Tu1891 Feasibility of Non-Invasive Method of Diagnosing Pancreatic Fibrosis Using Shear Wave Elastography

2015 ◽  
Vol 148 (4) ◽  
pp. S-929
Author(s):  
Takamichi Kuwahara ◽  
Yoshiki Hirooka ◽  
Hiroki Kawashima ◽  
Eizaburo Ohno ◽  
Hiroyuki Sugimoto ◽  
...  
2021 ◽  
Vol 6 (4) ◽  
pp. 111-118
Author(s):  
V. M. Ratchyk ◽  
◽  
T. G. Turytska ◽  
G. V. Oliinykov

The purpose of the study was to identify the patterns of changes in the state of the parenchyma of the pancreas in patients with complicated forms of chronic pancreatitis with evaluation of the diagnostic effectiveness of shear wave elastometry (graphy). Materials and methods. For the period from 2006 to 2018 58 patients with complicated forms of chronic pancreatitis were examined. The average age of patients is (47.1±3.2) years old. The medical history ranged from 3 to 15 years. The basis of morphological studies were biopsies of the pancreas obtained during surgery. Ultrasound elastometry and pancreatic parenchymal elastography were performed by transcutaneous shear wave approach in Shear Wave Elastography. Software consistency was assessed by the nature of the color mapping. Results and discussion. The morphometry of the volume parts of the structural components of the pancreas showed that with the development of complicated chronic pancreatitis there is an increase in the area of fibrous tissue and a decrease in the area of acinar components. The proof of this is the strong inverse relationship between the degree of fibrosis and the volume fraction of acinar tissue (r= -0.83; р <0.05), as well as the direct relationship between the degree of fibrosis and the volume fraction of connective tissue (r=0.61; р <0.05). If at a fibrosis of the III degree acinar tissue occupied (25.39±2.01)%, connective – (64.33±3.85)%, fatty – (6.42±4.48)%, at a fibrosis of the IV degree noted the following: the proportion of acinar tissue was only (2.86±0.76)%, connective – (74.11±4.17)%, and (20.14±4.29)% was adipose tissue. Such manifestations indicated severe irreversible changes in the external secretory function of the pancreas. When assessing changes in the stiffness of the pancreatic parenchyma with the deepening of fibrosis processes and data from transcutaneous shear wave elastography, it was found that the degree of fibrosis according to morphological data correlated with the degree of fibrosis according to shear wave elastography, r = 0.71; p <0.05. The following patterns were noted. Grade II pancreatic fibrosis was characterized by intralobular fibrosis, which covered 26-50% of the gland area, which corresponded to the shear wave elastography data in green-blue color (5.98-7.05 kPa). Grade III pancreatic fibrosis corresponded to intralobular fibrosis, which covered 51-75% of the gland area in shear wave elastography in green-yellow color (7.06-9.06 kPa). Grade IV pancreatic fibrosis was characterized by intralobular fibrosis, which covered 76-100% of the gland area, which corresponded to shear wave elastography data in yellow-red color (> 9.07 kPa). Conclusion. Thus, the objectification of shear wave elastography indicators of the pancreas based on the correlation of histological evaluation and morphometric indicators of structural changes in the pathological process allows to consider transcutaneous shear wave elastography as a promising and reliable method of non-invasive diagnosis of fibrosis in chronic pancreatitis


2016 ◽  
Vol 25 (4) ◽  
pp. 525-532 ◽  
Author(s):  
Monica Lupșor-Platon ◽  
Radu Badea ◽  
Mirela Gersak ◽  
Anca Maniu ◽  
Ioana Rusu ◽  
...  

There has been great interest in the development of non-invasive techniques for the diagnosis of liver fibrosis in chronic liver diseases, including ultrasound elastographic methods. Some of these methods have already been adequately studied for the non-invasive assessment of diffuse liver diseases. Others, however, such as two-dimensional Shear Wave Elastography (SWE), of more recent appearance, have yet to be validated and some aspects are for the moment incompletely elucidated. This review discusses some of the aspects related to two-dimensional SWE: the examination technique, the examination performance indicators, intra and interobserver agreement and clinical applications. Recommendations for a high-quality examination technique are formulated. Key words:  –  –  – Two-dimensional Shear Wave Elastography. Abbreviations: 2D- SWE: Two-dimensional Shear Wave Elastography; 3D- SWE: Three-dimensional Shear Wave Elastography; AUROC: area under the receiver operating characteristic curves; ARFI Acoustic Radiation Force Impulse Elastography; EFSUMB: European Federation of Societies for Ultrasound in Medicine and Biology; HVPG: hepatic venous pressure gradient; LS: liver stiffness; LR: likelihood ratio; NPV: negative predictive value; PPV: positive predictive value; ROI: region of interest; RT-E: Real Time-Elastography; Se: sensitivity; Sp: specificity; TE: Transient Elastography; US: ultrasound; VM: valid measurement; E: Young’s modulus


2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Mohammed Hazem ◽  
Ossama M. Zakaria ◽  
Mohamed Yasser Ibrahim Daoud ◽  
Ibrahim Khalid Al Jabr ◽  
Abdulwahab A. AlYahya ◽  
...  

Abstract Background Thyroid nodules are an important health problem in children and adolescents. They possess a higher risk of malignancy in comparison to adults. This fact forms a great dilemma for clinicians. The aim of this study was to evaluate the reliability of shear wave elastography (SWE) as a non-invasive technique in the characterization of thyroid nodules in children and adolescents. Methods This prospective study included 56 patients with thyroid nodules. All the patients underwent clinical assessment, laboratory investigations, ultrasound, and Doppler examination, followed by an SWE assessment. Statistical analysis was performed and the best cut-off value to differentiate benign from malignant nodules was determined using the ROC curve and AUC. Results Seventy-two nodules were detected in the examined patients (ages ranged from 11 to 19 years, with mean age of 14.89 ± 2.3 years). Fifty-eight nodules (80.6%) were benign, and fourteen nodules (19.4%) were malignant (histopathologically proved). Highly suspicious criteria for prediction of malignancy by ultrasound and Doppler were hypoechoic echopattern, internal or internal and peripheral vascularity, microcalcifications, taller-than-wide dimensions, irregular outlines, and absence of halo (p < 0.05). The diagnostic performance for their summation was 70.69% sensitivity, 82.8% specificity, 80.45% accuracy, a 63.79% positive predictive value (PPV), and 87.9% negative predictive values (NPV). Regarding SWE, our results showed that 42.2 kPa was the best cut-off value, with AUC = 0.921 to differentiate malignant from benign nodules; the diagnostic performance was 85.71% sensitivity, 94.83% specificity, 93.06% accuracy, 76.9% PPV, and 93.2% NPV. Conclusion Shear wave elastography is a non-invasive technique that can assist in the diagnosis of malignant thyroid nodules among children and adolescents.


2020 ◽  
Author(s):  
Yao-Kuang Huang ◽  
Ren-Ching Wang ◽  
Sheng-Shun Yang ◽  
Shou-Wu Lee ◽  
Hsin-Ju Tsai ◽  
...  

Abstract Studies for evaluating the diagnostic performance of two-dimensional Shear-wave Elastography (2D-SWE) in a patient cohort including various liver disorders, remain limited. We aimed to evaluate the validity of 2D-SWE in the diagnosis of advanced liver fibrosis amongst patients with various liver disorders. In this pathology-based study, patients who underwent a liver biopsy for various benign liver diseases were prospectively recruited during the period between February, 2017 and September, 2020. Data of 2D-SWE, Fibrosis-4 Index (FIB-4), and Aspartate Aminotransferase to Platelet Ratio Index (APRI) were simultaneously collected. The cut-off values for predicting advanced fibrosis, i.e. Metavir fibrosis stage ≥ F3, were determined using Receiver Operating Characteristic (ROC) analysis. The diagnostic performance was evaluated and then compared by Area Under the ROC (AUROC). In total, 95 patients were recruited for study analysis. The diagnostic performance of 2D-SWE was significantly superior to that of both FIB-4 (AUROC: 0.88, 95% confidence interval [CI]: 0.80-0.94; vs 0.72, 95%CI: 0.62-0.81; p=0.001) and APRI (AUROC: 0.88, 95%CI: 80-0.94; vs 0.76, 95%CI: 0.66-0.84; p=0.007). With an optimal cutoff value of 9.3 kPa, the sensitivity and specificity were 90.91% and 76.47%, respectively. In subgroup analysis, the AUROC of 2D-SWE was the highest when compared to that of FIB-4 and APRI in patients with chronic hepatitis B, chronic hepatitis C, fatty liver, and concurrent hepatitis. 2D-SWE can therefore be a valid non-invasive method in the detection of advanced liver fibrosis in various liver diseases.


2015 ◽  
Vol 26 (1) ◽  
pp. 109-113

According to available literature data, NAFLD may play crucial role in the pathogenesis of type 2 diabetes and other conditions connected with insulin resistance. In order to study the essence of the NAFLD, we have created an experimental model of the steatohepatosis. The mixed diet for 8 weeks consisting of standard food (47%), sweetened condensed milk (44%), vegetable oil (8%) and vegetable starch (1%) develops non-alcoholic steatohepatosis in the animals undergoing the experiment. The morphological signs of the non-alcoholic steatohepatosis comprised as follows in the hepatocytes of the rats undergoing the experiment: presence of fine-drop fattiness (fine-drop steatosis) and accumulation of fat vacuoles shifting the nucleus towards the cell peripheral. Substantial increase in the liver pulp of the animals undergoing the experiment defined using the ultrasound shear wave elastography technique is indicative of the presence of the non-alcoholic steatohepatosis. The ultrasound shear wave elastography technique can be used as a non-invasive diagnosis marker of the non-alcoholic steatohepatosis. The said diagnosis technique has been recommended for the first time.


2017 ◽  
Vol 66 (1) ◽  
pp. S667-S668
Author(s):  
M. Ronot ◽  
P.-E. Rautou ◽  
M.Di. Burgio ◽  
A. Payencé ◽  
P. Bedossa ◽  
...  

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