Effectiveness of Shear Wave Elastography in the diagnosis of acute pancreatitis on admission

Aim: We aimed to investigate the effectiveness of shear wave elastography (SWE) in the diagnosis of acute pancreatitis (AP).Material and methods: The pancreatic parenchyma of 50 patients whose clinical and laboratory findings were indicative of AP and of 70 healthy, asymptomatic volunteer participants with normal laboratory values was examined using SWE.Computed tomography was performed in all patients with AP on admission. Elastographic measurements were performed by manually drawing the contours of the pancreatic parenchyma using the free region of interest. The quantitative SWE values (meters/second [m/s], kilopascal [kPa]) of the patients and asymptomatic volunteers group were compared.Results: The mean SWE value of the pancreatic parenchyma was 2.60 ± 1.63 m/s in the asymptomatic volunteers and 3.48 ± 0.52 m/s in patients with AP, with a statistically significant difference (p<0.001, t=-3.685). The mean SWE value of the pancreatic parenchyma was 23.77±6.72 kPa in the asymptomatic volunteers and 45.71 ± 10.72 kPa in patients with AP, indicating a significant difference (p<0.001, t=-3.685). AP can be diagnosed with a sensitivity and specificity of 98.0% when 29.45 kPa was designated as cut-off value and with a 96.0% sensitivity and 98.3% specificity when 2.77 m/s was designated as the cut-off value. The superiority of SWE was found over B-mode US and CECT in the diagnosis of AP on admission. Conclusion: SWE can be used as an effective imaging method with high sensitivity and specificity for the diagnosis of AP. It may be used as an important imaging method to assist in the diagnosis of AP especially when B-mode US and CECT findings are normal.

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Shear wave elastography: Can it be a new radiologic approach for the diagnosis of erectile dysfunction?

Ultrasound ◽

10.1177/1742271x17697512 ◽

2017 ◽

Vol 25 (3) ◽

pp. 150-155 ◽

Cited By ~ 7

Author(s):

Rustu Turkay ◽

Ercan Inci ◽

Mustafa Gurkan Yenice ◽

Volkan Tugcu

Keyword(s):

Erectile Dysfunction ◽

Positive Predictive Value ◽

Shear Wave ◽

Predictive Value ◽

Corpus Cavernosum ◽

Shear Wave Elastography ◽

Significant Difference ◽

The Mean ◽

Group 2 ◽

Group 1

Introduction Erectile dysfunction (ED) is a common health problem among males, and radiology has limited use in its diagnosis and treatment. Shear wave elastography (SWE) is a new sonographic technique. In this study, we examined the significance of SWE in the diagnosis of ED. Methods The study included a total number of 70 participants. The mean age of the participants was 54.14 ± 8.03 years (range: 39 and 71 years old). We composed two groups. Group 1 had 35 patients who presented to the urology clinic in our hospital complaining of ED, and had a score of 17 or lower from the International Index of Erectile Function (IIEF) questionnaire. Group 2 consisted of 35 healthy volunteers who did not have ED. SWE measurements were performed from corpus cavernosum penis in both groups, and the results were noted. Differences between the groups were evaluated statistically. Results The difference between the mean SWE measurements of two groups (Group 1: 20.94 ± 6.23 kPa and group 2: 24.63 ± 7.58 kPa) was found to be statistically significant ( p = 0.027; p < 0.05). For a cut-off value of 17.1 kPa, the SWE method has specificity, sensitivity, positive predictive value, and negative predictive value regarding diagnosis of ED as 94.29%, 34.29%, 85.71%, and 58.93%, respectively. The mean age of the groups did not show a statistically significant difference ( p = 0.287; p > 0.05). Conclusions Due to its high specificity and positive predictive value, SWE can offer useful data in the radiologic evaluation of ED cases.

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Assessment of testes with two-dimensional Shear Wave Elastography in patients with operated inguinal hernia

Medical Ultrasonography ◽

10.11152/mu-2819 ◽

2021 ◽

Author(s):

Mehmet Sedat Durmaz ◽

Fatih Ates ◽

Serdar Arslan ◽

Turgay Kara ◽

Funda Gökgöz Durmaz ◽

...

Keyword(s):

Inguinal Hernia ◽

Healthy Volunteers ◽

Shear Wave ◽

Shear Wave Elastography ◽

Testicular Volume ◽

Two Dimensional ◽

Healthy Group ◽

Significant Difference ◽

Operation Techniques ◽

The Mean

Aim: We compared the two-dimensional shear-wave elastography (2D-SWE) values between the testes with same side operated inguinal hernia (IH) and the contralateral testes, as well as the testes of healthy volunteers without IH. Material and methods: A total of 189 participants (117 unilateral [117 testes] and 8 bilateral operated IH patients [16 testes] and 64 healthy volunteers [128 testes]), providing a total of 378 testicles, were investigated prospectively. All patients underwent B-mode ultrasonography (US) and 2D-SWE examinations. Operation type, the period between diagnosis and operation, the period since the operation, testes volumes, and 2D-SWE values were compared. Results: The B-mode US finding of the testes were normal in all participants. The mean testes’ volume of same side operated IH was significantly lower comparing to contralat-eral testes and the healthy group (p<0.001). The 2D-SWE values of the testes with same side operated IH were significantly higher comparing to the contralateral testes and the healthy group (p<0.001). There was a statistically significant correlation between 2D-SWE values and IH severity, as well as the duration of the hernia (p=0.001). There was no significant correlation between the IH severity and testes volume (p=0.285). No significant difference was found between the direct and indirect IH in terms of testicular volume and SWE values and between the duration of the hernia, the time after sugery, testicular volume and SWE values according to operation techniques(p>0.005). Conclusions: The 2D-SWE can be used as an effective imag-ing method to evaluate testicular stiffness with objective numerical values, to estimate the severity of histologic damage in patients with operated IH.

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Assessment of the optic nerve, optic disc, and perineural area using shear-wave elastography in patients with multiple sclerosis

10.22541/au.161093554.44969265/v1 ◽

2021 ◽

Author(s):

Suna Sahin Ediz ◽

Basak Atalay ◽

Ilknur Aydın Canturk ◽

Adnan Kabaalioglu

Keyword(s):

Multiple Sclerosis ◽

Optic Nerve ◽

Optic Neuritis ◽

Optic Disc ◽

Shear Wave ◽

Shear Wave Elastography ◽

Control Group ◽

Optic Nerves ◽

Significant Difference ◽

The Mean

Purpose: To observe and describe the stiffness changes of the optic nerve in the patients with multiple sclerosis (MS) with or without optic neuritis and healthy adults via shear wave elastography (SWE). Methods: Seventy optic nerves from thirty-five patients with MS and sixty optic nerves from thirty healthy subjects were included prospectively in the study. The optic nerve (ON), optic disc (OD), and perineural area were evaluated with SWE and optic nerve sheat diameter (ONSD) was measured by ultrasound. Results The mean age of patients was 39.68 ± 9.99 years. There was no statistically significant difference between the groups in terms of ONSD, SWE ON, SWE OD, and SWE perineural area levels (p> 0.05). In the MS group; No statistically significant difference was found between patients with and without optic neuritis for the mean age, gender distribution, duration of MS, types of MS, ONSD, SWE ON, SWE OD, SWE perineural area, and Expanded Disability Status Scale (EDSS) scores (p> 0.05). No statistically significant difference in terms of ONSD, SWE ON, SWE OD, and SWE perineural area between the MS patients with or without optic neuritis and the control group (p> 0.05). Conclusion: Shear wave elastography measurements of the optic nerve, optic disc, and perineural area do not contribute to the evaluation of optic neuritis in a patient with MS.

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Placental elastography in second trimester preeclampsia prediction: A prospective study

Ultrasound ◽

10.1177/1742271x211040543 ◽

2021 ◽

pp. 1742271X2110405

Author(s):

Rajkumar Meena ◽

Amita Malik ◽

Swarna Jain ◽

Achla Batra

Keyword(s):

Shear Modulus ◽

Shear Wave ◽

Predictive Value ◽

Shear Wave Elastography ◽

Mean Value ◽

Diagnostic Potential ◽

Significant Difference ◽

Group A ◽

The Mean ◽

Group B

Objective The aim of the study was to evaluate the diagnostic potential of placental shear wave elastography in predicting preeclampsia at 16 to 20 weeks of gestation. Materials and methods A total of 230 pregnant women between 16 and 20 weeks of gestation were observed for the study. These women underwent shear wave elastography ElastPQ (Philips Healthcare, Bothell, Washington, USA) of the placenta. The mean value of placental shear modulus was obtained for each participant. These participants were followed up for the development of preeclampsia and were divided into two groups; group A included those who developed preeclampsia and group B included those who remained normotensive until delivery. The elasticity values of the two groups were compared, and the ROC curve was drawn to obtain the best cut-off value that would predict the onset of preeclampsia. Results Placental shear modulus varied from 1.03 kPa to 7.4 kPa at 16 to 20 weeks of gestation with an average of 2.74 ± 0.87 kPa. There was a statistically significant difference in the mean value of elasticity between two groups, being 4.61 kPa in group A and 2.51 kPa in group B. Maximum diagnostic accuracy was obtained at 2.9667 kPa with area under the curve 0.970, sensitivity 92%, specificity 91.71%, positive predictive value 57.5% and negative predictive value 98.9%. Conclusion Stiffness of placenta, quantitatively measured by SWE at 16 to 20 weeks of gestation, is higher in the women who develop preeclampsia and hence may be used for predicting preeclampsia.

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Ultrasound shear wave elastography imaging of common carotid arteries in patients with Spontaneous Coronary Artery Dissection (SCAD)

Journal of Ultrasound ◽

10.1007/s40477-021-00627-2 ◽

2022 ◽

Author(s):

Fahad F. Al-mutairi ◽

Abtehal Al-hussaini ◽

Anne-Marie Marsh ◽

Nilesh Samani ◽

Gerry McCann ◽

...

Keyword(s):

Coronary Artery ◽

Shear Wave ◽

Carotid Arteries ◽

Shear Wave Elastography ◽

Artery Dissection ◽

Spontaneous Coronary Artery Dissection ◽

Coronary Artery Dissection ◽

Significant Difference ◽

The Mean ◽

Common Carotid Arteries

Abstract Background Shear wave elastography (SWE) is emerging as a valuable clinical tool for a variety of conditions. The aim of this pilot study was to assess the potential of SWE imaging of the common carotid arteries (CCA) in patients with spontaneous coronary artery dissection (SCAD), a rare but potentially life-threatening condition, hypothesized to be linked to changes in vessel wall elasticity. Methods Ultrasound shear wave elastography (SWE) estimates of artery wall elasticity were obtained from the left and right CCAs of 89 confirmed SCAD patients and 38 non-dissection controls. SWE images obtained over multiple cardiac cycles were analysed by a blinded observer to estimate elasticity in the form of a Young’s Modulus (YM) value, across regions of interest (ROI) located within the anterior and posterior CCA walls. Results YM estimates ranged from 17 to 133 kPa in SCAD patients compared to 34 to 87 kPa in non-dissection controls. The mean YM of 55 [standard deviation (SD): 21] kPa in SCAD patients was not significantly different to the mean of 57 [SD: 12] kPa in controls, p = 0.32. The difference between groups was 2 kPa [95% Confidence Interval − 11, 4]. Conclusions SWE imaging of CCAs in SCAD patients is feasible although the clinical benefit is limited by relatively high variability of YM values which may have contributed to our finding of no significant difference between SCAD patients and non-dissection controls.

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Liver Elastography in Healthy Children Using Three Different Systems – How Many Measurements Are Necessary?

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/a-1283-5906 ◽

2020 ◽

Author(s):

Anders Batman Mjelle ◽

Anesa Mulabecirovic ◽

Roald Flesland Havre ◽

Edda Jonina Olafsdottir ◽

Odd Helge Gilja ◽

...

Keyword(s):

Shear Wave ◽

Transient Elastography ◽

Intraclass Correlation ◽

Age Groups ◽

Liver Stiffness ◽

Shear Wave Elastography ◽

Healthy Children ◽

Significant Difference ◽

Pediatric Liver Disease ◽

Liver Elastography

Abstract Purpose Liver elastography is increasingly being applied in screening for and follow-up of pediatric liver disease, and has been shown to correlate well with fibrosis staging through liver biopsy. Because time is of the essence when examining children, we wanted to evaluate if a reliable result can be achieved with fewer acquisitions. Materials and Methods 243 healthy children aged 4–17 years were examined after three hours of fasting. Participants were divided into four age groups: 4–7 years; 8–11 years; 12–14 years and 15–17 years. Both two-dimensional shear wave elastography (2D-SWE; GE Logiq E9) and point shear wave elastography (pSWE; Samsung RS80A with Prestige) were performed in all participants, while transient elastography (TE, Fibroscan) was performed in a subset of 87 children aged 8–17 years. Median liver stiffness measurement (LSM) values of 3, 4, 5, 6, 7, and 8 acquisitions were compared with the median value of 10 acquisitions (reference standard). Comparison was performed for all participants together as well as within every specific age group. We investigated both the intraclass correlation coefficient (ICC) with absolute agreement and all outliers more than 10 %, 20 % or ≥ 0.5 or 1.0 kPa from the median of 10 acquisitions. Results For all three systems there was no significant difference between three and ten acquisitions, with ICCs ≥ 0.97. All systems needed 4 acquisitions to achieve no LSM deviating ≥ 1.0 kPa of a median of ten. To achieve no LSM deviating ≥ 20 % of a median of ten acquisitions, pSWE and TE needed 4 acquisitions, while 2D-SWE required 6 acquisitions. Conclusion Our results contradict recommendations of 10 acquisitions for pSWE and TE and only 3 for 2D-SWE.

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Effect of Resonant Frequency Vibration on Delayed Onset Muscle Soreness and Resulting Stiffness as Measured by Shear-Wave Elastography

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18157853 ◽

2021 ◽

Vol 18 (15) ◽

pp. 7853

Author(s):

Garrett C. Jones ◽

Jonathan D. Blotter ◽

Cameron D. Smallwood ◽

Dennis L. Eggett ◽

Darryl J. Cochrane ◽

...

Keyword(s):

Resonant Frequency ◽

Shear Wave ◽

Time Course ◽

Biceps Brachii ◽

Shear Wave Elastography ◽

Upper Body ◽

Maximum Voluntary Isometric Contraction ◽

Post Exercise ◽

Significant Difference ◽

Pain Ratings

This study utilized resonant frequency vibration to the upper body to determine changes in pain, stiffness and isometric strength of the biceps brachii after eccentric damage. Thirty-one participants without recent resistance training were randomized into three groups: a Control (C) group and two eccentric exercise groups (No vibration (NV) and Vibration (V)). After muscle damage, participants in the V group received upper body vibration (UBV) therapy for 5 min on days 1–4. All participants completed a visual analog scale (VAS), maximum voluntary isometric contraction (MVIC), and shear wave elastography (SWE) of the bicep at baseline (pre-exercise), 24 h, 48 h, and 1-week post exercise. There was a significant difference between V and NV at 24 h for VAS (p = 0.0051), at 24 h and 1-week for MVIC (p = 0.0017 and p = 0.0016, respectively). There was a significant decrease in SWE for the V group from 24–48 h (p = 0.0003), while there was no significant change in the NV group (p = 0.9341). The use of UBV resonant vibration decreased MVIC decrement and reduced VAS pain ratings at 24 h post eccentric damage. SWE was strongly negatively correlated with MVIC and may function as a predictor of intrinsic muscle state in the time course of recovery of the biceps brachii.

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Early assessment of shear wave elastography parameters foresees the response to neoadjuvant chemotherapy in patients with invasive breast cancer

Breast Cancer Research ◽

10.1186/s13058-021-01429-4 ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Juanjuan Gu ◽

Eric C. Polley ◽

Max Denis ◽

Jodi M. Carter ◽

Sandhya Pruthi ◽

...

Keyword(s):

Breast Cancer ◽

Neoadjuvant Chemotherapy ◽

Shear Wave ◽

Invasive Breast Cancer ◽

Shear Wave Elastography ◽

Early Prediction ◽

Early Assessment ◽

Significant Difference ◽

Mass Size ◽

Response To Neoadjuvant Chemotherapy

Abstract Background Early prediction of tumor response to neoadjuvant chemotherapy (NACT) is crucial for optimal treatment and improved outcome in breast cancer patients. The purpose of this study is to investigate the role of shear wave elastography (SWE) for early assessment of response to NACT in patients with invasive breast cancer. Methods In a prospective study, 62 patients with biopsy-proven invasive breast cancer were enrolled. Three SWE studies were conducted on each patient: before, at mid-course, and after NACT but before surgery. A new parameter, mass characteristic frequency (fmass), along with SWE measurements and mass size was obtained from each SWE study visit. The clinical biomarkers were acquired from the pre-NACT core-needle biopsy. The efficacy of different models, generated with the leave-one-out cross-validation, in predicting response to NACT was shown by the area under the receiver operating characteristic curve and the corresponding sensitivity and specificity. Results A significant difference was found for SWE parameters measured before, at mid-course, and after NACT between the responders and non-responders. The combination of Emean2 and mass size (s2) gave an AUC of 0.75 (0.95 CI 0.62–0.88). For the ER+ tumors, the combination of Emean_ratio1, s1, and Ki-67 index gave an improved AUC of 0.84 (0.95 CI 0.65–0.96). For responders, fmass was significantly higher during the third visit. Conclusions Our study findings highlight the value of SWE estimation in the mid-course of NACT for the early prediction of treatment response. For ER+ tumors, the addition of Ki-67improves the predictive power of SWE. Moreover, fmass is presented as a new marker in predicting the endpoint of NACT in responders.

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Stiffness of the Masseter Muscle in Children—Establishing the Reference Values in the Pediatric Population Using Shear-Wave Elastography

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18189619 ◽

2021 ◽

Vol 18 (18) ◽

pp. 9619

Author(s):

Cyprian Olchowy ◽

Anna Olchowy ◽

Aleksander Pawluś ◽

Mieszko Więckiewicz ◽

Luca Maria Sconfienza

Keyword(s):

Shear Wave ◽

Masseter Muscle ◽

Pediatric Population ◽

Shear Wave Elastography ◽

Total Sample ◽

Healthy Children ◽

Significant Difference ◽

The Right ◽

The Impact ◽

Masseter Muscles

In children, the quality and muscle function are altered in many pathologic conditions, including temporomandibular disorders. Although several methods have been used to evaluate muscle tonus, none became a golden standard. Moreover, the masseter muscle characteristics in children have not been investigated to date. This study aimed to measure the stiffness of the masseter muscle using shear-wave elastography in healthy children. We enrolled 30 healthy children (mean age 10.87 ± 3.38 years). The stiffness of masseter muscles was measured with shear wave elastography. Stiffness for the total sample was 6.37 ± 0.77 kPa. A comparison of the measurements did not show significant differences between the right and the left masseter muscles (left—6.47 ± 0.78 kPa; right—6.24 ± 0.76 kPa; p = 0.3546). A significant difference was seen between boys and girls (boys—5.94 ± 0.50 kPa; girls—6.63 ± 0.80; p = 0.0006). Shear-wave elastography is a promising diagnostic tool. It may help to detect changes in the stiffness of the masseter muscle and draw attention to pathological processes within the jaw muscles. Directions for further research shall include determining stiffness values in pathological conditions and the impact of biological and functional factors on the stiffness of the masseter muscle.

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Shear wave elastography in optic neuritis: diagnostic accuracy of the optic nerve and adjacent fat tissue values

Journal of Ultrasonography ◽

10.15557/jou.2021.0031 ◽

2021 ◽

Vol 21 (86) ◽

pp. e194-e199

Author(s):

Mustafa Devran Aybar ◽

◽

Onder Turna ◽

Keyword(s):

Optic Nerve ◽

Diagnostic Accuracy ◽

Optic Neuritis ◽

Shear Wave ◽

Shear Wave Elastography ◽

Curve Analysis ◽

Fat Tissue ◽

Roc Curve Analysis ◽

Optic Nerves ◽

The Mean

Introduction: In this study, we attempt to determine the diagnostic performance of shear wave elastography of the optic nerve and adjacent fat tissue in patients with optic neuritis. Methods: The study included a patient group consisting of 72 eyes of 36 patients who were diagnosed with unilateral optic neuritis, and an age-matched control group of 36 eyes of 18 healthy subjects. The patient group consisted of 25 multiple sclerosis patients and 11 recurrent isolated optic neuritis patients. The mean shear wave elastography values of the optic nerves and intraorbital fat tissue adjacent optic nerves were recorded using m/s and kPa as units. ROC curve analysis was performed, and the diagnostic accuracy of shear wave elastography values was determined. Results: The mean shear wave elastography values of the optic nerves with neuritis (2.49 ± 0.41 m/s and 17.56 ± 4.42 kPa) were significantly higher than the values of the contralateral normal optic nerves (1.71 ± 0.32 m/s and 9.02 ± 2.34 kPa) (p = 0.006 and p = 0.004, respectively) in the optic neuritis group. The mean shear wave elastography values of intraorbital fat tissue adjacent optic nerves with neuritis (1.87 ± 0.32 m/s and 9.65 ± 1.12 kPa) were significantly higher than the values of the contralateral normal side (1.47 ± 0.27 m/s and 6.78 ± 1.14 kPa) (p = 0.025 and p = 0.022, respectively) in the optic neuritis group. ROC curve analysis showed a high diagnostic accuracy for determining optic neuritis with shear wave elastography values of the optic nerves (AUC 0.955 [95% CI, 0.933–0.978] in m/s and AUC 0.967 [95% CI, 0.940–0.985] in kPa). Conclusions: Shear wave elastography may be an important alternative diagnostic tool in the diagnosis of optic neuritis.

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