scholarly journals Using shear wave elastography to assess uterine tonicity after vaginal delivery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Joanna Sichitiu ◽  
Jean-Yves Meuwly ◽  
David Baud ◽  
David Desseauve
Keyword(s):  
Blood Loss ◽  
Correlation Coefficient ◽  
Shear Wave ◽  
Wave Velocity ◽  
Shear Wave Velocity ◽  
Wave Speed ◽  
Shear Wave Elastography ◽  
Shear Wave Speed ◽  
Time Points ◽  
Tertiary Center

AbstractThis 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.

scholarly journals A soft cervix, categorized by shear-wave elastography, in women with short or with normal cervical length at 18–24 weeks is associated with a higher prevalence of spontaneous preterm delivery

2018 ◽  
Vol 46 (5) ◽  
pp. 489-501 ◽  
Author(s):  
Edgar Hernandez-Andrade ◽  
Eli Maymon ◽  
Suchaya Luewan ◽  
Gaurav Bhatti ◽  
Mohammad Mehrmohammadi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Delivery ◽  
Shear Wave ◽  
Wave Speed ◽  
Shear Wave Elastography ◽  
Cervical Length ◽  
Singleton Pregnancy ◽  
Short Cervix ◽  
Shear Wave Speed ◽  
Spontaneous Preterm Delivery

AbstractObjective:To determine whether a soft cervix identified by shear-wave elastography between 18 and 24 weeks of gestation is associated with increased frequency of spontaneous preterm delivery (sPTD).Materials and methods:This prospective cohort study included 628 consecutive women with a singleton pregnancy. Cervical length (mm) and softness [shear-wave speed: (SWS) meters per second (m/s)] of the internal cervical os were measured at 18–24 weeks of gestation. Frequency of sPTD <37 (sPTD<37) and <34 (sPTD<34) weeks of gestation was compared among women with and without a short (≤25 mm) and/or a soft cervix (SWS <25thpercentile).Results:There were 31/628 (4.9%) sPTD<37 and 12/628 (1.9%) sPTD<34 deliveries. The combination of a soft and a short cervix increased the risk of sPTD<37 by 18-fold [relative risk (RR) 18.0 (95% confidence interval [CI], 7.7–43.9); P<0.0001] and the risk of sPTD<34 by 120-fold [RR 120.0 (95% CI 12.3–1009.9); P<0.0001] compared to women with normal cervical length. A soft-only cervix increased the risk of sPTD<37 by 4.5-fold [RR 4.5 (95% CI 2.1–9.8); P=0.0002] and of sPTD<34 by 21-fold [RR 21.0 (95% CI 2.6–169.3); P=0.0003] compared to a non-soft cervix.Conclusions:A soft cervix at 18–24 weeks of gestation increases the risk of sPTD <37 and <34 weeks of gestation independently of cervical length.

scholarly journals Strain Elastography - How To Do It?

2017 ◽  
Vol 03 (04) ◽  
pp. E137-E149 ◽  
Author(s):  
Christoph Dietrich ◽  
Richard Barr ◽  
André Farrokh ◽  
Manjiri Dighe ◽  
Michael Hocke ◽  
...  
Keyword(s):  
Shear Wave ◽  
Wave Speed ◽  
Shear Wave Elastography ◽  
Ultrasound Elastography ◽  
Tissue Stiffness ◽  
Shear Wave Speed ◽  
Strain Elastography ◽  
Advantages And Disadvantages ◽  
Similar Information ◽  
Qualitative Technique

AbstractTissue stiffness assessed by palpation for diagnosing pathology has been used for thousands of years. Ultrasound elastography has been developed more recently to display similar information on tissue stiffness as an image. There are two main types of ultrasound elastography, strain and shear wave. Strain elastography is a qualitative technique and provides information on the relative stiffness between one tissue and another. Shear wave elastography is a quantitative method and provides an estimated value of the tissue stiffness that can be expressed in either the shear wave speed through the tissues in meters/second, or converted to the Young’s modulus making some assumptions and expressed in kPa. Each technique has its advantages and disadvantages and they are often complimentary to each other in clinical practice. This article reviews the principles, technique, and interpretation of strain elastography in various organs. It describes how to optimize technique, while pitfalls and artifacts are also discussed.

scholarly journals A Cross-Machine Comparison of Shear-Wave Speed Measurements Using 2D Shear-Wave Elastography in the Normal Female Breast

2021 ◽  
Vol 11 (20) ◽  
pp. 9391
Author(s):  
Emma Harris ◽  
Ruchi Sinnatamby ◽  
Elizabeth O’Flynn ◽  
Anna M. Kirby ◽  
Jeffrey C. Bamber
Keyword(s):  
Adipose Tissue ◽  
Shear Wave ◽  
Subcutaneous Adipose Tissue ◽  
Wave Speed ◽  
Shear Wave Elastography ◽  
Shear Wave Speed ◽  
Skin Region ◽  
Subcutaneous Adipose

Quantitative measures of radiation-induced breast stiffness are required to support clinical studies of novel breast radiotherapy regimens and exploration of personalised therapy, however, variation between shear-wave elastography (SWE) machines may limit the usefulness of shear-wave speed (cs) for this purpose. Mean cs measured in four healthy volunteers’ breasts and a phantom using 2D-SWE machines Acuson S2000 (Siemens Medical Solutions) and Aixplorer (Supersonic Imagine) were compared. Shear-wave speed was measured in the skin region, subcutaneous adipose tissue and parenchyma. cs estimates were on average 2.3% greater when using the Aixplorer compared to S2000 in vitro. In vivo, cs estimates were on average 43.7%, 36.3% and 49.9% significantly greater (p << 0.01) when using the Aixplorer compared to S2000, for skin region, subcutaneous adipose tissue and parenchyma, respectively. In conclusion, despite relatively small differences between machines observed in vitro, large differences in absolute measures of shear wave speed measured were observed in vivo, which may prevent pooling of cross-machine data in clinical studies of the breast.

scholarly journals Feasibility and Reliability of Two-Dimensional Shear-Wave Elastography of the Liver of Clinically Healthy Cats

2020 ◽  
Vol 7 ◽  
Author(s):  
Kyeonga Kim ◽  
Jieun Lee ◽  
Jaebeom So ◽  
Yong-seok Jang ◽  
Mingyu Jung ◽  
...  
Keyword(s):  
Shear Wave ◽  
Wave Speed ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Acoustic Radiation Force Impulse ◽  
Breath Holding ◽  
Two Dimensional ◽  
Shear Wave Speed ◽  
Left Liver ◽  
The Right

Given the broad overlap of normal and abnormal liver tissue in the subjective evaluation of the liver in conventional B-mode ultrasonography, there is a need for a non-invasive and quantitative method for the diagnosis of liver disease. Novel two-dimensional shear-wave elastography (2-D SWE) can measure tissue stiffness by propagation of the shear wave induced using acoustic radiation force impulse in real time. To the best of our knowledge, two-dimensional shear-wave measurement of the liver in cats has not been reported to date. This study assessed the feasibility, reliability, normal values, and related influencing factors of 2-D SWE for assessment of the feline liver without anesthesia and breath-holding. Two-dimensional shear-wave ultrasonography was performed by two evaluators at the right and left sides of the liver. Twenty-nine client-owned clinically healthy adult cats were included. The means and standard deviations for the shear-wave speed and stiffness in the right liver were 1.52 ± 0.13 m/s and 6.94 ± 1.26 kPa, respectively, and those for the left liver were 1.61 ± 0.15 m/s and 7.90 ± 1.47 kPa, respectively. Shear-wave speed (P = 0.005) and stiffness (P = 0.002) were significantly lower in the right liver when compared to the left. The intraclass correlation value for liver stiffness was 0.835 and 0.901 for the right and left liver, respectively, indicating high interobserver agreement. Age, weight, body condition score (BCS), gabapentin administration, and measurement depths were not significantly correlated with liver stiffness or elastography measurements (P &gt; 0.05). Our findings suggest that 2-D SWE measurements of the liver are not influenced significantly by age, weight, or BCS and can be reliably performed without anesthesia and breath-holding in cats. The values determined here can help form the basis for reference elastography values for evaluation of the feline liver.

Modern sonographic markers for the prognosis of preterm birth in women with different somatotypes

2021 ◽  
Vol 70 (4) ◽  
pp. 91-98
Author(s):  
Kristina G. Tomaeva ◽  
Sergey N. Gaidukov ◽  
Elena N. Komissarova ◽  
Georgii G, Tomaev
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Shear Wave ◽  
Wave Speed ◽  
Shear Wave Elastography ◽  
Test Method ◽  
Shear Wave Speed ◽  
Risk Of Death ◽  
Increased Risk ◽  
Average Shear

BACKGROUND:Preterm birth is one of the causes of perinatal morbidity and mortality. Premature infants have an increased risk of death and the development of neurological and other disorders. AIM:The aim of this study was to evaluate the modern sonographic parameters of the cervix in pregnant women with different somatotypes and to develop a mathematical model for predicting preterm birth. MATERIALS AND METHODS:The study included 390 women, among whom 110 were classified with macrosomatic, 173 with mesosomatic, and 107 with microsomatic types. Somatotype was determined in women in early stages of pregnancy (before 9-10 weeks of gestation) using the R.N. Dorokhov anthropometric test method. The utero-cervical angle was measured, shear wave elastography was performed, and the average shear wave speed in the area of the internal cervical os was determined. All measurements were performed on a Philips EPIQ 5 ultrasound machine. RESULTS:Preterm birth was more often identified in women with macro- and microsomatic types in comparison with women with mesosomatic type (p 0.05). In pregnant women with subsequent preterm birth at 22-23 weeks, the average SWS in the area of the internal cervical os was reduced (p 0.05) and the utero-cervical angle was higher in comparison with those women who did not have preterm birth (p 0.05). Using multiple regression analysis, we obtained the regression equation (formula), which predicts the development of preterm birth in women with different somatotypes. CONCLUSIONS:Such parameters as the average shear wave speed in the area of the internal cervical os and the utero-cervical angle may be regarded as markers of preterm birth. The mathematical formula obtained allows for predicting the development of preterm birth in women with different somatotypes and for timely prevention of pathology.

No Association of Plantar Aponeurosis Stiffness with Medial Longitudinal Arch Stiffness

2021 ◽  
Author(s):  
Hiroaki Noro ◽  
Naokazu Miyamoto ◽  
Naotoshi Mitsukawa ◽  
Toshio Yanagiya
Keyword(s):  
Shear Wave ◽  
Wave Velocity ◽  
Shear Wave Velocity ◽  
Shear Wave Elastography ◽  
Medial Longitudinal Arch ◽  
Plantar Aponeurosis ◽  
Longitudinal Arch ◽  
The Difference ◽  
Young Subjects

AbstractLower stiffness of the medial longitudinal arch is reportedly a risk factor for lower leg disorders. The plantar aponeurosis is considered essential to maintaining the medial longitudinal arch. It is therefore expected that medial longitudinal arch stiffness is influenced by plantar aponeurosis stiffness. However, this has not been experimentally demonstrated. We examined the relationship between the plantar aponeurosis stiffness and medial longitudinal arch stiffness in humans in vivo. Thirty young subjects participated in this study. The navicular height and shear wave velocity (an index of stiffness) of the plantar aponeurosis were measured in supine and single-leg standing positions, using B-mode ultrasonography and shear wave elastography, respectively. The medial longitudinal arch stiffness was calculated based on body weight, foot length, and the difference in navicular height between the supine and single-leg standing conditions (i. e., navicular drop). Shear wave velocity of the plantar aponeurosis in the supine and single-leg standing positions was not significantly correlated to medial longitudinal arch stiffness (spine: r=−0.14, P=0.45 standing: r=−0.16, P=0.41). The findings suggest that the medial longitudinal arch stiffness would be strongly influenced by the stiffness of foot structures other than the plantar aponeurosis.

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