Strain Ration Research Articles

Applied research of ultrasound real-time elastography in early diagnosis of congenital muscular torticollis in infants

Objective To discuss the applied value of ultrasound real-time elastography (RTE) in early diagnosis of congenital muscular torticollis (CMT) in infants. Methods Three hundred and thirty-six infants with CMT under 3-year-old were received the conventional ultrasound and RTE examination on their diseased sternocleidomastoid (SCM). And then a retrospective analysis was carried out by comparing the examination result with clinical observation and surgical pathology. Results The ultrasound performance of these 336 infants were divided into mass type (251 cases, 75%), and diffuse type (85 cases, 25%). RTE score for healthy side was grade Ⅰ; RTE scores for unhealthy side was grade Ⅱ in 97 cases, grade Ⅲ in 186 cases, and grade Ⅳ in 53 cases, respectively. Strain ration (SR) for mass type was 0.76-4.42, and for diffuse type was 1.49-7.07. By regarding pathological result as the standard, ROC curve was constructed to determine the best operation opportunity guided by ultrasound, SR 3.35 was a critical point of operative and nonoperative treatment (sensitivity 87.7%, specificity 98.2%, accuracy 96.1%). By using RTE dynamic observation, 272 cases (81%) with low RTE scoring of CMT got the effect by non-operative treatment and 64 cases (19%) with high RTE scoring of CMT were cured by operative treatment. Conclusions RTE can provide more objective semi-quantitative data about stiffness for SCM disease and it′s helpful for making resonable clinical treatment plans and dynamically observing its efficacy. Key words: Elasticity imaging techniques; Infant; Torticollis

Ultrasound elastography in pathological enlarged cervical lymph nodes compared to histopathology

ObjectiveTo detect the diagnostic efficiency of ultrasound elastography in differentiation between benign and malignant enlarged cervical lymph nodes. Patient and methodsThis study included 27 patients, ranging in age from 21 to 70 years. Enlarged cervical lymph nodes were defined in this study as those nodes having short axis measuring more than 8 mm. Approval was taken from our hospital institutional review board and an informed consent was obtained from each patient before participating in the study. All patients were subjected to B-mode ultrasound and ultrasound elastography. ResultsB-mode score had the highest sensitivity in this study (sensitivity=100%) and the least specificity and positive predictive value. Ultrasound Elastography (UE) and strain ration (SR) showed higher specificity (75%) and PPV (81.3% and 82.4% respectively). There was a statistical significant difference between the diagnostic performance of ES and B-mode score (p=0.034), and a nearly significant difference between SR and B-mode score (p=0.059). ROC curve analysis for SR measurements (cutoff value ⩾1.62) showed sensitivity=93.3%, specificity=75% and overall accuracy=85.2%. However, no statistically significant difference was shown between the performance of ES and SR (p=0.317). ConclusionHardness on more than 50% of the node surface and SR>1.62 are fair to good indicators of malignancy.