Factors associated with the elasticity of asymptomatic carotid plaques in hypertension Tibetan population

Vascular ◽  
2021 ◽  
pp. 170853812110609
Author(s):  
Guyue Liu ◽  
Qing Xu ◽  
Min Sun ◽  
Rong Xiao

Aims Hypertension is a major risk factor for coronary, cerebrovascular, and the greatest cause of stroke. Half of stroke events are the result of cerebrovascular atherosclerosis, including carotid plaques. It is of major importance to detect which plaques are vulnerable, even though not yet ruptured. Due to the particularity of the Tibetan population, this study evaluated the elasticity of asymptomatic carotid plaques in Tibetan hypertension patients using shear wave elastography (SWE) and explored associated risk factors. Methods A total of 91 Tibetan patients were divided into normotension, grade 1-2, and grade 3 hypertension groups based on the level of blood pressure. All subjects underwent common duplex ultrasonic examination and SWE evaluation for carotid plaques. Elasticity of carotid plaque was assessed by Young’s modulus. Results The final analysis included 126 plaques as representative plaques according to Total Plaque Risk Score. The mean and maximum Young’s modulus in the grade 3 hypertension group were smaller, and more plaques with irregularity surface compared with the other two groups ( p < 0.05). Multivariate regression analysis showed drinking butter tea (β = −0.220, p = 0.009; β = −0.240, p = 0.004, respectively) was the independent factor associated with mean and maximum Young’s modulus. Conclusions SWE is feasible for measurement of Young’s modulus of carotid plaques. Plaques in the grade 3 hypertension group were more likely to become vulnerable ones. In hypertension Tibetan patients, drinking butter tea was an independent factor associated with mean and maximum Young’s modulus of asymptomatic carotid plaque.

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


2021 ◽  
Author(s):  
Andjoli Davidhi ◽  
Vasileios Rafailidis ◽  
Evangelos Destanis ◽  
Panos Prassopoulos ◽  
Stefanos Foinitsis

Recent literature has shown that various carotid plaque features, other than stenosis, contribute to plaque vulnerability. Features such as surface morphology and plaque composition with distinct components (e.g. intraplaque hemorrhage, lipid core) have been associated with the increased risk of future cerebrovascular events. Ultrasonography constitutes the first line modality for the assessment of carotid disease and has traditionally been used to grade stenosis with high accuracy. Recenttechnological advances such as contrast-enhanced ultrasound and elastography increased the diagnostic yield of ultrasound in assessing the morphology of carotid plaques. The purpose of this review is to present the available literature on ultrasound elastography of the atherosclerotic carotid. Strain and shear wave elastography allow for the characterization of plaque components, thus indicating its nature and importantly, the plaque’s vulnerability. Shear wave elastography indices appear morerobust than Strain indices. Overall, elastography is a feasible method to distinguish vulnerable carotid plaques. There is, however, a need for larger and longer prospective controlled clinical studies in order to validate elastography as an imaging modality used for the detection of unstable carotid plaques.


2021 ◽  
pp. 1-10
Author(s):  
Xia Jiang ◽  
Li Li ◽  
Hong-Yuan Xue

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.


2020 ◽  
Vol 10 (4) ◽  
pp. 864-867
Author(s):  
Jia Zheng ◽  
Xiaoxin Wang ◽  
Xianjing Han ◽  
Chunyan Li ◽  
Jianan Wang ◽  
...  

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.


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


2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Xingxing Duan ◽  
Ya Peng ◽  
Wengang Liu ◽  
Liu Yang ◽  
Jie Zhang

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.


2016 ◽  
Vol 97 (6) ◽  
pp. 860-864
Author(s):  
R I Fatykhov ◽  
I V Klyushkin ◽  
Yu A Klyushkina ◽  
N A Minnemullin ◽  
M N Nasrullaev

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.


2019 ◽  
Vol 21 (4) ◽  
pp. 382 ◽  
Author(s):  
Ye Yang ◽  
Xinxin Zhao ◽  
Xinxin Zhao ◽  
Jingwen Shi ◽  
Ying Huang

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. 


2018 ◽  
Vol 40 (6) ◽  
pp. 380-393 ◽  
Author(s):  
Jaromir Vachutka ◽  
Zuzana Sedlackova ◽  
Tomas Furst ◽  
Miroslav Herman ◽  
Jan Herman ◽  
...  

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.


Проведена мультипараметрическая ультразвуковая оценка злокачественных опухолей яичка у 31 пациента в возрасте от 19 до 65 лет (медиана - 33 года, 25-75-й процентили - 27-40 лет). Во всех случаях было одностороннее поражение. Во всех случаях диагноз подтвержден морфологически (семинома - 18 (58,1%), эмбриональная карцинома - 5 (16,1%), смешанные герминогенные опухоли - 7 (22,6%), спермоцитарная семинома - 1 (3,2%)). В 13 (41,9%) случаях была стадия pT1, в 15 (48,4%) - pT2, в 3 (9,7%) - pT3. Режим эластографии сдвиговой волной использовался после предварительной серошкальной визуализации яичек (аппарат Aixplorer (Supersonic Imagine, Франция), линейный датчик 4-15 МГц). Медиана Emean в максимально жестких участках опухоли (n = 31) составила 109,3 кПа, 25-75-й процентили - 77,7-145,5 кПа, 5-95-й процентили - 18,7-192,4 кПа, минимальное - максимальное значения - 15,3-241,4 кПа. Значения модуля Юнга (Emean) в области опухоли достоверно выше при сравнении с эхографически неизмененной паренхимой ипсилатерального яичка (1), эхографически неизмененным контрлатеральным яичком (2) и нормативными данными (3) (P 0,0001 для трех сравнений). Качественная оценка эластографической картины (деление на типы эластографической картины) дает представление о жесткостной природе опухоли, однако зависит от выбранной шкалы. На настоящий момент целесообразно ее использование именно для идентификации наиболее жестких участков образования с проведением последующих измерений. Не выявлены значимые корреляции значений модуля Юнга ни с объемом опухоли, ни с максимальным ее линейным размером, ни со стадиями pT, ни с морфологическими типами. Выявлена умеренная прямая корреляция значений индекса жесткости 1 (отношение значений Emean в областях опухоли и эхографически неизмененной паренхимы ипсилатерального яичка при ее наличии) со стадиями pT (τк = 0,32, P = 0,0305). Эластометрия в качестве одного из звеньев мультипараметрической ультразвуковой диагностики дает новую информацию о жесткости опухолей яичка, что может быть использовано в рутинном диагностическом процессе с учетом низкой временной затратности методики. Ключевые слова: мультипараметрическая ультразвуковая диагностика, ультразвуковая эластография, эластография сдвиговой волной, жесткость, модуль Юнга, скорость сдвиговой волны, рак яичка, multiparametric ultrasound, ultrasound elastography, shear wave elastography, stiffness, Young’s modulus, shear wave velocity, testicular cancer


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