosis, 3 coarctation) were studied during cardiac catheterization and there were 5 age-matched controls. Interventricular septal MS was measured by SWI every 100ms during the cardiac cycle, pre- and post-balloon dilation. ESPVR and EDPVR were assessed by pressure-volume loops by a pressure catheter and real-time 3D-echo volumes. Results (Fig 2): Peak-systolic MS was higher in LV-PO (22.7±6.7 kPa) than controls (8.4±2.8 kPa; p&lt;0.01) and compared to end-diastolic MS (LV-PO 4.8±1.7 kPa, control 1.3±0.8 kPa; p&lt;0.01). End-diastolic MS was correlated with LV end-diastolic pressure (r=0.74). Relief of PO did not change the peak MS in the LV-PO (p=0.88). Correlations between peak-systolic MS and ESPVR (r=0.72), and between end-diastolic MS and EDPVR (r=0.79) were confirmed. Conclusions: Non-invasive MS is a load-independent measure of LV systolic contractility and diastolic compliance in children.

Abstract 10567: Systolic and Diastolic Myocardial Stiffness of the Right Ventricle Free Wall Assessed by Ultrafast Ultrasound Imaging in Humans: Comparison with Pressure-Volume Loop in Healthy Volunteers and Pulmonary Arterial Hypertension Patients

Background: Echocardiographic parameters to assess systolic and diastolic RV function are strongly dependent on loading conditions. Myocardial stiffness (MS) is an intrinsic myocardial property that influences both diastolic and systolic cardiac function. MS is independent of loading conditions and pre-clinical studies have demonstrated a correlation between 1) systolic MS and contractility (or ESPVR); 2) end-diastolic MS and compliance (or EDPVR). Shear wave imaging (SWI) by ultrafast ultrasound imaging allows quantitative MS assessment at any time of the cardiac cycle. This noninvasive technique could provide load-independent measure of RV function. Methods (figure 1): Ten children, 5 pulmonary arterial hypertension patients (PAH) undergoing diagnostic right heart catheterization (RHC) were prospectively enrolled as well as 5 age-matched heathy volunteers (HV). MS was assessed at baseline and during FiO2 70%+40ppm NO for the PAH group. MS in the RV free wall using SWI every 100ms during the cardiac cycle. RV-ESPVR and RV-EDPVR were assessed by pressure-volume loops using a pressure catheter and real-time 3D-echo volumes. Results (figure 2): MS increased significatively in systole compared to end-diastole in both groups (p&lt;0.01) and more significantly in the PAH group (p&lt;0.01). In the PAH group, no difference was found in systolic MS between baseline and during FiO2 70%+40ppm NO (p=0.67). Systolic MS correlated with RV-ESPVR (r=0.75). End-diastolic MS correlated with RV-EDP (r=0.76) and RV-EDPVR (r=0.85). Conclusions: Our preliminary data demonstrate that MS could be a quantitative measure of RV contractility and diastolic compliance of the RV.

Detection of delamination and rebar debonding in concrete structures with ultrasonic SH-waveform tomography

The detection of delamination and rebar debonding is among the most frequently encountered issues for inspecting concrete for quality control and assurance. This paper presents a novel application of a 2D full-waveform inversion of ultrasonic SH-waves (SH-FWI) for detection of delamination and rebar debonding in concrete structures. The ultrasonic data are collected by a commercial shear-wave tomography device (MIRA) and analyzed by the SH-FWI method to extract the material properties (density and S-wave velocity) at mm-resolutions. Tested on a concrete slab with four delaminations of various sizes and depths and rebar debonding, the method was able to characterize all delaminations at accurate location and sizes, as well as identify the existence of rebar debonding. Compared to the synthetic aperture focusing technique (SAFT), the SH-FWI method provided clearer structural images with more detailed information of the delamination and rebar debonding.

Phase-Aberration Correction in Shear-Wave Elastography Imaging Using Local Speed-of-Sound Adaptive Beamforming

Shear wave elasticity imaging (SWEI) is a non-invasive imaging modality that provides tissue elasticity information by measuring the travelling speed of an induced shear-wave. It is commercially available on clinical ultrasound scanners and popularly used in the diagnosis and staging of liver disease and breast cancer. In conventional SWEI methods, a sequence of acoustic radiation force (ARF) pushes are used for inducing a shear-wave, which is tracked using high frame-rate multi-angle plane wave imaging (MA-PWI) to estimate the shear-wave speed (SWS). Conventionally, these plane waves are beamformed using a constant speed-of-sound (SoS), assuming an a-priori known and homogeneous tissue medium. However, soft tissues are inhomogeneous, with intrinsic SoS variations. In this work, we study the SoS effects and inhomogeneities on SWS estimation, using simulation and phantoms experiments with porcine muscle as an abbarator, and show how these aberrations can be corrected using local speed-of-sound adaptive beamforming. For shear-wave tracking, we compare standard beamform with spatially constant SoS values to software beamforming with locally varying SoS maps. We show that, given SoS aberrations, traditional beamforming using a constant SoS, regardless of the utilized SoS value, introduces a substantial bias in the resulting SWS estimations. Average SWS estimation disparity for the same material was observed over 4.3 times worse when a constant SoS value is used compared to that when a known SoS map is used for beamforming. Such biases are shown to be corrected by using a local SoS map in beamforming, indicating the importance of and the need for local SoS reconstruction techniques.

Coherent Plane Wave Compounding Combined With Tensor Completion Applied for Ultrafast Imaging.

To solve the problem of resolution and contrast in plane wave imaging (PWI), coherent plane wave compounding (CPWC) was introduced, in which scanning was performed at different angles, which can achieve the desired image quality by combining the images obtained from PWI at different angles. However, the application of this idea reduces the frame rate in proportion to the number of plane waves (PWs) or angles, so that in this modality, when dealing with some applications such as shear wave imaging (SWI) and strain imaging, there is always a compromise between the frame rate and the image quality. Tensor completion (TC) is a powerful technique to recover missing information of a low-rank tensor from limited observations based on rank minimization. In this article, we present an idea based on TC to make this compromise lighter; in other words, with a smaller number of angles, we can achieve the desired quality of the output image. To evaluate the proposed idea, plane wave imaging challenge in medical ultrasound (PICMUS) datasets was used, which were recorded at 75 different angles. The results of the resolution evaluation showed that using 20% of the coherent PWs and reconstructing other 80% by TC, compared with the situation of using only 20% of the coherent PWs provided a resolution improvement of 14.97% and 17.4% in the simulated and experimental point targets, respectively. Also, the results of the contrast investigation showed that the contrast ratio (CR) improved by 72.6%, 62.9%, and 111.4% in the simulated cyst target data, experimental cyst targets, and in vivo carotid cross section, respectively. The results confirmed that using 20% of the coherent PWs and reconstructing other 80% by TC, the image quality is very close to that obtained by considering all 75 angles, so that the difference in resolution is less than 2% and the difference in contrast to noise ratio (CNR) is less than 5 dB. Therefore, with this idea, it can be said that less compromise is needed; in other words, despite having a higher frame rate, an acceptable quality can be achieved.

An ex vivo investigation of ultrasonic shear wave imaging for detecting liver cracks

Liver crack is a type of liver trauma in which a capsular tear of different geometries occurs due to external impacts. Since liver crack is an important source of morbidity and mortality in emergency medicine, a timely and accurate detection of the crack location and geometry is highly demanded. In current emergency care, ultrasonography, although has a low accuracy, is mostly used for initial examination of liver trauma due to its immediate availability, high mobility, and nonionizing nature. To improve the diagnosis accuracy, ultrasonic shear wave imaging, a technique based on shear wave generation and tracking in liver tissue, was proposed. In this study, the feasibility and effectiveness of this method was investigated in an ex vivo scenario. A porcine liver with cracks of different geometries was tested. Shear waves were generated using acoustic radiation force impulse and recorded using ultrafast ultrasound imaging. To find the best way to display the cracks, different methods of signal processing based on time-of-flight, shear wave modulus, and accumulated shear wave path were applied to the shear wave displacement extracted. The results show that shear wave imaging is a more sensitive method than the conventional ultrasonography in detecting liver cracks.

Externally induced shear waves in the right ventricular free wall during the cardiac cycle

Increased right ventricular (RV) diastolic stiffness is linked to adverse prognosis in pulmonary arterial hypertension. Currently, a non-invasive method for measuring RV stiffness is lacking. In the left ventricle, shear wave (SW) speed is related to diastolic stiffness. We show for the first time that SWs in the RV free wall (RVFW) can be induced and imaged transthoracically with ultrasound. SW imaging was performed using an L7-4 array (ATL, USA) with a Vantage 256 system (Verasonics, USA) in a 5-weeks-old Yorkshire-Landrace pig (±120 beats/min). SWs were induced by a push beam (f0 = 4.5MHz, push duration = 800μs) on the RVFW and its propagation was imaged (f0 = 5.2MHz) using plane wave compounding (-12 deg, 0 deg, +12 deg) at 3 kHz framerate. Three acquisitions of 1 s were performed, where fourteen SWs were sequentially induced during each acquisition. SW propagation speeds were calculated using a semi-automatic pipeline that includes tissue velocity estimation along a manually traced spline on the RVFW, and Radon transform to estimate SW speed. At least 85% of the waves were tracked successfully for all acquisitions. The SW velocities varied during the heart cycle as expected, ranging from 0.58 ± 0.09 m/s at end-diastole to 1.8 ± 0.2 m/s during systole. Pathological increase in stiffness may be demonstrated in longitudinal case/control studies.

Fluids Alter Elasticity Measurements: Porous Wave Propagation Accounts for Shear Wave Dispersion in Elastography

In shear wave elastography, rotational wave speeds are converted to elasticity measures using elastodynamic theory. The method has a wide range of applications and is the gold standard for non-invasive liver fibrosis detection. However, the observed shear wave dispersion of in vivo human liver shows a mismatch with purely elastic and visco-elastic wave propagation theory. In a laboratory phantom experiment we demonstrate that porosity and fluid viscosity need to be considered to properly convert shear wave speeds to elasticity in soft porous materials. We extend this conclusion to the clinical application of liver stiffness characterization by revisiting in vivo studies of liver elastography. To that end we compare Biot’s theory of poro-visco-elastic wave propagation to Voigt’s visco-elastic model. Our results suggest that accounting for dispersion due to fluid viscosity could improve shear wave imaging in the liver and other highly vascularized organs.

Quantitative effects of off-resonance related distortion on brain mechanical property estimation with magnetic resonance elastography.

Off-resonance related geometric distortion can impact quantitative MRI techniques, such as magnetic resonance elastography (MRE), and result in errors to these otherwise sensitive metrics of brain health. MRE is a phase contrast technique to determine the mechanical properties of tissue by imaging shear wave displacements and estimating tissue stiffness through inverse solution of Navier's equation. In this study, we systematically examined the quantitative effects of distortion and corresponding correction approaches on MRE measurements through a series of simulations, phantom models, and in vivo brain experiments. We studied two different k-space trajectories, echo-planar imaging and spiral, and we determined that readout time, off-resonance gradient strength, and the combination of readout direction and off-resonance gradient direction, impact the estimated mechanical properties. Images were also processed through traditional distortion correction pipelines, and we found that each of the correction mechanisms works well for reducing stiffness errors, but are limited in cases of very large distortion. The ability of MRE to detect subtle changes to neural tissue health relies on accurate, artifact-free imaging, and thus off-resonance related geometric distortion must be considered when designing sequences and protocols by limiting readout time and applying correction where appropriate.

Parameter Identification for Ultrasound Shear Wave Elastography Simulation

Abstract Elasticity of soft tissue is a valuable information to physicians in treatment and diagnosis of diseases. The elastic properties of tissue can be estimated with ultrasound (US) shear wave imaging (SWEI). In US-SWEI, a force push is applied inside the tissue and the resulting shear wave is detected by high-frequency imaging. The properties of the wave such as the shear wave velocity can be mapped to tissue elasticity. Commonly, wave features are extracted by tracking the peak of the shear wave, estimating the phase velocity or with machine learning methods. To tune and test these methods, often simulation data is employed since material properties and excitation can be accurately controlled. Subsequent validation on real US-SWEI data is in many cases performed on tissue phantoms such as gelatine. Clearly, validation performance of these procedures is dependent on the accuracy of the simulated tissue phantom and a thorough comparison of simulation and experimental data is needed. In this work, we estimate wave parameters from 400 US-SWEI data sets acquired in various homogeneous gelatine phantoms. We tune a linear material model to these parameters. We report an absolute percentage error for the shear wave velocity between simulation and phantom experiment of &lt;2.5%. We validate our material model on unknown gelatine concentrations and estimate the shear wave velocity with an error &lt;3.4% for in-range concentrations indicating that our material model is in good agreement with US-SWEI measurements.

SWE and SMI ultrasound techniques for monitoring needling treatment of ankylosing spondylitis: study protocol for a single-blinded randomized controlled trial

BackgroundAnkylosing spondylitis (AS) is a high-incidence disease in young men that interferes with patients’ physical and mental wellbeing and overall quality of life (QoL). It is often accompanied by arthralgia, stiffness, and limited lumbar flexibility. Acupuncture is safe and effective for reducing the symptoms of AS, but the underlying mechanisms by which it does so are not fully understood. Therefore, to objectively assess acupuncture efficacy, which is critical for patients making informed decisions about appropriate treatments, we will use shear-wave elastography (SWE) and superb microvascular imaging (SMI) ultrasound techniques to evaluate elasticity of lumbar paraspinal muscles and blood flow to the sacroiliac joint (SIJ) in AS.MethodsWe will recruit a total of 60 participants diagnosed with AS and 30 healthy subjects. Participants will be randomly allocated 1:1 to either an acupuncture group or a sham control acupuncture group. Primary-outcome measures will be musculoskeletal ultrasound, Ankylosing Spondylitis Quality of Life Scale (ASQoL), Bath Ankylosing Spondylitis Metrology Index (BASMI), and the Visual Analogue Scale (VAS) for pain. Secondary outcome measures will be the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Function Index (BASFI), and Fatigue Scale-14 (FS-14). We will monitor the effect of acupuncture or sham acupuncture on blood flow and SIJ inflammation using SMI, lumbar-muscle stiffness using SWE and the lumbar paraspinal-muscle cross-sectional area (CSA) using a two-dimensional (2D) grayscale imaging. QoL, physical function, and fatigue will be assessed using an evaluation scale or questionnaire developed for this study, with outcomes measured by the ASQoL, BASMI, BASDAI, BASFI, and FS-14. Healthy subjects will not receive acupuncture but undergo only musculoskeletal ultrasound at baseline. Acupuncture and sham control acupuncture interventions will be conducted for 30 min, 2–3 times/week for 12 weeks. Musculoskeletal ultrasound will be conducted at baseline and post-intervention, while other outcomes will be measured at baseline, 6 weeks, and post-intervention. The statistician, outcome assessor, and participants will be blinded to treatment allocation.DiscussionThe results of this single-blinded, randomized trial with sham controls could help demonstrate the efficacy of acupuncture and clarify whether musculoskeletal ultrasound could be used to evaluate AS.Trial registrationClinicalTrials.gov ChiCTR2000031476. Registered 3 April 2020.

Using shear wave elastography to assess uterine tonicity after vaginal delivery

This study aims to evaluate the feasibility and clinical interest of shear wave elastography, by quantitatively estimating the baseline stiffness of the myometrium before and after placental expulsion. We conducted a prospective cohort study of women at term, without known risk factors for postpartum hemorrhage, who gave birth via spontaneous labor in our tertiary center. Myometrium tonicity was evaluated based on measurements of shear wave speed (SWS) in the anterior uterine corpus. All data points were collected by a single operator. Measurements were carried out at three different time points: after fetal delivery (T1), after placental delivery (T2) and 30 min after placental delivery (T3). Our primary objective was to assess the feasibility of this new imaging technique. Ten valid SWS measurements obtained at each of the three different time points were considered as a positive primary outcome. Our secondary objectives were to evaluate the difference in median myometrial shear wave velocity between each time point, as well as to determine the correlation between myometrial shear wave velocity and patients’ characteristics. 38 women were recruited during the study period, of whom 34 met the study criteria. 1017 SWS measurements were obtained. The median time to perform measurements was 16 s for one value, and 2 min 56 s for ten. For 11 women (32%) it was not possible to achieve ten SWS at T1 as placental expulsion immediately followed the birth of the newborn. One patient experienced placental retention and only measurements at T1 were performed. For all other patients, we were successfully able to obtain all measures as intended. There was no difference in the mean shear wave speed between the three time points. After adjustments for confounders, we observed a significant correlation for total blood loss (correlation coefficient = − 0.26, p < 0.001, units of oxytocin (correlation coefficient = − 0.34, p = 0.03), and newborn weight (correlation coefficient = − 0.08, p = 0.001). It is feasible to assess uterine tonicity by shear wave imaging, after placental expulsion. We did not observe a variance in uterine tonicity between the three time points. Women who had higher blood loss, received more units of oxytocin and/or those with newborns of a higher weight exhibited lower shear wave speed measures.

Fibrosis in hypertrophic cardiomyopathy: role of novel echo techniques and multi-modality imaging assessment

Hypertrophic cardiomyopathy (HCM) represents one of the primary cardiomyopathies and may lead to heart failure and sudden cardiac death. Among various histologic features of the disease examined, assessment of myocardial fibrosis may offer valuable information, since it may be considered the common nominator for all HCM connected complications. Late gadolinium-enhanced cardiac magnetic resonance (LGE-CMR) has emerged as the reference noninvasive method for visualizing and quantifying myocardial fibrosis in patients with HCM. T1 mapping, a promising new CMR technique, may provide an advantage over conventional LGE-CMR, by permitting a more valid quantification of diffuse fibrosis. On the other hand, echocardiography offers a significantly more portable, affordable, and easily accessible solution for the study of fibrosis. Various echocardiographic techniques ranging from integrated backscatter and contrast-enhanced ultrasound to two- (2D) or three-dimensional (3D) deformation and shear wave imaging may offer new insights into substrate characterization in HCM. The aim of this review is to describe thoroughly all different modalities that may be used in everyday clinical practice for HCM fibrosis evaluation (with special focus on echocardiographic techniques), to concisely present available evidence and to argue in favor of multi-modality imaging application. It is essential to understand that the role of various imaging modalities is not competitive but complementary, since the information provided by each one is necessary to illuminate the complex pathophysiologic pathways of HCM, offering a personalized approach and treatment in every patient.

Multiscale, radially anisotropic shear wave imaging of the mantle underneath the contiguous United States through joint inversion of USArray and global data sets

SUMMARYEarthScope's USArray seismic component provided unprecedented coverage of the contiguous United States and has therefore spurred significant advances in tomographic imaging and geodynamic modelling. Here, we present a new global, radially anisotropic shear wave velocity tomography model to investigate upper mantle structure and North American Plate dynamics, with a focus on the contiguous United States. The model uses a data-adaptive mesh and traveltimes of both surface waves and body waves to constrain structure in the crust and mantle in order to arrive at a more consistent representation of the subsurface compared to what is provided by existing models. The resulting model is broadly consistent with previous global models at the largest scales, but there are substantial differences under the contiguous United States where we can achieve higher resolution. On these regional scales, the new model contains short wavelength anomalies consistent with regional models derived from USArray data alone. We use the model to explore the geometry of the subducting Farallon Slab, the presence of upper mantle high velocity anomalies, low velocity zones in the central and eastern United States and evaluate models of dynamic topography in the Cordillera. Our models indicate a single, shallowly dipping, discontinuous slab associated with the Farallon Plate, but there are remaining imaging challenges. Inferring dynamic topography from the new model captures both the long-wavelength anomalies common in global models and the short-wavelength anomalies apparent in regional models. Our model thus bridges the gap between high-resolution regional models within the proper uppermost mantle context provided by global models, which is crucial for understanding many of the fundamental questions in continental dynamics.

Defect detection in concrete plates with impulse-response test and statistical pattern recognition

Statistical and machine learning analysis of structural health monitoring data is a popular approach for efficient structural level defect detection. However, the application of these techniques to stress-wave methods such as impact-echo and impulse-response data for local level detection has been limited. In this research, statistical pattern recognition in conjunction with the impulse-response test is shown to provide an efficient means for the detection of defects in concrete plates. For this purpose, the Frequency Response Function (FRF) derived from the impulse-response test following ASTM C1740 protocols at specific points on the test plate to define the feature space matrix. Analytical results demonstrate that the variability of the FRF increases in the presence of defects, which forms the physical basis for the proposed pattern recognition algorithm. First, Principal Component Analysis (PCA) is performed on the covariance of the feature space matrix to identify the dominant features of the FRFs and to determine the number of statistically significant factors or principal components. Factor scores are next used to identify locations on the plate that are associated most closely to each pattern. The generalized Extreme Value Studentized (ESD) test and box and whisker plots are applied to the factor score vector of all the test points to objectively identify test points with defects and rank these based on their severity. Two experimental specimens are used to demonstrate the applicability of the proposed detection algorithm. The first specimen, a partially reinforced clamped concrete plate, is used to demonstrate the relationship between the shapes and variability of the FRFs and the severity of defects (delaminations), the efficacy of the factor score as damage sensitive feature, and identification and the ranking of the severity of defects by using outlier statistical tests. The second specimen is used to demonstrate the efficiency of the procedure for detecting both void and honeycomb defects in a larger reinforced concrete plate on elastic supports. The proposed procedure is shown to provide similar levels of detectability as the highly refined yet time consuming ultrasonic shear-wave tomography test. While the impulse-response test has been in use for the condition assessment of concrete elements other than drilled shaft piles since 1980′s, defect detection has been based primarily on empirical observations and correlations with limited features of the frequency response function. The use of pattern recognition techniques to the full range of the frequency response function is proposed and shown to greatly improve the detection and characterization of defects.

Normal values of combinational elastography in adult liver: the influence of age.

We aimed to clarify the normal values obtained by simultaneous use of shear wave imaging and strain imaging (combinational elastography) in liver and reveal how aging influences them. In our checkup center, 257 examinees were diagnosed with normal liver based on questionnaires about liver disease and their drinking history, liver function test results, and ultrasound B-mode study findings. We estimated the values of combinational elastography and considered the correlation between the values and age. A multivariate analysis was performed concerning several features and the liver fibrosis (LF) index. We divided examinees into a younger group (< 65years old) and an older group (≥ 65years old), and assessed the effect of age on the LF index. The mean shear wave velocity (Vs) of shear wave measurement (SWM) was 1.10 ± 0.17m/s (range 0.84-1.93), and the mean LF index of real-time tissue elastography (RTE) was 1.371 ± 0.458 (range 0.258-3.173). There was no significant correlation between Vs and age. However, the LF index increased significantly with age. The multivariate analysis showed that age (P < 0.001) and BMI (P < 0.05) significantly affected the LF index. Indeed, the LF index in the older group was significantly higher than that in the younger group (P < 0.001). In adult liver, the normal Vs of SWM was 1.10 ± 0.17m/s, and the normal LF index of RTE was 1.371 ± 0.458. The LF index increased significantly with age in contrast to Vs; therefore, the influence of age should be considered when using combinational elastography.

Shear Wave Velocity Estimation Using the Real-Time Curve Tracing Method in Ultrasound Elastography

The estimation of shear wave velocity is very important in ultrasonic shear wave elasticity imaging (SWEI). Since the stability and accuracy of ultrasonic testing equipment have been greatly improved, in order to further improve the accuracy of shear wave velocity estimation and increase the quality of shear wave elasticity maps, we propose a novel real-time curve tracing (RTCT) technique to accurately reconstruct the motion trace of shear wave fronts. Based on the curve fitting of each frame shear wave, the propagation velocity of two-dimensional shear waves can be estimated. In this paper, shear wave velocity estimation and shear wave image reconstruction are implemented for homogeneous regions and stiff spherical inclusion regions with different elasticity, respectively. The experimental result shows that the proposed shear wave velocity estimation method based on the real-time curve tracing method has advantages in accuracy and anti-noise performance. Moreover, by eliminating artifacts of shear wave videos, the velocity map acquired can restore the shape of inclusions better. The real-time curve tracing method can provide a new idea for the estimation of shear wave velocity and elastic parameters.

Smart ultrasound device for real-time myocardial stiffness quantification of the human heart

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): ERC Introduction Myocardial stiffness (MS) is crucial to understand cardiac biomechanics and evaluate cardiac function. We recently demonstrated that shear wave imaging using acoustic radiation force can provide quantitative end-diastolic MS in human patients [1] . However, the dependence of shear wave velocity with myofiber orientation remained a limitation and required to perform Shear Wave Velocity (SWV) estimations from different probe orientations which is challenging in clinical practice. We propose a new approach to provide real-time quantitative assessment of MS without dependence of the probe orientation based on a dedicated smart ultrasound (US) device. Methods A new US probe was designed and manufactured to generate acoustic radiation force along the central axis and track the SWV simultaneously along three different orientations to obtain an elliptic profile of SWS. The probe was connected to dedicated electronics and software to provide real-time end-diastolic MS with ECG gating. Validation was performed on 4 in-vitro calibrated phantoms (0.92 – 1.49 – 2.58 – 3.49 m/s) and on ex vivo porcine hearts. MS along and across the fibers were compared to the values measured by conventional shear wave imaging with a linear probe mounted on a rotation motor (angular step of 10°) (Aixplorer, Supersonic imaging). Finally, the in vivo feasibility and reproducibility of measuring MS of the antero-septal wall and of the right ventricular (RV) wall was assessed transthoracically on four human volunteer . Results In vitro results on phantoms showed a good agreement with calibrated value (r2 = 0.98, std = 4.8%). Elliptic profiles on ex-vivo porcine heart showed good agreement with Aixplorer measurements acquired at different angles, with a relative difference along the long axis (LA) of: Δ=7.0%, Δ=7.1%, Δ=9% respectively for left ventricle (LV), right ventricle (RV) and septum. Finally, myocardial SWV assessment in human volunteers was obtained successfully on the RV and on the septum in late diastole. The mean MS was 1.79+/- 0.15 m/s along the fiber direction, the fractional anisotropy (FA) was 0.25 +/- 0.06 on septal wall in good agreement with previous results [1] and 1.06 +/- 0.11 m/s along fibers orientation and a FA of 0.27 +/- 0.08 on RV. Finally the beat to beat reproducibility of MS measurement was estimated to be 8.22%. Conclusion The new smart US device allowed non-invasive quantification of anisotropic myocardial tissues in real time. Results showed the accuracy of the methods. This approach could offer a new clinical tool for the evaluation of the myocardium in cardiomyopathies and in heart failure patients. Abstract Figure. SWV on myocardium human volonteer