Value Of Shear Wave Elastography Research Articles

Experimental study on monitoring microwave ablation efficacy by real-time shear wave elastography in ex vivo porcine brain

Objective: Glioma constitutes the most common primary malignant tumor in the central nervous system. In recent years, microwave ablation (MWA) was expected to be applied in the minimally invasive treatment of brain tumors. This study aims to evaluate the feasibility and accuracy of microwave ablation in ex vivo brain tissue by Shear Wave Elastography (SWE) to explore the application value of real-time SWE in monitoring the process of MWA of brain tissue. Methods: Thirty ex vivo brain tissues were treated with different microwave power and ablation duration. The morphologic and microscopic changes of MWA tissues were observed, and the diameter of the ablation areas was measured. In this experiment, SWE is used to quantitatively evaluate brain tissue’s degree of thermal injury immediately after ablation. Results: This study It is found that the ablation range measured by SWE after ablation is in good consistency with the pathological range [ICCSWEL1-L1 = 0.975(95% CI:0.959 − 0.985), ICCSWEL2-L2 = 0.887(95% CI:0.779 − 0.938)]. At the same time, the SWE value after ablation is significantly higher than before (mean ± SD,9.88 ± 2.64 kPa vs.23.6 ± 13.75 kPa; p < 0.001). In this study, the SWE value of tissues in different pathological states was further analyzed by the ROC curve (AUC = 0.86), and the threshold for distinguishing normal tissue from tissue after ablation was 13.7 kPa. The accuracy of evaluating ablation tissue using SWE can reach 84.72%, providing data support for real-time quantitative observation of the ablation range. Conclusion: In conclusion the accurate visualization and real-time evaluation of the organizational change range of the MWA process can be realized by real-time SWE.

Combined Assessment of 2-D Ultrasound and Real-Time Shear Wave Elastography of Low-Intensity Pulsed Ultrasound Therapy Efficacy in Rabbits with Achilles Tendinopathy

ObjectivesLow-intensity pulsed ultrasound (LIPUS) has been gradually used to treat Achilles tendinopathy. However, there are limited noninvasive and efficient instruments for monitoring the LIPUS efficacy in Achilles tendinopathy. The purpose of this study was to assess the therapeutic effectiveness of LIPUS following Achilles tendinopathy by two-dimensional (2D) ultrasound and real-time shear wave elastography (SWE). MethodsNinety New Zealand white rabbits were divided into control, sham, and LIPUS groups after tendinopathy modeling. On days 1, 4, 7, 14, and 28, the Achilles tendon thickness and SWE Young's modulus on the long axis were measured. The tissues of the Achilles tendon were then evaluated histologically. ResultsThe mean SWE values increased while the average thickness and histologic scores decreased, especially in the LIPUS group (9.5% and 80.7% on Day 28, respectively). The SWE values in the LIPUS group were significantly lower than those in the control group on Day 1 (121.0 KPa vs. 177.6 KPa) and peaked on Day 7 (173.7 KPa, p<0.001). By Day 28, the SWE value had approached that of the control (191.2 KPa vs. 192.4 KPa), and it had been significantly higher than that in the sham group since Day 7. SWE values and histologic scores were correlated (r = -0.792, p<0.01). The average thickness decreased in the three groups but did not show significant differences. Conclusions2D ultrasound is beneficial to the diagnosis of Achilles tendinopathy. SWE could quantify changes in Achilles tendon stiffness noninvasively during LIPUS treatment, enabling the study of early Achilles tendon healing after LIPUS treatment.

Evaluation of placenta in patients with gestational diabetes using shear wave elastography and superb microvascular imaging.

Gestational diabetes mellitus (GDM) is a common disease, and the placenta shows various functional and morphological changes in these patients. Superb microvascular imaging (SMI) and shear wave elastography (SWE) are innovative ultrasound (US) methods that provide detailed information about tissue vascularization and elasticity. To evaluate placental changes in patients with GDM with SMI and SWE methods. For this case-control study, 20 healthy and 20 women with GDM were included. Women at >21 weeks of pregnancy were evaluated with SMI and SWE by two independent radiologists. Mean SMI values and mean SWE values from three different region of interest-based measurements were compared between the two groups. We identified that the mean SMI and SWE value ​​of the GDM group was found to be significantly higher than that of the control group (P = 0.002, P = 0.001 respectively). Using a receiver operating characteristic curve, the cutoff value of the SMI ratio, which maximizes the prediction of the presence of GDM, was 0.1234279750 (95% confidence interval [CI] = 0.625-0.920), the SWE cut-off value was 15.5 kPa (95% CI = 0.794-0.989). We have demonstrated that evaluation with SMI and SWE might allow quantitative assessment of the morphological changes of placentas in women with GDM. We believe that the use of innovative methods such as SMI and SWE in addition to conventional US examinations in daily practice and studies will provide significant clinical benefits to patient management.

Diagnosis of Benign and Malignant BI-RADS 4 Breast Masses by Contrastenhanced Ultrasound Combined with Shear Wave Elastography.

Breast cancer, one of the most prevalent malignant tumors in females, usually occurs in the breast epithelial tissues. The study aimed to explore the diagnostic value of contrast-enhanced ultrasound (CEUS) combined with shear wave elastography (SWE) in the diagnosis of benign and malignant breast masses in BI-RADS (Breast Imaging Reporting and Data System) 4. Examination outcomes and clinical information of 83 patients with BI-RADS 4 breast masses were analyzed retrospectively. These included patients who received CEUS, SWE, and pathological examinations. The difference of CEUS in determining the classification of BI-RADS 4 breast masses was evaluated using histopathological outcomes of breast masses as a reference standard. The diagnostic value of CEUS, SWE, and CEUS combined with SWE in the diagnosis of benign and malignant breast masses in BI-RADS 4 was also explored. Pathological biopsy results revealed 63 malignant masses and 20 benign masses among 83 BI-RADS 4 breast masses, with a 75.9% incidence of malignant masses. After the diagnosis of BI-RADS 4 breast masses with CEUS, SWE, and CEUS+SWE, the incidence of malignancy was 56.6%, 78.3%, and 73.5%, respectively. CEUS+SWE showed higher sensitivity (93.7% vs. 81% and 68.3%), specificity (90% vs. 30% and 80%), positive predictive value (96.7% vs. 78.5% and 91.5%), negative predictive value (81.8% vs. 33.3% and 44.4%), and diagnostic coincidence rate (92.8% vs. 68.7% and 71.1%) than SWE and CEUS alone in diagnosing pathological type of breast masses. Moreover, CEUS combined with SWE exhibited a larger area under the receiver operating characteristic (ROC) curve (0.918) than SWE (0.741, p = 0.028) and CEUS (0.555, p < 0.001) alone in the diagnosis of BI-RADS 4 breast masses. Overall, the diagnostic value of CEUS+SWE for the pathological type of BI-RADS is preferred over CEUS and SWE alone. CEUS+SWE showed higher values than CEUS and SWE alone in diagnosing BI-RADS 4 breast masses. Specifically, CEUS+SWE can correctly identify benign and malignant masses, reduce unnecessary trauma, and avoid misdiagnosis. In summary, CEUS combined with SWE can serve as an effective diagnostic method and avoid delaying the best treatment opportunity for some malignant lesions.

Correlation Between Postpartum Myometrial Elasticity and Obstetric Complications in Pregnant Women with Gestational Diabetes Mellitus.

To investigate postpartum myometrial elasticity in pregnant women with gestational diabetes mellitus (GDM) using shear wave elastography (SWE) and analyze the correlation between myometrial SWE values and obstetric complications. Clinical data of women who gave birth at Affiliated Hospital of Yangzhou University from August 2022 to July 2023 were retrospectively analyzed and divided into two groups based on GDM diagnosis: the GDM group and the healthy control group. SWE was used to measure the elasticity values of the anterior and posterior myometrial walls in both groups. Differences in placental attachment position and SWE values at the placental attachment site were compared between the two groups. Spearman correlation analysis was utilized to evaluate the correlation between SWE values and obstetric complications. Glycated hemoglobin (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR), fasting plasma glucose (FPG), 2-hour postprandial glucose (2h PG), triglycerides (TG), and total cholesterol (TC) levels were higher in the GDM group than in the healthy control group (P<0.05). There was a statistically significant difference in placental attachment position between the two groups (P<0.05). In both the GDM (17.52±0.42 vs 25.29±0.74, P=0.001) and control groups (14.06±5.01 vs 22.20±6.34, P=0.001), mean SWE values were significantly lower for anterior versus posterior placental attachment, and mean SWE values were also significantly higher in the GDM versus control group for both anterior (17.52±0.42 vs 14.06±5.01, P=0.001) and posterior placental attachment (25.29±0.74 vs 22.20±6.34, P=0.001). Spearman correlation analysis showed that postpartum hemorrhage (r=0.632, P=0.017), preeclampsia (r=0.818, P=0.014), premature rupture of membranes (r=0.710, P=0.012), placental abruption (r=0.732, P=0.031), and ketoacidosis (r=0.729, P=0.022) were negatively correlated with average myometrial SWE values in the GDM group (P<0.05). SWE values at the placental attachment site were higher in GDM patients than in healthy pregnant women, and myometrial elasticity was positively correlated with obstetric complications.

The Role of Superb Microvascular Imaging and Shear Wave Elastography in the Prediction of Hemorrhage Complications After Renal Parenchyma Biopsy.

The aim of study was to evaluate the diagnostic utility of the renal parenchyma elasticity with the shear wave elastography (SWE) and microvascularization with the superb microvascular imaging (SMI) technique before kidney biopsy and to predict the complication of hemorrhage before kidney biopsy. A total of 75 patients were included in the prospective study. Before the biopsy, vascularity features of the kidney parenchyma in the area to be biopsied were assessed by SMI and parenchymal stiffness by SWE and were examined by 2 independent radiologists. A statistically significant difference was found in the SMI and SWE values between the groups with and without hematoma and hematuria when compared with the Student t test and Mann-Whitney U test ( P < 0.05). The SWE hardness cutoff value, which maximizes the prediction of the development of hematuria, was found to be 18.40 kPa, and the sensitivity and specificity values were 84.4% and 62.8%, respectively. In SMI vascularity index values, the cutoff value was found to be 0.247410800 kPa, and sensitivity and specificity values were 81.3% and 83.7%, respectively. The cutoff value of the SMI vascularity index values that maximized the prediction of hematoma development was 0.297009650, and the sensitivity and specificity values were 87% and 87%, respectively. We believe that evaluating and standardizing the microvascularization and elasticity of the kidney parenchyma before a percutaneous kidney biopsy will be potentially useful as a guiding method in the prediction of postbiopsy hemorrhage development.

Non-invasive evaluation of testicular torsion using ultrasound shear wave elastography: an experimental study.

The goal of this study was to examine changes in testicular stiffness at various intervals after the induction of testicular torsion, as well as to assess the predictive value of testicular stiffness for testicular spermatogenesis after torsion. Sixty healthy male rabbits were randomly assigned to one of three groups: complete testicular torsion, incomplete testicular torsion, or control. All rabbits underwent preoperative and postoperative scrotal ultrasonography, including shear wave elastography (SWE), at predetermined intervals. Changes in SWE values were analyzed and compared using repeatedmeasures analysis of variance. To assess the diagnostic performance of SWE in determining the degree of spermatogenic function impairment, the areas under the receiver operating characteristic curves (AUCs) were calculated. SWE measurements in both central and peripheral zones of the testicular parenchyma affected by torsion demonstrated significant negative correlations with spermatogenesis, with coefficients of r=-0.759 (P<0.001) and r=-0.696 (P<0.001), respectively. The AUCs of SWE measurements in the central or peripheral zones of the torsed testicular parenchyma were 0.886 (sensitivity, 83.3%; specificity, 100%) and 0.824 (sensitivity, 83.3%; specificity, 73.3%) for distinguishing between hypospermatogenesis and spermatogenic arrest, respectively (P=0.451, DeLong test). Variations in the stiffness of both central and peripheral regions of the testicular parenchyma correlate with the extent and duration of torsion, exhibiting a specific pattern. The "stiff ring sign" is the characteristic SWE finding associated with testicular torsion. SWE appears to aid in the non-invasive determination of the extent of spermatogenic damage in torsed testes.

Analysis of the thenar muscles with ultrasound shear wave elastography: Reliability and preliminary findings.

Ultrasound shear wave elastography (SWE) of the thenar muscles has the potential to provide a simple and noninvasive assessment of the severity of carpal tunnel syndrome (CTS), but its reliability is unknown. The purpose of this study was to assess the intra- and inter-rater reliability of SWE measurements of the elastic modulus of individual thenar muscles, to assess their suitability for clinical application. Fourteen healthy volunteers, seven male and seven female, participated in this study. The elastic modulus of the thenar muscles was measured with SWE, with two independent examiners to assess inter-rater reliability. The first examiner also performed a second measurement after an interval of least 1 day to assess intra-rater reliability. Reliability was evaluated using an intraclass correlation coefficient (ICC) and 95% confidence interval (CI). For the abductor pollicis brevis (APB) and opponens pollicis (OPP), the CI of ICC in intra-rater reliability was 0.47-0.85 and 0.56-0.88, respectively. The CI of ICC in inter-rater reliability was 0.27-0.78 for the APB and 0.22-0.76 for the OPP. The ICCs of intra- and/or inter-rater reliability of other thenar muscles were less than 0.5. In this study, SWE evaluations of thenar muscles were quite variable in terms of their reliability. A larger study will be needed to determine the source of this variability, improve reliability, and assess the value of SWE in the evaluation of the severity of CTS.

Preoperative Role of Superb Microvascular Imaging and Shear-Wave Elastography for Prediction of Axillary Lymph Node Metastasis in Patients With Breast Cancer.

This study aims to evaluate the role of shearwave elastography (SWE) and superb microvascular imaging (SMI) for preoperative prediction of axillary lymph node metastasis (ALNM) in patients with breast cancer. In a cohort of 214 women with breast cancer, B-Mode ultrasonography (US), SMIvascular-index (SMIvi), and SWE (E-mean, E-ratio) values were recorded before tru-cut biopsy. Axillary fine-needle aspiration biopsy (FNAB) and sentinel lymph node sampling results were collected. Imaging findings and histopathological data were statistically compared. Receiver operating characteristic curve analysis was used to evaluate diagnostic performance. Reverse stepwise logistical regression analysis was conducted. Although ALNM was negative in 111 cases, it was positive in 103 patients. Axillary lymph node metastasis (+) group had larger size ( P < 0.001), higher vascularization (SMIvi: 8.0 ± 6.0 versus 5.0 ± 4.3, P < 0.001), and higher elasticity value (E-mean: 129 ± 31 kPa versus 117.3 ± 40 kPa, P = 0.014). Axillary lymph node metastasis was observed statistically more frequently in Her-2 positive cases ( P = 0.005). There was no significant difference between other B-mode US findings ( P > 0.05), SMI Adler ( P = 0.878), and E-ratio ( P = 0.212). The most appropriate cutoff value for the prediction of ALNM was 23.5 mm for size, 3.8 for SMIvi, and 138.5 kPa for E-mean. The most sensitive (77%) method was the SMIvi measurement, while the most specific (86%) finding was Her-2 positivity. The combined model (being Her-2 positive, >23.5 cm, and >3.8 SMIvi) increased the specificity (78%), PPV (71%), and accuracy (68%). Although the increased size is a previously studied parameter in predicting the risk of ALNM, Her-2 and data obtained by SWE, and SMI can be used to assist conventional US.

The value of ultrasound measurement of muscle thickness at different sites and shear wave elastography in Parkinson's disease with sarcopenia: a pilot study.

Patients with Parkinson's disease (PD) and sarcopenia often exhibit resilience, frailty, disability, and depression, highlighting the complex and interrelated nature of these conditions. Despite the presence of clinical manifestations of muscle atrophy in both PD and sarcopenia, accurately discerning the coexistence of sarcopenia in PD patients remains a challenging task with significant implications for treatment strategies and prognostic assessments. This study aims to elucidate the specific ultrasonic diagnostic parameters associated with PD accompanied by sarcopenia through a comparative analysis of muscle ultrasound parameters in patients with PD, thereby presenting a novel approach for rapid identification of this condition. A total of 110 participants were enrolled in this study, including patients with PD and control subjects. Demographic data, clinical characteristics, physical performance tests, appendicular skeletal muscle mass index (ASMI), bioelectrical impedance analysis and muscle ultrasound measurements were collected from all participants. The muscle ultrasound measurements encompassed assessments of muscle thickness, pennation angle and shear wave elastography at various anatomical sites. Parkinson's disease patients exhibited decreased muscle strength and physical performance, and increased shear wave elastography value. In PD patients with sarcopenia, body circumference, including calf circumference, mid-arm circumference, Waist-to-Hip Ratio and body mass index (BMI) were all significantly decreased. Biceps brachii muscle thickness (MT) and gastrocnemius MT decreased in PD patients with sarcopenia and low ASMI. Binary logistic regression analysis revealed that male PD patients, BMI and gastrocnemius MT were predictive factors for ASMI in PD patients. Biceps brachii MT and gastrocnemius MT are important indicators for distinguishing whether PD patients have sarcopenia. Male patients, low BMI and gastrocnemius MT were identified as valid predictors of low ASMI in PD patients. The findings of this study provide important insights into the use of muscle ultrasound in the diagnosis of PD with sarcopenia.

The Evaluation of Testes by Shear Wave Elastography in Patients with Isolated Hypogonadotropic Hypogonadism

Aim: The aim of this study was to evaluate testicular stiffness by shear wave elastography (SWE) in patients with isolated hypogonadotropic hypogonadism (IHH) and to compare it with healthy controls.&#x0D; &#x0D; Methods: In this prospective study, 35 patients with IHH (group 1) and 40 healthy controls (group 2) were evaluated. These two groups were compared in terms of age, testicular volume, and SWE values. In a subsequent analysis, IHH patients were divided into 3 groups: those who were newly diagnosed and did not receive any treatment (group A), those who received testosterone replacement (group B), and those who received human chorionic gonadotrophin alpha (hCG) (group C). Testicular volumes and SWE values were also compared between these subgroups.&#x0D; &#x0D; Results: Testicular volumes were significantly lower in group 1 than in group 2 (p

Comparison of ultrasonic shear wave elastography, AngioPLUS planewave ultrasensitive imaging, and optimized high-resolution magnetic resonance imaging in evaluating carotid plaque stability.

This study aimed to compare the efficiency of evaluating carotid plaque stability using ultrasonic shear wave elastography (SWE), AngioPLUS planewave ultrasensitive imaging (AP), and optimized high-resolution magnetic resonance imaging (MRI). A total of 100 patients who underwent carotid endarterectomy at our hospital from October 2019 to August 2022 were enrolled. Based on the final clinical diagnosis, these patients were divided into vulnerable (n=62) and stable (n=38) plaque groups. All patients were examined using ultrasound SWE, AP, and optimized high-resolution MRI before surgery. The clinical data and ultrasound characteristics of patients of the two groups were compared. Considering the final clinical diagnosis as the gold standard, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SWE, AP, high-resolution MRI, and the final clinical diagnosis of vulnerable plaque were calculated. Pearson's correlation test was used to analyze the correlations of AP, SWE, and MRI results with the grading results of carotid artery stenosis. Statistically significant differences were noticed in terms of the history of smoking and coronary heart disease, plaque thickness, surface rules, calcified nodules, low echo area, and the degree of carotid artery stenosis between the two groups (P<0.05). Considering the final clinical diagnosis as the gold standard, the sensitivity, specificity, PPV, and NPV of SWE-based detection of carotid artery vulnerability were 87.10% (54/62), 76.32% (29/38), 85.71% (54/63) and 78.38% (29/37), respectively, showing a general consistency with the final clinical results (Kappa = 0.637, P<0.05). Considering the final clinical diagnosis as the gold standard, the sensitivity, specificity, PPV and NPV of AP-based detection of carotid artery vulnerability were 93.55% (58/62), 84.21% (32/38), 90.63% (58/64), and 88.89% (32/36), respectively, which agreed with the final clinical detection results (Kappa = 0.786, P<0.05). Considering the final clinical diagnosis as the gold standard, the sensitivity, specificity, PPV and NPV of high-resolution MRI-based detection of carotid artery vulnerability were 88.71% (55/62), 78.95% (30/38), 87.30% (55/63), and 81.08% (30/37), respectively, showing consistency with the final clinical results (Kappa = 0.680, P<0.05). AP, SWE, and MRI results were positively correlated with the results of carotid artery stenosis grading (P<0.05). AP technology is a non-invasive, inexpensive, and highly sensitive method to evaluate the stability of carotid artery plaques. This method can dynamically display the flow of blood in new vessels of plaque in real time and provide a reference for clinical diagnosis and treatment.

Preoperative prediction of microvascular invasion in hepatocellular carcinoma using ultrasound features including elasticity.

Microvascular invasion (MVI) is an important predictor of poor prognosis in patients with hepatocellular carcinoma (HCC). Accurate preoperative prediction of MVI in HCC would provide useful information to guide the choice of therapeutic strategy. Shear wave elastography (SWE) plays an important role in hepatic imaging, but its value in the preoperative prediction of MVI in HCC has not yet been proven. To explore the value of conventional ultrasound features and SWE in the preoperative prediction of MVI in HCC. Patients with a postoperative pathological diagnosis of HCC and a definite diagnosis of MVI were enrolled in this study. Conventional ultrasound features and SWE features such as maximal elasticity (Emax) of HCCs and Emax of the periphery of HCCs were acquired before surgery. These features were compared between MVI-positive HCCs and MVI-negative HCCs and between mild MVI HCCs and severe MVI HCCs. This study included 86 MVI-negative HCCs and 102 MVI-positive HCCs, including 54 with mild MVI and 48 with severe MVI. Maximal tumor diameters, surrounding liver tissue, color Doppler flow, Emax of HCCs, and Emax of the periphery of HCCs were significantly different between MVI-positive HCCs and MVI-negative HCCs. In addition, Emax of the periphery of HCCs was significantly different between mild MVI HCCs and severe MVI HCCs. Higher Emax of the periphery of HCCs and larger maximal diameters were independent risk factors for MVI, with odds ratios of 2.820 and 1.021, respectively. HCC size and stiffness of the periphery of HCC are useful ultrasound criteria for predicting positive MVI. Preoperative ultrasound and SWE can provide useful information for the prediction of MVI in HCCs.

Diagnostic value of shear wave elastography combined with super microvascular imaging for BI-RADS 3-5 nodules.

To investigate the diagnostic value of shear wave elastography (SWE) and super microvascular imaging (SMI) integrated with the traditional ultrasound breast imaging reporting and data system (BI-RADS) classification in differentiating between benign and malignant breast nodules. For analysis, 88 patients with 110 breast nodules assessed as BI-RADS 3-5 by conventional ultrasound were selected. SWE and SMI evaluations were conducted separately, and all nodules were verified as benign or malignant ones by pathology. Receiver operating characteristic (ROC) curves were plotted after obtaining quantitative parameters of different shear waves of nodules, including maximum (Emax), mean (Emean), minimum (Emin) Young's modulus, modulus standard deviation (SD), and modulus ratio (Eratio). The best cut-off value, specificity, sensitivity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) for diagnosing malignant nodules employing Emax were obtained, and the diagnostic value of combining Emax and BI-RADS classification was compared. SMI graded nodule based on the Alder blood flow grading standard, whereas the BI-RADS classification was based on microvascular morphology. We assessed the diagnostic value of SMI for breast nodules and investigated the diagnostic efficacy of SWE combined with SMI in differentiating benign and malignant breast nodules with BI-RADS classification 3-5. The adjusted the BI-RADS classification using SMI and SWE technologies promoted the sensitivity, specificity, and accuracy of discriminating benign and malignant breast nodules (P < 0.05). The combination of traditional ultrasound BI-RADS classification with SWE and SMI technologies offered high sensitivity, specificity, accuracy, PPV, and NPV for identifying benign and malignant breast lesions. Moreover, combining SWE and SMI technologies with the adjusted BI-RADS classificationhad the best diagnostic efficacy for distinguishing benign and malignant breast nodules with BI-RADS 3-5. The combination of SWE and SMI with the adjusted BI-RADS classification is a promising diagnostic method for differentiating benign and malignant breast nodules.

Assessment of Knee Menisci in Healthy Adults Using Shear Wave Elastography.

The aim of this study was to explore the application value of shear wave elastography in healthy adults with knee meniscus. One hundred adult subjects who underwent health checkups at our hospital from December 2022 to February 2023 were selected as research participants. Shear wave elastography was used to evaluate the periphery of the lateral and medial meniscus in both knees. To assess the mean differences in Young's modulus values between male and female groups, a one-way analysis of variance (ANOVA) and independent samples t-test were conducted. In addition, a Pearson correlation coefficient test was used to analyze the correlation between the elastic values of the meniscus and age, height, weight, and body mass index (BMI). There were no significant differences in elastic values between the lateral meniscus of the left and right sides or between the medial meniscus of the left and right sides within the same gender group (P > .05). Stiffness values of the medial meniscus were higher in each gender group than those of the lateral meniscus (P < .01). Additionally, males demonstrated higher stiffness values than females (P < .01). As age increased, the Young's modulus of the meniscus increased significantly (r > .75, P < .01). Shear wave elastography can serve as an adjunctive tool to aid in the assessment of knee meniscal elasticity.

Comparison of Medical Treatment Efficiency With Shear Wave Elastography Values of Thrombus in Patients With Lower Extremity Deep Vein Thrombosis.

In lower-extremity deep vein thrombosis (DVT), thrombus age is essential for successful treatment. The aim of our study was to compare the shear wave elastography (SWE) values measured before treatment and achieved lumen patency after treatment in lower-extremity DVT patients with total occlusion. Patients diagnosed with DVT in the acute-subacute stage (<4 week) with total thrombosis in lower extremity were included in this prospective study. Shear wave elastography measurements were performed where the thrombus was most prominent and homogeneous. To evaluate patient response to treatment, lumen patency (partial [>25%] or total recanalization) was examined using color Doppler imaging in the first and third months posttreatment. Shear wave elastography values with and without patency were compared using an independent t test. Among 75 patients in this study, at the first-month color Doppler imaging examination, the SWE values were 1.77 ± 0.49 (1.09-3.03) m/s in patients who achieved lumen patency (n = 42) and 2.21 ± 0.54 (1.24-3.36) m/s in those who did not show lumen patency (n = 33). The difference between the groups' mean elastography value was statistically significant ( P < 0.001). At the third-month examination, the SWE values were 1.76 ± 0.46 (1.09-3.03) m/s in patients with lumen patency (n = 55) and 2.52 ± 0.48 (1.74-3.36) in patients without lumen patency (n = 20). The difference between the 2 groups' mean elastography value was statistically significant ( P < 0.001). We concluded that it is more difficult to achieve lumen patency in veins occluded by thrombus with higher elasto values, and endovascular interventional procedures should be considered during the initial treatment of high SWE value thrombosis.

Diagnostic value of shear wave elastography quantification combined with conventional ultrasound in salivary gland tumors.

The histopathological classification of salivary gland tumors is extremely complex. The imaging manifestations of some tumors are nonspecific. It is particularly important to improve the value of ultrasound in the diagnosis of salivary gland tumors. This study aimed to analyze the diagnostic value of different parameters of shear wave elastography (SWE) in the quantitative diagnosis of salivary gland tumors, and to evaluate the value of SWE combined with conventional ultrasound. The study was conducted retrospectively. Patients who underwent salivary gland tumor resection from April 2021 to November 2022 in the Ninth People's Hospital, Shanghai Jiaotong University School of Medicine were randomly recruited to the study. A total of 305 masses were divided into an elastography group (150 cases) and a control group (155 cases). The control group underwent conventional ultrasonography, whereas the elastography group underwent conventional ultrasonography and elastography. The Young's modulus E of the mass was quantitatively measured in the elastography group, including maximum cross-sectional area (S), maximum Young's modulus (Emax), mean Young's modulus (Emean), and Young's modulus standard deviation (SD). Pathologic diagnosis was used as the reference standard to determine the cut-off of shear wave elastography of salivary gland tumors, and the diagnostic performance of the 2 groups was compared. In the elastography group, the diagnostic value of Emax·S (the product of the maximum Young's modulus of the mass and the maximum cross-sectional area of the mass) in the differential diagnosis of malignant tumors (MT) and non-malignant tumors (NMT) was the highest, with a sensitivity and specificity of 72.0% and 80.0%, respectively. The diagnostic value of Emax/D (the quotient of the maximum Young's modulus of the mass and the maximum diameter of the mass) in the differential diagnosis of pleomorphic adenoma (PA) and adenolymphoma (AL) was the highest, with a sensitivity and specificity of 62.3% and 82.4%, respectively. The receiver operating characteristic (ROC) curves for the diagnosis of salivary gland tumors were compared between the elastography group and the control group. The area under the curve (AUC) of the elastography group was 0.915, the sensitivity, specificity, and Youden index were 84.0%, 88.0%, and 0.720, respectively. The AUC of the control group was 0.906, the sensitivity, specificity, and Youden index were 76.0%, 90.0%, and 0.660, respectively, which is the main finding of the study. SWE can be used as a complementary method for the diagnosis of salivary gland tumors, which has certain value in improving the diagnostic performance. As a result, the sensitivity is improved but the specificity is worsened by addition of SWE to B-mode ultrasound and color Doppler flow imaging (CDFI).

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.

Quantitative assessment of thenar to evaluate hand function after stroke by Bayes discriminant

BackgroundThe incidence rate of stroke or cerebrovascular accidents ranks first in China. More than 85% of stroke patients have residual upper limb motor dysfunction, especially hand dysfunction. Normalizing the rehabilitation evaluation process and standard quantitative evaluation method is a complex and key point in rehabilitation therapy. The study aimed to establish a function model based on the Bayes discriminant by measuring the thenar stiffness with shear wave elastography (SWE) to quantitatively evaluate the hand motor function of hemiplegic patients after stroke.MethodsThis study collected 60 patients diagnosed with hemiplegia after stroke from October 2021 to October 2022. Therapists used the Brunnstrom assessment (BA)scale to divide the patients into the stage. All the patients underwent the measurement of SWE examination of abductor pollicis brevis (APB), opponens pollicis (OP), flexor pollicis long tendon (FPLT), and flexor pollicis brevis (FPB) by two sonographers. The SWE change rate of four parts of the thenar area was calculated prospectively with the non-hemiplegic side as the reference, the function equation was established by the Bayes discriminant method, and the evaluation model was fitted according to the acquired training set data. Lastly, the model was verified by self-validation, cross-validation, and external data validation methods. The classification performance was evaluated regarding the area under the ROC curve (AUC), sensitivity, and specificity.ResultsThe median SWE values of the hemiplegic side of patients were lower than those of the non-hemiplegic side. According to the BA stage and SWER of APB, OP, FPLT, and FPB, our study established the Bayes discriminative model and validated it via self-validation and cross-validation methods. Then, the discriminant equation was used to validate 18 patients prospectively, the diagnostic coincidence rate was about 78.8%, and the misjudgment rate was approximately 21.2%. The AUC of the discriminant model for diagnosing BA stage I-VI was 0.928(95% CI: 0.839-1.0),0.858(95% CI: 0.748–0.969),1.0(95% CI: 1.0–1.0), 0.777(95% CI: 0.599–0.954),0.785(95% CI: 0.593–0.977) and 0.985(95% CI: 0.959-1.0), respectively.ConclusionThis Bayes discriminant model built by measuring thenar stiffness was of diagnostic value and can provide an objective basis for evaluating clinical rehabilitation.

Effectiveness of color Doppler ultrasound and shear-wave elastography for characterization of intestinal inflammation and fibrosis in Crohn's disease: A comparison with surgical histopathology analysis

Background & aimsDifferentiation between predominantly inflammatory or fibrous strictures is particularly important to decide the optimal therapy in patients with refractory symptoms in Crohn's disease. The purpose of this research was to evaluate the accuracy of color Doppler US and Shear Wave Elastography in differentiating the degree of inflammation or fibrosis in ileal strictures in patients with Crohn's disease by comparing with resected bowel samples. Materials and methodsPreoperative ultrasound examination, including SWE, was performed in 30 consecutive patients with Crohn's disease undergoing elective bowel resection. Ultrasound variables, Shear Wave Elastography quantitative analysis and visual elastographic color map, were prospectively evaluated. Histopathology grading of acute inflammation using the acute inflammatory score and the degree of fibrostenosis was performed. ResultsIn pathology analysis there were 21 segments with severe fibrosis. The mean Shear Wave Elastography value of the stenotic bowel wall was significantly higher in severe fibrosis (3.56 ± 1.4 m/s) than in mild fibrosis (1.89 ± 0.75 m/s) (P = 0.004). Using 2.5 m/s as the cut-off value to discriminate between mild and severe fibrosis, the sensitivity and specificity was 76.2% and 100% with an area under the curve (AUC) of 0.889. The sensitivity and specificity of the visual assessment of the elastographic color map in differentiating severe from mild fibrosis was 82.4% and 88.9%. Conclusionsthis study suggests that Shear Wave Elastography is accurate for detecting severe intestinal fibrosis in Crohn's disease patients. This information may be useful in the treatment strategy for CD.