scholarly journals Myocardial stiffness assessed by natural shear wave elastography is related to pressure-volume loop derived parameters

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Bezy ◽  
A Caenen ◽  
J Duchenne ◽  
M Orlowska ◽  
M Amoni ◽  
...  
Keyword(s):  
Shear Wave ◽  
Wave Speed ◽  
Propagation Speed ◽  
Shear Wave Elastography ◽  
Frame Rate ◽  
Myocardial Stiffness ◽  
High Frame Rate ◽  
Shear Wave Speed ◽  
Non Invasive ◽  
Operating Chamber

Abstract Background Several cardiovascular disorders are accompanied by a stiffening of the myocardium and may result in diastolic heart failure. The non-invasive assessment of myocardial stiffness could therefore improve the understanding of the pathophysiology and guide treatment. Shear wave elastography (SWE) is a recent technique with tremendous potential for evaluating myocardial stiffness in a non-invasive way. Using high frame rate echocardiography, the propagation speed of shear waves is evaluated, which is directly related to the stiffness of the myocardium. These waves are induced by for instance mitral valve closure (MVC) and propagate throughout the cardiac muscle. However, validation of SWE against an invasive gold standard method is lacking. Purpose The aim of this study was to compare echocardiographic shear wave elastography against invasive pressure-volume loops, a gold standard reference method for assessing chamber stiffness. Methods In 15 pigs (31.2±4.1 kg) stiffness of the myocardium was acutely changed by inducing ischemia/reperfusion (I/R) injury. For this, the proximal LAD was balloon occluded for 90 minutes with subsequent reperfusion for 40 minutes. Conventional and high frame rate echocardiographic images were acquired simultaneously with pressure-volume loops during baseline conditions and after the induction of the I/R injury. Preload was reduced in order to acquire a set of pressure-volume loops to derive the end-diastolic pressure volume relation (EDPVR). From the EDPVR, the stiffness coefficient β and the operating chamber stiffness dP/dV were obtained. High frame rate echocardiographic datasets of the parasternal long axis view were acquired with an experimental ultrasound scanner (HD-PULSE) at an average frame rate of 1304±115 Hz. Tissue acceleration maps were obtained by drawing an M-mode line along the interventricular septum in order to visualize shear waves after MVC (at end-diastole). The propagation speed was assessed by semi-automatically measuring the slope (Figure A). Results I/R injury led to an elevated chamber stiffness constant β (0.09±0.03 1/ml vs. 0.05±0.01 1/ml; p<0.001) and operating chamber stiffness dP/dV (1.09±0.38 mmHg/ml vs. 0.50±0.18 mmHg/ml; p<0.01). Likewise, shear wave speed after MVC increased after the induction of the I/R injury in comparison to baseline (6.1±1.2 m/s vs. 3.2±0.8 m/s; p<0.001). Shear wave speed had a moderate positive correlation with β (r=0.63; p<0.001) (Figure B) and a strong positive correlation with dP/dV (r=0.81; p<0.001) (Figure C). Conclusion End-diastolic shear wave speed is strongly related to chamber stiffness, assessed invasively by pressure-volume loops. These results indicate that shear wave propagation speed could be used as a novel non-invasive measurement of the mechanical properties of the ventricle. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): FWO - Research Foundation Flanders

scholarly journals The influence of hemodialysis-induced preload changes on the propagation speed of natural shear waves

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
S Bezy ◽  
M Orlowska ◽  
A Van Craenenbroeck ◽  
M Cvijic ◽  
J Duchenne ◽  
...  
Keyword(s):  
Wave Propagation ◽  
Shear Wave ◽  
Wave Speed ◽  
Shear Waves ◽  
Propagation Speed ◽  
Left Ventricular ◽  
Frame Rate ◽  
High Frame Rate ◽  
Shear Wave Speed ◽  
Wave Propagation Speed

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Research Foundation - Flanders (FWO) Background Shear wave elastography (SWE) is a novel ultrasound technique based on the detection of transverse waves travelling through the myocardium using high frame rate echocardiography. The propagation speed of these shear waves is dependent on the stiffness of the myocardium. Previous studies have shown the potential of SWE for the non-invasive assessment of myocardial stiffness. It is unclear, however, if preload changes lead to measurable changes in the shear wave propagation speed in the left ventricle. In patients undergoing hemodialysis, the volume status is acutely changed. In this way, the effect of preload changes on shear wave speed can be assessed. Purpose The aim of this study was to explore the influence of preload changes on end-diastolic shear wave propagation speed. Methods Until now, 6 patients (age: 80[53-85] years; female: n = 2) receiving hemodialysis treatment were included. Echocardiographic images were taken before and every hour during a 4 hour hemodialysis session. Left ventricular parasternal long-axis views were acquired with an experimental high frame rate ultrasound scanner (average frame rate: 1016[941-1310] Hz). Standard echocardiography was performed with a conventional ultrasound machine. Shear waves were visualized on tissue acceleration maps by drawing an M-mode line along the interventricular septum. Shear wave propagation speed after mitral valve closure (MVC) was calculated by measuring the slope of the wave pattern on the acceleration maps (Figure A). Results Over the course of hemodialysis, the systolic (141[135-156] mmHg vs. 165[105-176] mmHg; p = 0.35 among groups) and diastolic blood pressure (70[66-75] mmHg vs. 82[63-84] mmHg; p = 0.21 among groups), heart rate (56[54-73] bmp vs. 57[50-67] bpm; p = 0.76 among groups), E/A ratio (1.6[0.7-1.8] vs. 1.2[0.6-1.4]; p = 0.43 among groups) and E/e’ (14[9-15] vs. 9[8-13]; p = 0.24 among groups ) remained the same. The ultra-filtrated volumes are shown in Figure B. The shear wave propagation speed after MVC gradually decreased during hemodialysis (6.7[5.4-9.7] m/s vs. 4.4[3.6-9.0] m/s; p = 0.04 among groups) (Figure C). There was a moderate negative correlation between shear wave speed and the ultra-filtrated volume (r=-0.63; p < 0.01) (Figure D). Conclusion The shear wave propagation speed at MVC significantly decreased over the course of hemodialysis and correlated to the ultra-filtrated volume. These results indicate that alterations in left ventricular preload affect the speed of shear waves at end-diastole. End-diastolic shear wave speed might therefore be a potential novel parameter for the evaluation of the left ventricular filling state. More patients will be included in the future to further explore these findings. Abstract Figure.

scholarly journals Shear wave elastography by high frame rate echocardiography can detect diffuse myocardial fibrosis after heart transplantation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Petrescu ◽  
S Bezy ◽  
M Cvijic ◽  
P Santos ◽  
J Duchenne ◽  
...  
Keyword(s):  
Shear Wave ◽  
Myocardial Fibrosis ◽  
Myocardial Injury ◽  
Shear Wave Elastography ◽  
Diffuse Myocardial Fibrosis ◽  
Frame Rate ◽  
Myocardial Stiffness ◽  
High Frame Rate ◽  
Native T1 ◽  
Propagation Velocities

Abstract Background Myocardial fibrosis is fundamental in the development of cardiac failure, regardless of ethiology. In both animal models and humans it has been shown that diffuse myocardial fibrosis (DMF) contributes to functional impairment, especially to increased passive myocardial stiffness, which is an important pathophysiological determinant of left ventricular diastolic dysfunction. Histological examination is the gold standard for myocardial fibrosis quantification, however, it requires endomyocardial biopsies which are invasive and not without risk. Echocardiographic shear wave (SW) elastography, based on high frame rate imaging, is an emerging approach for measuring myocardial stiffness in vivo. Natural SWs occur after mechanical excitation of the myocardium, e.g. after mitral valve closure (MVC) and their propagation velocity is directly related to myocardial stiffness, thus providing an opportunity to assess myocardial stiffness at end-diastole. Purpose The aim was to investigate if propagation velocities of natural SWs can be used to detect diffuse myocardial fibrosis in a cohort of heart transplant recipients. Methods We prospectively enrolled 22 patients (10.3±6.3 years after HTx) that underwent CMR during their annual check-up. We performed SW elastography in parasternal long axis views of the left ventricle using a fully programmable experimental scanner (HD-PULSE) equipped with a clinical phased array transducer (Samsung Medison P2–5AC) at 1100±250 frames per second. The SW propagation velocities at MVC were measured in the basal LV septum. Native T1 and extracellular volume (ECV) were measured at the same segment to evaluate DMF. A cut-off value for native T1 of 1040 ms and for ECV of 29% was used to define DMF in our cohort. Results We found good correlations between SW velocities and both myocardial T1 (r=0.80, p<0.0001, Figure A) and ECV (r=0.64, p=0.003, Figure B) measured with CMR. Further, we derived reference thresholds of natural SW velocities to identify DMF in HTx patients. The optimal cut-off value of SW velocity to identify patients with nativT1>1040 ms was 4.84 m/s (AUC 0.81, sensitivity 82%, specificity 82%, Figure C). To identify patients with ECV>0.29 the cut-off value of SW velocity was 4.74 m/s (AUC 0.74, sensitivity 73%, specificity 78%, Figure D). Conclusions End-diastolic shear wave propagation velocities, as measure of myocardial stiffness, showed a good correlation with CMR defined diffuse myocardial injury. Values higher than 4.74 m/s could identify diffuse myocardial injury in HTX patients with a good sensitivity and good specificity. These findings thus suggest that shear wave elastography has the potential to become a valuable non-invasive method for the detection of diffuse myocardial fibrosis. Funding Acknowledgement Type of funding source: None

Shear wave elastography: can we estimate filing pressures?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.E Werner ◽  
S Bezy ◽  
M Orlowska ◽  
G Kubiak ◽  
W Desmet ◽  
...  
Keyword(s):  
Diastolic Function ◽  
Shear Wave ◽  
Propagation Velocity ◽  
Shear Wave Elastography ◽  
Left Ventricular ◽  
Filling Pressure ◽  
Frame Rate ◽  
Funding Source ◽  
High Frame Rate ◽  
Non Invasive

Abstract Background The assessment of the left ventricular diastolic function is complex, as there is no single non-invasive parameter that provides a direct measurement of myocardial relaxation, myocardial compliance, or – as a surrogate - LV filling pressure. Estimation of diastolic function is therefore based on the combination of many parameters. Shear wave (SW) elastography (SWE) is a novel method based on high frame rate echocardiography. SWs occur after mechanical excitation of the myocardium, e.g. after mitral valve closure (MVC), and their propagation velocity is directly related to myocardial stiffness (MS). Purpose The aim of this study was to investigate if velocities of natural shear waves are related to MS at end diastole (ED) and, thus, could be used to estimate left ventricular end-diastolic pressures (LVEDP) as marker of diastolic function. Methods So far, we have prospectively enrolled 30 patients with a wide range of diastolic function, scheduled for heart catheterization so that LV filling pressures could be invasively measured. Patients with severe aortic stenosis, mitral stenosis of any degree and a more than moderate mitral regurgitation, as well as regional myocardial abnormalities or dysfunction in the anteroseptal wall were excluded. Echocardiography was performed immediately after catheterization. SW elastography in parasternal long axis views of the left ventricle (LV) was performed using an experimental scanner (HD-PULSE) at 1100±250 frames per second. Tissue acceleration maps were extracted from an anatomical M-mode line along the midline of the LV septum. The SW propagation velocity at MVC was measured as the slope on the M-mode acceleration map (Figure A). Results SW velocities at ED correlated very well with the invasively measured LVEDP (r=0.815, p<0.001, Figure B). In comparison, classical echocardiographic parameters correlated only weakly or not with LVEDP (E/A: r=0.528, p=0.036, Figure C; E/e': r=−0.169, p=0,531, Figure D) with LVEDP. For the detection of an elevated LVEDP above 15 mmHg, a cut off value for the SW velocity at MVC of 3.75 m/s was associated with a Sensitivity of 92.9% and a Specificity of 83.3%. Conclusions End-diastolic shear wave velocities, measured by high frame rate shear wave elastography, showed a significant correlation with the end-diastolic filling pressure of the LV indicating a potential clinical value of the new method for a non-invasive and direct assessment of LV diastolic function. More patients will be included to confirm these findings. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Fonds Wetenschappelijk Onderzoek Flanderen (Research Foundation Flanders)

scholarly journals Natural shear wave propagation speed is influenced by both changes in myocardial structural properties as well as loading conditions

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
S Bezy ◽  
J Duchenne ◽  
M Orlowska ◽  
M Amoni ◽  
A Caenen ◽  
...  
Keyword(s):  
Wave Propagation ◽  
Structural Properties ◽  
Shear Wave ◽  
Wave Speed ◽  
Propagation Speed ◽  
Left Ventricular ◽  
Balloon Occlusion ◽  
Frame Rate ◽  
Shear Wave Speed ◽  
Wave Propagation Speed

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Research Foundation - Flanders (FWO) Background Shear wave elastography (SWE) is a promising tool for the non-invasive assessment of myocardial stiffness. It is based on the evaluation of the propagation speed of shear waves by high frame rate echocardiography. These waves can be induced by for instance mitral valve closure (MVC) and the speed at which they travel is related to the instantaneous stiffness of the myocardium. Myocardial stiffness is defined by the local slope of the stress-strain relation and can therefore be altered by both changes in structural properties of the myocardium as well as loading conditions. Purpose The aim of this study was to investigate how changes in myocardial structural properties as well as loading conditions affect shear wave speed after MVC. Methods Until now, 8 pigs (weight: 33.6 ± 5.4 kg) were included. The following interventions were performed: 1) preload was reduced by balloon occlusion of the vena cava inferior, 2) afterload was increased by balloon occlusion of descending aorta, 3) preload was increased by intravenous administration of 500 ml of saline and 4) ischemia/reperfusion injury (I/R injury) was induced in the septal wall by balloon occlusion of the LAD for 90 min. with subsequent reperfusion for 40 min. Echocardiographic and left ventricular pressure recordings were simultaneously obtained during each intervention. Left ventricular parasternal long-axis views were acquired with an experimental high frame rate ultrasound scanner (average frame rate: 1279 ± 148 Hz). Shear waves were visualized on tissue acceleration maps by drawing an M-mode line along the interventricular septum. Shear wave propagation speed after MVC was calculated by assessing the slope of the wave pattern on the tissue acceleration map (Figure A). Results The change in left ventricular end-diastolic pressure (LVEDP) and shear wave speed after MVC between baseline and each intervention are shown in Figure B and C, respectively. Preload reduction resulted in significant lower LVEDP compared to baseline (p < 0.01), while the other loading changes did not have a significant effect. Shear wave speed after MVC significantly increased by afterload and preload increase (p < 0.01). I/R injury resulted in increased shear wave speed (p < 0.01) without significantly altering LVEDP. There was a good positive correlation between the change in LVEDP and the change in shear wave speed induced by loading changes (r = 0.76; p < 0.001) (Figure D). However, the correlation became less strong if data of I/R injury was taken into account as well (r = 0.63; p < 0.001). Conclusion Our results suggest that SWE is capable to characterize myocardial tissue properties and besides has the potential as a novel method for the estimation of left ventricular filling pressures. However, in the presence of structural changes of the myocardium, care should be taken when estimating filling pressures based on shear wave propagation speed. Abstract Figure.

scholarly journals Cardiac shear wave elastography can distinguish healthy and scarred myocardium in patients with conduction delays

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
L Wouters ◽  
J Duchenne ◽  
S Bezy ◽  
K Papangelopoulou ◽  
A Puvrez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Shear Wave ◽  
Ischemic Cardiomyopathy ◽  
Shear Waves ◽  
Propagation Speed ◽  
Shear Wave Elastography ◽  
Myocardial Scar ◽  
Frame Rate ◽  
Non Invasive

Abstract Background Cardiac resynchronization therapy (CRT) is an established therapy for patients suffering from heart failure and left bundle branch block (LBBB) conduction delays. Despite its proven beneficial effects, CRT is associated with a high percentage of non-response. Since CRT has shown to be less effective in patients with ischemic cardiomyopathy, determining the presence of myocardial scar before implantation could help to improve the response-rate. However, the gold standard to assess myocardial scar, magnetic resonance imaging (MRI), cannot be used in every patient, due to already implanted devices and/or reduced renal function. Recently introduced shear wave elastography (SWE) allows the non-invasive assessment of myocardial stiffness. Natural shear waves are excited by mitral valve closure (MVC) and travel through the heart with a speed directly related to tissue stiffness. SWE has previously been proven to be able to detect myocardial scar, however this has never been shown in the presence LBBB. Purpose The aim of this study was to evaluate the capability of SWE as a novel method to determine myocardial scar in patients with conduction delays. Methods We included 24 heart failure patients (age: 68±10; 50% males) with ischemic (n=8) and non-ischemic (n=16) cardiomyopathy. The CRT device was set to AAI mode in order to obtain native ventricular conduction. For patients with ischemic cardiomyopathy, the presence and location of scar was determined by MRI or scintigraphy. All ischemic patients had septal scar only. For SWE, left ventricular parasternal long-axis views were acquired with an experimental high frame rate ultrasound scanner (average frame rate: ±1200 Hz). Shear waves were visualized in M-modes of the septum, colour coded for tissue acceleration. The slope of the shear waves in the M-mode represents their propagation speed (Figure A). Results There was no significant difference between the ischemic and non-ischemic patients in QRS width after CRT (149±31 ms vs 144±26 ms), systolic blood pressure blood pressure (135±11 mmHg vs 135±23 mmHg), diastolic blood pressure (74±9 mmHg vs 70±11 mmHg) and heart rate (58±4 bpm vs 63±9 bpm) (all p>0.05). Ejection fraction (33±8% vs 45±10%), end-diastolic volume (196±34 ml vs 129±64 ml) and global longitudinal strain (−9.8±3.1% vs −14.1±4.1%) differed significantly between the groups (all p<0.05). Shear wave speed after MVC was significantly higher in patients with septal scar compared to non-ischemic patients (8.2±1.9 m/s vs 5.5±1.2 m/s; p<0.01) (Figure B). Conclusion In the presence of scar, we found markedly elevated shear wave propagation speed compared to non-ischemic patients. These results indicate that SWE is able to identify scarred myocardium even in patients with LBBB. We therefore believe that SWE could be a novel easy and non-invasive method to evaluate septal myocardial scarring in patients before CRT implantation. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): FWO - Research Foundation Flanders

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.

P1501Can we measure the stiffening of hypertensive hearts non-invasively? A shear wave imaging study using ultra-high frame rate echocardiography

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Cvijic ◽  
P Santos ◽  
A M Petrescu ◽  
S Bezy ◽  
M Orlowska ◽  
...  
Keyword(s):  
Left Atrium ◽  
Shear Wave ◽  
Interventricular Septum ◽  
Left Ventricular ◽  
Frame Rate ◽  
Volume Index ◽  
Healthy Controls ◽  
Myocardial Stiffness ◽  
High Frame Rate ◽  
Concentric Hypertrophy

Abstract Background Cardiac shear wave (SW) elastography is a novel technique based on high-frame-rate (HFR) echocardiography which has been shown to be related to myocardial stiffness. In this study we explore the relation between myocardial SW velocity and myocardial remodelling in remodelled hearts of patients with arterial hypertension (AH). Methods We prospectively included 33 treated AH patients with hypertrophic left ventricular (LV) remodelling (59±14 years, 55% male) and 26 aged matched healthy controls (55±15 years, 77% male). AH patients were further divided according to their LV geometric pattern into a concentric remodelling (CR) group (13 patients) and a concentric hypertrophy (CH) group (20 patients). LV parasternal long axis views were acquired with an experimental HFR ultrasound scanner (HD-PULSE) at 1266±317 frames per seconds. Myocardial acceleration maps were created from the HFR-datasets and an anatomical M-mode line was drawn along the midline of the interventricular septum (IVS). The propagation velocity of natural SWs occurring at mitral valve closure (MVC) was measured on these M-modes (Figure A) in order to assess passive myocardial stiffness. Standard echocardiography using a commercial scanner was performed to evaluate LV remodelling. Results SW velocities at MVC differed significantly between AH patients and controls (5.83±1.20 m/s vs. 4.04±0.96 m/s; p<0.001). Within the patient group, patients with CH had highest SW velocities at MVC (p<0.001), whereas values between controls and patients with CR were comparable (p=0.075) (Figure B). In AH patients, significant positive correlations were found between SW velocity at MVC and parameters of LV remodelling (IVS thickness: r=0.728, p<0.001; LV mass index: r=0.780, p<0.001, LV end-diastolic volume: r=0.604, p=0.008) (Figure C) and also parameters of diastolic function (E/e': r=0.495, p=0.005, left atrium diameter: r=0.866, p<0.001, left atrium volume index: r=0.661, p<0.001). Figure A, B, C Conclusions SW velocity – and therefore myocardial stiffness – is higher in AH patients compared to healthy controls and increases with increasing severity of hypertensive heart disease. Patients with concentric remodelling have still close-to-normal passive myocardial properties while patients with concentric hypertrophy show significant stiffening. Echocardiographic shear wave elastography is a promising new technique for the non-invasive assessment of myocardial stiffness and might provide valuable new insights into myocardial function and the pathophysiology of myocardial disease.

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.

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