Wave Elastography Research Articles

Breast cancer imaging-clinical experience with two-dimensional-shear wave elastography: A retrospective study

Breast cancer imaging-clinical experience with two-dimensional-shear wave elastography: A retrospective study

Study of Role of Shear- Wave Elastography and Musculoskeletal Ultrasound in Assessment of Hand and Wrist in Rheumatoid Arthritis Patients

Study of Role of Shear- Wave Elastography and Musculoskeletal Ultrasound in Assessment of Hand and Wrist in Rheumatoid Arthritis Patients

Relationship between Novel Elastography Techniques and Renal Fibrosis-Preliminary Experience in Patients with Chronic Glomerulonephritis.

A renal biopsy represents the gold standard in the diagnosis, prognosis, and management of patients with glomerulonephritis. So far, non-invasive elastographic techniques have not confirmed their utility in replacing a biopsy; however, the new and improved software from Hologic Supersonic Mach 30 is a promising method for assessing the renal tissue's stiffness and viscosity. We investigated whether this elastography technique could reveal renal tissue fibrosis in patients with chronic glomerulonephritis. Two-dimensional-shear wave elastography (SWE) PLUS and viscosity plane-wave ultrasound (Vi PLUS) assessments were performed in 40 patients with chronic glomerulopathies before being referred for a renal biopsy. For each kidney, the mean values of five stiffness and viscosity measures were compared with the demographic, biological, and histopathological parameters of the patients. In total, 26 men and 14 women with a mean age of 52.35 ± 15.54 years, a mean estimated glomerular filtration rate (eGFR) of 53.8 ± 35.49 mL/min/1.73m2, and a mean proteinuria of 6.39 ± 7.42 g/24 h were included after providing their informed consent. Out of 40 kidney biopsies, 2 were uninterpretable with inappropriate material and were divided into four subgroups based on their fibrosis percentage. Even though these elastography techniques were unable to differentiate between separate fibrosis stages, when predicting between the fibrosis and no-fibrosis group, we found a cut-off value of <20.77 kPa with the area under the curve (AUC) of 0.860, a p < 0.001 with 88.89% sensitivity, and a 75% specificity for the 2D SWE PLUS measures and a cut-off value of <2.8 Pa.s with an AUC of 0.792, a p < 0.001 with 94% sensitivity, and a 60% specificity for the Vi PLUS measures. We also found a cut-off value of <19.75 kPa for the 2D SWE PLUS measures (with an AUC of 0.789, p = 0.0001 with 100% sensitivity, and a 74.29% specificity) and a cut-off value of <1.28 Pa.s for the Vi PLUS measures (with an AUC 0.829, p = 0.0019 with 60% sensitivity, and a 94.29% specificity) differentiating between patients with over 40% fibrosis and those with under 40%. We also discovered a positive correlation between the glomerular filtration rate (eGFR) and 2D-SWE PLUS values (r = 0.7065, p < 0.0001) and Vi PLUS values (r = 0.3637, p < 0.0211). C reactive protein (CRP) correlates with the Vi PLUS measures (r = -0.3695, p = 0.0189) but not with the 2D SWE PLUS measures (r = -0.2431, p = 0.1306). Our findings indicate that this novel elastography method can distinguish between individuals with different stages of renal fibrosis, correlate with the renal function and inflammation, and are easy to use and reproducible, but further research is needed for them to be employed routinely in clinical practice.

Modern possibilities of quantitative assessment of diffusion-weighted images in magnetic resonance imaging of liver in diagnosis of alcoholic liver disease

Objective. To evaluate the modern possibilities of quantitative assessment of diffusion-weighted imaging (DWI) using magnetic resonance imaging of the liver (MRI) in alcoholic liver disease (ALD). Material and methods. 121 patients with ALD were examined. The structure of clinical forms: 27 (22.3 %) – steatosis, 29 (23.9 %) – steatohepatitis, 48 (39.7 %) – hepatitis, 17 (14.1 %) – cirrhosis. The patients were hospitalized in the gastroenterology department of the Clinical Hospital No. 1 in Smolensk (September 2019 – March 2020), followed by outpatient observation (April 2020 – January 2022). All patients underwent a comprehensive radiological examination, including ultrasound examination (ultrasound) of the abdominal organs with clinical elastography (CE) of the liver (n = 121) (transient elastography/compression elastography/shear wave elastography), MRI with DWI of the liver was mandatory in the design of the study (n = 121). Results. According to the CE data, there is no possibility to confirm the clinical form of ALD in a patient, the stage of the fibrous process in the liver parenchyma is limited by marginal results; a liver biopsy allows you to fully establish the stage of fibrosis and suspect the clinical form of ALD. According to the quantitative assessment of DWI of the liver during MRI in patients with ALD, criteria for clinical forms were established in comparison with CE: for steatosis – 2.66 ± 0.90 × 10 –3 mm 2 /sec corresponds to F0–F1, for steatohepatitis – 2.14 ± 0,50 × 10 –3 mm 2 /sec – F1–F2, for hepatitis – 1.75 ± 0.60 × 10 –3 mm 2 /sec – F2–F3, for cirrhosis – 1.15 ± 0.60 × 10 –3 mm 2 /sec – F4 (AUROC = 0.985; 95 % CI: 0.945–0.912). Conclusion. Upon admission and monitoring of patients (after 1, 3, 6, 9, 12 months), there is a high correlation in assessing the comparison of quantitative indicators of DWI with CE (r = 0.873) and an average correlation with liver biopsy data (r = 0.715). The diagnostic and prognostic significance of the developed criteria for DWI of the liver during MRI in patients with ALD at admission was assessed for quantitative assessment of AUROC = 0.908 (95 % CI: 0.875–0.911).

Diagnostic performance of 2D-shear wave elastography and serum fibrosis markers for evaluation of hepatic graft fibrosis in pediatric liver-inclusive transplant recipients: A prospective pilot study.

Liver biopsy is the gold standard for hepatic fibrosis staging, but it is invasive and has potential severe complications. We aimed to determine the diagnostic performance of 2D-SWE and serum markers to predict significant hepatic graft fibrosis (≥F2) in pediatric liver-inclusive transplant recipients. This prospective, cross-sectional pilot study included children younger than 19years who had received a LT or LSBT and underwent a liver biopsy performed for clinical indications. LS was measured using 2D-SWE. The AUROC was calculated to evaluate the diagnostic performance of 2D-SWE and biomarkers (AST/ALT ratio, APRI, FIB4) for predicting significant fibrosis. Twenty-two children (13males, 8 LSBT) were included. Eighteen (81.8%) children received a whole liver graft. Thirteen (59.1%) patients had hepatic fibrosis (≥F1) and four (18.2%) had significant fibrosis. The AUROCs of AST/ALT ratio, APRI, and FIB4 for predicting significant hepatic graft fibrosis were 0.71 (p=.29), 0.85 (p=.0001), and 0.76 (p=.03), respectively. When FIB4 was calculated using the hepatic graft's age, its AUROC improved to 0.85 (p<.0001). The AUROC of 2D-SWE for predicting significant hepatic graft fibrosis was 0.80 (p=.046). When 2D-SWE was combined with APRI or FIB4, its AUROC improved to 0.82 (p=.08) and 0.87 (p=.002), respectively. APRI and FIB4 can accurately predict significant hepatic graft fibrosis. 2D-SWE may serve as a valuable adjunct tool to detect significant graft fibrosis, especially when combined with these serum markers.

New radiation techniques in controlling bone regeneration in fractures

Objective: comparative study of the possibilities of radiation methods in control of bone regeneration in fractures.Materials and methods. A study of bone calluse formation was conducted in 116 patients with broken tubular bones of the upper and lower limbs from the first day of the fracture to the complete consolidation of the fractures. In X-rays and CT determined the mineral density of bone calluses, with ultrasonic elastography shear wave and compression elastography determined the rigidity of bone calluses in kPa.Results. X-ray bone corn was determined at the end of the second – the beginning of the third stage of bone calluse formation. On CT bone corn density (in the HU), its structure and the condition of bone breaks were determined in some patients in all stages of bone regenerate formation. In ultrasound examination in the multiparametric mode studied the rigidity, structure and vascularization of bone calluses, the correct comparison of bone breaks from the first day of the fracture to their complete fusion.Conclusions. Ultrasonic studies in multiparametric mode can be used to control bone regeneration in fractures. Ultrasonic elastography shear wave, in determining the rigidity of bone calluse, in sensitivity and specificity exceeds the indicators of ultrasonic compression elastography at all stages of bone regenerate formation.

Bowel Ultrasound in Inflammatory Bowel Disease: How Far in the Grayscale?

Bowel ultrasound (BUS) is a non-invasive and accurate technique for assessing activity, extension of disease, and complications in inflammatory bowel diseases. The main advantages of BUS are its safety, reproducibility, and low costs. Ancillary technologies of BUS (i.e., color Doppler and wave elastography) could broaden the diagnostic power of BUS, allowing one to distinguish between inflammation and fibrosis. Considering the costs and invasiveness of colonoscopy and magnetic resonance, BUS appears as a fast, safe, and accurate technique. The objective measures of disease allow one to make clinical decisions, such as optimization, switch, or swap of therapy. Previous studies reported a sensitivity and a specificity of more than 90% compared to endoscopy and magnetic resonance. Lastly, transperineal ultrasound (TPUS) is a promising approach for the evaluation of perianal disease in Crohn’s disease (CD) and disease activity in patients with ulcerative proctitis or pouchitis. Bowel ultrasound is being incorporated in the algorithm of managing inflammatory bowel diseases. Transmural healing evaluated through ultrasonography is emerging as a complementary target for disease treatment. In this review, we aimed to summarize and discuss the current evidence on BUS in the management of inflammatory bowel diseases and to address the challenges of a full validation of this technique.

Diagnostic possibilities of the method of elastography and shear wave steatorei patients with non-alcoholic fatty liver disease

The steady increase in the number of patients with chronic diff use liver diseases, including non-alcoholic fatty liver disease, leads to the need to introduce non-invasive methods of diagnosis and monitoring changes in the structure of the organ into clinical practice.Objective. To evaluate the possibility of using shear wave steatometry and elastography in the diagnosis of fi brosis stage and degree of steatosis in patients with non-alcoholic fatty liver disease.Materials and methods of research. The study involved 52 patients of the I. I. Mechnikov NWSMU clinic with NAFLD, 28 of them men and 24 women, the average age was 51-+11.2 g, the average BMI-30,7-+5,4 kg / m2. The control group consisted of 20 healthy volunteers. All patients underwent complex ultrasound on the Angiodin-Sono/P-Ultra device (Bioss, Russia) with a 1–6 MHz convexic sensor (B-mode, Doppler modes—vascular mapping and spectral pulse, shear wave elastometry, elastography (active and natural compression—Active / Natural Strain)).

Differentiation of hypertensive heart disease and hypertrophic cardiomyopathy with myocardial stiffness measurements: a shear wave imaging study using ultra-high frame rate echocardiography

Abstract Background Recently, cardiac shear wave (SW) elastography, based on high frame rate (HFR) echocardiography, has been proposed as new non-invasive technique for assessing myocardial stiffness. As myocardial stiffness increases with increasing wall stress, differences in measured operating myocardial stiffness do not necessarily reflect differences in intrinsic myocardial properties, but can also be caused by mere changes in loading or chamber geometry. This complicates myocardial stiffness interpretation for different types of pathologic hypertrophy. Purpose To explore the relationship between myocardial stiffness and underlying pathological substrates for cardiac hypertrophy. Methods We included 20 patients with hypertension (HT) and myocardial remodelling (59±14 years, 75% male), 20 patients with hypertrophic cardiomyopathy (HCM) (59±16 years, 60% male) and 20 healthy controls (56±14 years, 75% male). Left ventricular (LV) parasternal long axis views were acquired with an experimental HFR scanner at 1293±362 frames per seconds. Propagation velocity of SW occurring after mitral valve closure in the interventricular septum (IVS) served as measure of operating myocardial stiffness (Figure A). To compare myocardial stiffness among hearts with differing loading conditions and chamber geometry, SW velocities were normalized to end-diastolic wall stress, estimated at IVS from regional wall thickness, longitudinal and circumferential regional radii of curvature, and non-invasively estimated LV end-diastolic pressure (EDP). Results SW velocities differed significantly between groups (p&amp;lt;0.001). The controls had the lowest SW velocities (4.02±0.97 m/s), whereas values between HT and HCM group were comparable (6.46±0.99 m/s vs. 7.00±2.10 m/s; p=0.738). Considering end-diastolic wall stress, HCM patients had the same SW velocity at lower wall stress compared to HT (Figure B), indicating higher myocardial stiffness in the HCM group. SW velocities normalized for wall stress indicated significantly different myocardial stiffness among all groups (p&amp;lt;0.001) (Figure C). In a multiple linear regression model, the underlying pathological substrate independently influenced SW velocity (beta 1.37, 95% CI (0.78–1.96); p&amp;lt;0.001), while wall stress did not significantly affect its value (p=0.479). Conclusions Our study demonstrated that SW elastography can detect differences in myocardial stiffness in hypertensive heart and hypertrophic cardiomyopathy. Additionally, our results suggest that SW velocity is dominated by underlying myocardial tissue properties. We hypothesize that differential changes in cardiomyocytes and/or the extracellular matrix contribute to the differential myocardial stiffening in different pathologic entities of LV hypertrophy. Thus, SW elastography could provide useful novel diagnostic information in the evaluation of LV hypertrophy. Figure A, B, C Funding Acknowledgement Type of funding source: None

Elastography reference values of facial skin elasticity.

IntroductionWith an introduction of new ultrasonographic transducers, skin elastography may find an application in dermatology and aesthetic medicine enabling direct evaluation of various pathological or natural processes.AimTo verify which elastographic technique, strain elastography (SE) or shear wave elastography (SWE), is a better candidate for the reference method of facial skin elasticity examination and to determine normal ranges for elastographic parameters in various facial regions.Material and methodsThe study included 71 female volunteers (age: 40–67 years, mean: 52 ±7.5 years). All participants were subjected to SE and SWE of the skin in five anatomical regions: the forehead, suborbital regions, cheeks, nasolabial folds and chin. Reference ranges for elastographic parameters were defined as 95% confidence intervals and ±2 standard deviations and estimated by means of ROC analysis.ResultsShear wave elastography parameters, but not SE indices, showed strong inverse correlations with the patient age. No significant correlations were found between SE and SWE parameters of the facial skin. In contrast to SWE, no significant correlations were observed between bilateral SE parameters. Based on these findings, SWE was chosen as the reference method to determine age-specific normative values for the elasticity of the facial skin. Reference and cut-off values of SWE parameters were defined for three age groups.ConclusionsShear wave elastography is suitable for the determination of elastographic parameters of normal facial skin, and can be used to determine reference ranges thereof. Elasticity of the facial skin decreases considerably with age, and this factor should be considered during determination of reference values for the elastographic parameters.

Combination of Strain and Shear - Wave Elastography Can Reduce the Unnecessary Biopsy of Breast Lesions

Combination of Strain and Shear - Wave Elastography Can Reduce the Unnecessary Biopsy of Breast Lesions

Can Shear -Wave Elastography be used to detect liver decreased stiffness in liver due to hepatic steatosis?

The most common liver disorder in developed countries is the Non-alcoholic fatty liver disease (NAFLD) [1,2]. Insulin resistance and the metabolic syndrome are both related to NAFLD [3]. The disease occurs up to 80% of obese people [4]. The most extreme form of NAFLD is Nonalcoholic steatohepatitis (NASH) which is the major cause of cirrhosis of the liver of unknown cause [5]. More commonly NAFLD is detected routine blood tests followed by diagnosed abnormal liver function tests. In the presence of insulin resistance and metabolic syndrome (obesity, combined hyperlipidemia, diabetes mellitus (type II), and high blood pressure ) NAFLD may seen often [3,5]. A spectrum of disease activity is being considered to cover in NAFLD. This spectrum begins as fatty accumulation in the liver (hepatic steatosis). A liver can remain fatty liver could work without any disturbing liver function, but by varying mechanisms and possible insults to the liver may also progress to become non-alcoholic steatohepatitis (NASH), a state in which steatosis is combined with inflammation and fibrosis (steatohepatitis). NASH is a progressive disease: over a 10-year period and also up to 20% of patients with NASH may develop cirrhosis of the liver, and 10% will suffer death related to liver disease [6].

Ультразвуковая эластография (компрессионная и сдвиговой волной) в акушерстве и гинекологии

Ультразвуковая эластография (компрессионная и сдвиговой волной) в акушерстве и гинекологии