scholarly journals Does Supersonic Shear Wave Elastography Help Differentiate Biliary Atresia from Other Causes of Cholestatic Hepatitis in Infants Less than 90 Days Old? Compared with Grey-Scale US

2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Xingxing Duan ◽  
Ya Peng ◽  
Wengang Liu ◽  
Liu Yang ◽  
Jie Zhang
Keyword(s):  
Biliary Atresia ◽  
Young’S Modulus ◽  
Shear Wave ◽  
Sensitivity And Specificity ◽  
Diagnostic Performance ◽  
Young's Modulus ◽  
Shear Wave Elastography ◽  
Cholestatic Hepatitis ◽  
Serial Test ◽  
Grey Scale

Purpose. To investigate the diagnostic performance of shear wave elastography (SWE) for measuring liver stiffness to identify and differentiate biliary atresia (BA) from cholestatic hepatitis in infants younger than 90 days. Methods. A total of 138 infants younger than 90 days with cholestatic hepatitis were examined by SWE. The infants were subclassified into BA and nonbiliary atresia (non-BA) groups. Receiver operating characteristic (ROC) analysis was used to determine the sensitivity and specificity of hepatic Young’s modulus measurements, the ultrasonic findings in the differential diagnosis of suspected BA, and the cut-off value to diagnose BA. Results. In all infants with cholestatic hepatitis, the cut-off value of hepatic Young’s modulus to differentiate the BA group from the non-BA group was 12.35 kPa and the area under the ROC curve (AUC) was 0.937, with a sensitivity of 84.3% and a specificity of 89.7%; nevertheless the AUC of the abnormal gallbladder (AbGB) was 0.940, with a sensitivity of 96.1% and a specificity of 92.0%. In the parallel test, triangular cord (TC) sign combined with AbGB had the best diagnostic performance and the AUC was 0.960, with a sensitivity of 100% and a specificity of 92.0%. In the serial test, SWE combined with AbGB achieved the best diagnostic performance; the AUC was 0.902, the sensitivity and specificity were 80.4% and 100%, respectively. Conclusions. SWE could not only help differentiate BA from cholestatic hepatic diseases but also increase the diagnostic specificity when combined with grey-scale ultrasound in the serial test.

The impact of body position and exercise on the measurement of liver Young’s modulus by real-time shear wave elastography

2021 ◽  
pp. 1-10
Author(s):  
Xia Jiang ◽  
Li Li ◽  
Hong-Yuan Xue
Keyword(s):  
Healthy Volunteers ◽  
Real Time ◽  
Young’S Modulus ◽  
Shear Wave ◽  
Supine Position ◽  
Young's Modulus ◽  
Body Position ◽  
Shear Wave Elastography ◽  
Lateral Position ◽  
Left Lateral Position

BACKGROUND: In the past ten years, liver biopsies have been used as a method to accurately diagnose the stage of fibrosis. OBJECTIVE: This study aimed to evaluate whether body position and exercise affect the measurement of liver Young’s modulus of healthy volunteers by real-time shear wave elastography (RT-SWE). Methods: RT-SWE was used to measure liver Young’s modulus in the supine and left lateral positions of 70 healthy volunteers at rest and measure the liver Young’s modulus in the lying position before exercise, and at zero, five, and ten minutes of rest after exercise. RESULTS: The liver Young’s modulus in the left lateral position was significantly higher than in the supine position (P< 0.05), and the measured value in the supine position was more stable than the left lateral position. The liver Young’s modulus measured at zero minutes after exercise was significantly higher than that measured before exercise (P< 0.05). The liver Young’s modulus measured at five minutes after exercise was significantly higher than that measured at zero minutes after exercise (P<0.05) and was not statistically different from the measured value before exercise (P> 0.05). The liver Young’s modulus measured at ten minutes after exercise was significantly higher from that measured at zero minutes after exercise (P< 0.05) and was not statistically different from the measured value at five minutes after exercise (P> 0.05). CONCLUSION: Body position and exercise have a significant impact on the measurement of liver Young’s modulus. It is recommended that the examinees take a supine position during the measurement, and measurement should be conducted at least ten minutes after exercise.

Прицельная эластометрия (эластография сдвиговой волной) в диагностике рака предстательной железы (предварительные результаты)

2019 ◽  
pp. 17-29
Keyword(s):  
Prostate Cancer ◽  
Young’S Modulus ◽  
Shear Wave ◽  
Young's Modulus ◽  
Shear Wave Elastography ◽  
Grade 3

В исследование было включено 96 пациентов с подозрением на рак предстательной железы. Всем пациентам выполнялось мультипараметрическое трансректальное ультразвуковое исследование предстательной железы и семенных пузырьков на аппарате Aixplorer (Supersonic Imagine, Франция) с помощью высокочастотного внутриполостного датчика, работающего в диапазоне частот 3-12 МГц. Предстательная железа была разделена на 12 секторов для ультразвуковой оценки (серошкальная эхография, энергетическое допплеровское картирование, эластография сдвиговой волной) и последующей системной биопсии предстательной железы (каждый из секстантов основания, средней части и верхушки железы справа и слева подразделялся на латеральный и медиальный субрегионы - итого 12 секторов). В случаях выявления очаговых изменений, подозрительных на злокачественность, в дополнение к системной биопсии проводили прицельную биопсию. Для статистического анализа использовали следующие показатели модуля Юнга: среднее арифметическое из трех Emean, измеренных в каждом секторе (aveEmean) (1), и максимальное из трех Emean, измеренных в каждом секторе (maxEmean) (2). При выявлении очаговых изменений при эластографии сдвиговой волной был применен аналогичный подход. Для последующего анализа значения aveEmean и maxEmean привязывали к конкретным биопсийным пробам (раздельная маркировка биоптатов) с последующей морфологической верификацией. Было проанализировано 1308 биоптатов. По результатам морфологического исследования рак предстательной железы был выявлен в 275 образцах (основная группа). Остальные образцы составили группу сравнения (n = 1033). Значения aveEmean и maxEmean в основной группе и группе сравнения достоверно различаются при P 0,0001. При проведении корреляционного анализа в основной группе выявлены заметные достоверные корреляции суммы Глисона, с одной стороны, и aveEmean (rS - 0,558, P 0,0001), maxEmean (rS - 0,548, P 0,0001) - с другой. Чувствительность диагностического теста “aveEmean > 35,4 кПа - рак предстательной железы” (n = 1308) равна 85,1%, специфичность - 85,8%, AUC - 0,908. Чувствительность диагностического теста “maxEmean > 37,9 кПа - рак предстательной железы” (n = 1308) равна 88,4%, специфичность - 80,4%, AUC - 0,912. Чувствительность прогностического теста “aveEmean > 59,2 кПа - рак предстательной железы” (n = 275) (прогнозирование морфологически значимого рака предстательной железы) равна 76,8%, специфичность - 77,7%, AUC - 0,807. Чувствительность прогностического теста “maxEmean > 62,7 кПа - рак предстательной железы” (n = 275) (прогнозирование морфологически значимого рака предстательной железы) равна 79,3%, специфичность - 71,5%, AUC - 0,802. Эластография сдвиговой волной показывает большую информативность в диагностике рака предстательной железы, меньшую - в прогнозировании морфологической значимости (ISUP grade ≥ 3). Ключевые слова: ультразвуковая эластография сдвиговой волной, жесткость, модуль Юнга, предстательная железа, рак предстательной железы, ultrasound shear wave elastography, stiffness, Young’s modulus, prostate, prostate cancer

Latest diagnostic performance of different ultrasonic features for biliary atresia

2021 ◽  
pp. 028418512110558
Author(s):  
Pan Yang ◽  
Yajie Tang ◽  
Hongying Wang ◽  
Xiangxiang Zhang ◽  
Boyang Yang
Keyword(s):  
Biliary Atresia ◽  
Sensitivity And Specificity ◽  
Diagnostic Performance ◽  
Shear Wave Elastography ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Clinical Challenge ◽  
Mesh Terms ◽  
Methodologic Quality ◽  
Central Register

Background Early diagnosis of biliary atresia (BA) is an important clinical challenge. Purpose To summarize the latest diagnostic performance of different ultrasonic (US) features for BA. Material and Methods MeSH terms “biliary atresia” and “ultrasonography” and related hyponyms were used to search PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. Eligible articles were included and data were retrieved. The methodologic quality was assessed by version 2 of the Quality Assessment of Diagnostic Accuracy Studies tool. Estimated sensitivity and specificity of each US feature were calculated by Stata 14.0. Results Fifty eligible studies on 5622 patients were included. Respective summary sensitivity and specificity were 77% (95% CI=69–84) and 98% (95% CI=96–99) for triangular cord sign (TCS) in 32 studies, 86% (95% CI=78–92) and 86% (95% CI=72–94) for shear wave elastography (SWE) in seven studies, 75% (95% CI=65–83) and 92% (95% CI=86–95) for gallbladder and biliary system abnormality (GBA) in 25 studies, and 81% (95% CI=69–90) and 79% (95% CI=67–87) for hepatic artery (HA) enlargement in seven studies. The overall US features from 11 studies yielded a summary sensitivity of 84% (95% CI=72–92) and specificity of 86% (95% CI=77–92). Conclusion TCS and GBA were the two most widely accepted US features currently used for differential diagnosis of BA. The newly developed SWE was an objective and convenient method with good diagnostic performance. HA enlargement can be used as an auxiliary sign.

Application of Shear Wave Elastography in the Diagnosis of Thyroid Nodules of Thyroid Imaging Report and Data System

2020 ◽  
Vol 10 (4) ◽  
pp. 864-867
Author(s):  
Jia Zheng ◽  
Xiaoxin Wang ◽  
Xianjing Han ◽  
Chunyan Li ◽  
Jianan Wang ◽  
...  
Keyword(s):  
Young’S Modulus ◽  
Shear Wave ◽  
Thyroid Nodules ◽  
Ultrasound Examination ◽  
Young's Modulus ◽  
Shear Wave Elastography ◽  
Diagnostic Value ◽  
Data System ◽  
Thyroid Imaging ◽  
The Mean

The purpose of this study is to explore whether shear wave elastography has diagnostic value in distinguishing benign and malignant thyroid imaging report and data system (TI-RADS) nodules, so as to provide more accurate information for clinical diagnosis and treatment of thyroid nodules. In this study, 134 patients with thyroid nodules who underwent ultrasound examination from February 2018 to October 2018 are collected. Firstly, according to the diagnostic criteria proposed by Horvath, TI-RADS grading is performed on them, and 78 patients with TI-RADS4 single solid nodules are screened out. Secondly, conventional ultrasound examination is performed on all the researchers, and shear wave elastographies are obtained 1 week after the examination. Thirdly, parameters of each lesion are measured by ultrasound physicians, and the maximum, minimum and average values of Young's modulus of each lesion are recorded. The results show that the mean and maximum of Young's modulus of benign lesions are (26.31 ± 9.88) kPa and (51.36 ± 14.51) kPa, respectively, the mean and maximum of Young's modulus of malignant lesions are (48.36 ± 16.53) and (69.15 ± 19.98) kPa, respectively, and the area under the ROC curve of Emean and Emax is 0.852 and 0.748, respectively. Therefore, shear wave elastography is a new type of ultrasound elastography, which has the advantages of objectivity and little influence from operators without artificial pressure. It has high sensitivity, specificity and accuracy in diagnosing benign and malignant thyroid nodules. Among them, the average value of Young's modulus has the greatest diagnostic value.

Эластография сдвиговой волной в рамках мультипараметрической ультразвуковой диагностики в оценке местного распространения рака предстательной железы

2019 ◽  
pp. 30-44
Keyword(s):  
Prostate Cancer ◽  
Seminal Vesicle ◽  
Young’S Modulus ◽  
Shear Wave ◽  
Young's Modulus ◽  
Shear Wave Elastography ◽  
Cancer Staging ◽  
Seminal Vesicle Invasion ◽  
Extraprostatic Extension ◽  
Prostate Cancer Staging

В статье представлены три клинических наблюдения, которые демонстрируют полезность ультразвуковой информации, полученной при мультипараметрическом трансректальном ультразвуковом исследовании, в оценке местного распространения рака предстательной железы. Ультразвуковая картина верифицирована данными мультипараметрической магнитно-резонансной томографии и трансректальной мультифокальной системной пункционной биопсии предстательной железы из 12 точек под контролем ультразвукового исследования, дополненной прицельной биопсией из подозрительных на злокачественность очагов, выявленных при мультипараметрическом трансректальном ультразвуковом исследовании. Представлен краткий обзор литературы, который показывает, что на сегодняшний день мультипараметрическая ультразвуковая диагностика не позволяет с приемлемой диагностической точностью выполнить предоперационное стадирование рака предстательной железы. Как и другие методы ультразвуковой диагностики (серошкальная визуализация, 3D-визуа лизация, цветокодированные допплерографические режимы), эластография сдвиговой волной не рассматривается в рутинной практике среди инструментальных методов, осуществляющих стадирование по категории Т. Но в тех случаях, когда врач ультразвуковой диагностики выявляет с помощью эластографии сдвиговой волной (как и с помощью серошкального и цветокодированных допплерографических режимов) признаки экстрапростатического распространения опухоли или прорастания опухоли в семенные пузырьки, он может указать эти данные в протоколе ультразвукового исследования. Ключевые слова: ультразвуковая эластография сдвиговой волной, жесткость, модуль Юнга, предстательная железа, рак предстательной железы, стадирование, экстрапростатическое распространение, инвазия в семенные пузырьки, ultrasound shear wave elastography, stiffness, Young’s modulus, prostate, prostate cancer, staging, extraprostatic extension, seminal vesicle invasion

scholarly journals Impact of region of interest (ROI) size on the diagnostic performance of shear wave elastography in differentiating solid breast lesions

2017 ◽  
Vol 59 (6) ◽  
pp. 657-663 ◽  
Author(s):  
Jin Hee Moon ◽  
Ji-Young Hwang ◽  
Jeong Seon Park ◽  
Sung Hye Koh ◽  
Sun-Young Park
Keyword(s):  
Shear Wave ◽  
Sensitivity And Specificity ◽  
Diagnostic Performance ◽  
Characteristic Curve ◽  
Region Of Interest ◽  
Shear Wave Elastography ◽  
Breast Lesions ◽  
Malignant Breast ◽  
Solid Lesions ◽  
The Impact

Background Shear wave elastography (SWE) using a region of interest (ROI) can demonstrate the quantitative elasticity of breast lesions. Purpose To prospectively evaluate the impact of two different ROI sizes on the diagnostic performance of SWE for differentiating benign and malignant breast lesions. Material and Methods A total of 154 breast lesions were included. Two types of ROIs were investigated: one involving an approximately 2-mm diameter, small round ROIs placed over the stiffest area of the lesion, as determined by SWE (ROI-S); and another ROI drawn along the margin of the lesion using a touch pen or track ball to encompass the entire lesion (ROI-M). Maximum elasticity (Emax), mean elasticity (Emean), minimum elasticity (Emin), and standard deviation (SD) were measured for the two ROIs. The area under the receiver operating characteristic curve (AUC) as well as the sensitivity and specificity of each elasticity value were determined. Results The AUCs for ROI-S were higher than those for ROI-M when differentiating benign and malignant breast solid lesions. The Emax, Emean, Emin, and SD of the elasticity values for ROI-S were 0.865, 0.857, 0.816, and 0.849, respectively, and for ROI-M were 0.820, 0.780, 0.724, and 0.837, respectively. However, only Emax ( P = 0.0024) and Emean ( P = 0.0015) showed statistically significant differences. For ROI-S, the sensitivity and specificity of Emax were 78.8% and 84.3%, respectively, and those for Emean were 80.8% and 81.4%, respectively. Conclusion Using ROI-S with Emax and Emean has better diagnostic performance than ROI-M for differentiating between benign and malignant breast lesions.

Liver stiffness measurements with supersonic shear wave elastography in the diagnosis of biliary atresia: a comparative study with grey-scale US

2017 ◽  
Vol 27 (8) ◽  
pp. 3474-3484 ◽  
Author(s):  
Lu-yao Zhou ◽  
Hong Jiang ◽  
Quan-yuan Shan ◽  
Dong Chen ◽  
Xiao-na Lin ◽  
...  
Keyword(s):  
Comparative Study ◽  
Biliary Atresia ◽  
Shear Wave ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Grey Scale

scholarly journals Ultrasound elastography as a method of emergency diagnosis of the first signs of transient ischemia of the lower limbs in diabetic foot syndrome

2016 ◽  
Vol 97 (6) ◽  
pp. 860-864
Author(s):  
R I Fatykhov ◽  
I V Klyushkin ◽  
Yu A Klyushkina ◽  
N A Minnemullin ◽  
M N Nasrullaev
Keyword(s):  
Young’S Modulus ◽  
Shear Wave ◽  
Diabetic Foot ◽  
Modulus Of Elasticity ◽  
Young's Modulus ◽  
Shear Wave Elastography ◽  
Lower Limbs ◽  
Diabetic Foot Syndrome ◽  
Transient Ischemia ◽  
Young’S Modulus Of Elasticity

Aim. Evaluate the data of elastography characteristic for the first signs of transient ischemia of lower limbs in diabetes foot syndrome.Methods. In Kazan city clinical hospital №7 measurement of Young’s modulus of elasticity was performed in 12 patients with transient ischemia in diabetic foot syndrome. The methods and assessment of parameters typical for soft tissues of lower limbs we have developed earlier (patent «Method of elastography diagnosis of tissue changes in diabetic foot syndrome»). Color duplex scan of the arteries was performed according to standard method with the use of 5 to 10 MHz linear array probe starting from distal parts of limbs. Measurement of ultrasound density was performed with the use of shear wave elastography with 4 to 15 MHz wide-band linear probe. All parameters were measured in real time mode.Results. Increase of elastomeric index (Young’s modulus of elasticity) to 23.74±2.34 kPa (93,49±1,26%) in the distal segment of the lower extremity (on the foot) is associated with development of transient disorders in the lower limbs in diabetic foot syndrome, which is not always detected with invasive methods of diagnosis.Conclusion. Shear wave elastography is recommended for emergency medical care in diabetic foot syndrome; patients after being diagnosed with type 2 diabetes should dynamically monitor microcirculation of lower limbs that will decrease the risk of need of surgical treatment.

scholarly journals Value of shear wave elastography for diagnosis of primary prostate cancer: a systematic review and meta-analysis

2019 ◽  
Vol 21 (4) ◽  
pp. 382 ◽  
Author(s):  
Ye Yang ◽  
Xinxin Zhao ◽  
Xinxin Zhao ◽  
Jingwen Shi ◽  
Ying Huang
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Young’S Modulus ◽  
Shear Wave ◽  
Young's Modulus ◽  
Meta Analysis ◽  
Shear Wave Elastography ◽  
Benign Tissue ◽  
High Degree

Aim: To evaluate the difference in stiffness between prostate cancer (PCa) and benign tissue based on Young’s modulus determined by shear wave elastography (SWE). In addition, the diagnostic accuracy of SWE for the detection of PCa was evaluated comprehensively.Material and methods: We conducted our systematic review and meta-analysis based on databases of PubMed, Embase and Web of Science. Relevant studies regarding to the diagnostic accuracy of SWE for detecting PCa compared to a reference standard of histopathology were included. The pooled weighted mean difference (WMD) of Young’s modulus, sensitivity (SEN) and specificity (SPE), and area under the curve (AUC) were calculated using Stata software.Results: Based on our search strategy, 9 studies were ultimately included. The pooled results indicated that the mean Young’s modulus for detecting prostate cancer was significantly higher than that for prostate benign tissue (WMD = 38.01, 95%CI = 25.59–50.44, p<0.01). In addition, the pooled SEN was 0.86 (95%CI = 0.75–0.92), and the SPE was 0.89 (95%CI = 0.82–0.93). Moreover, an overall high degree of accuracy was indicated by the summary receiver operator characteristic curve with an AUC of 0.94 (95%CI = 0.91–0.95).Conclusion: Our study indicated that SWE is a useful technique for differentiating PCa and benign tissue with a high degree of diagnostic accuracy. 

Evaluation of the Effect of Tissue Compression on the Results of Shear Wave Elastography Measurements

2018 ◽  
Vol 40 (6) ◽  
pp. 380-393 ◽  
Author(s):  
Jaromir Vachutka ◽  
Zuzana Sedlackova ◽  
Tomas Furst ◽  
Miroslav Herman ◽  
Jan Herman ◽  
...  
Keyword(s):  
Young’S Modulus ◽  
Shear Wave ◽  
Ex Vivo ◽  
Young's Modulus ◽  
Shear Wave Elastography ◽  
Shear Wave Imaging ◽  
Phantom Measurements ◽  
Wave Imaging ◽  
Tissue Compression

Shear wave imaging is considered to be more precise and less operator dependent when compared with strain imaging. It enables quantitative and reproducible data (Young’s modulus of the imaged tissue). However, results of shear wave imaging can be affected by a variety of different factors. The aim of this study is to evaluate the effect of the pressure applied by the ultrasound probe during examination on the measured values of Young’s modulus. The effect of the tissue compression on the results of the real-time shear wave elastography was evaluated via the gelatine phantom measurements, via the ex vivo experiments with pig liver, and via the in vivo measurements of the thyroid gland stiffness on healthy volunteers. The results of our measurements confirmed that the measured value of Young’s modulus increases with the increasing pressure applied on the imaged object. The highest increase was observed during the ex vivo experiments (400%), and the lowest increase was detected in the case of the phantom measurements (8%). A two- to threefold increase in Young’s modulus was observed between the minimum and maximum pressure in the case of the in vivo elastography measurements of thyroid gland. The Veronda-Westman theoretical model was used for the description of the tissue nonlinearity. We conclude that tissue compression by the force exerted on the probe can significantly affect the results of the real-time shear wave elastography measurements. Minimum pressure should be used when measuring the absolute value of Young’s modulus of superficial organs.

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