scholarly journals Strain and shear wave ultrasound elastography in evaluation of chronic inflammatory disorders of major salivary glands

2020 ◽  
Vol 49 (3) ◽  
pp. 20190225
Author(s):  
Yasmein Maher Elbeblawy ◽  
Maha Eshaq Amer Mohamed
Keyword(s):  
Diagnostic Accuracy ◽  
Salivary Glands ◽  
Shear Wave ◽  
Shear Wave Velocity ◽  
Strain Ratio ◽  
Ultrasound Elastography ◽  
Control Group ◽  
P Value ◽  
Inflammatory Conditions ◽  
Major Salivary Glands

Objective: The aim of this study was to assess chronic inflammatory conditions of major salivary glands by ultrasound elastography. Methods: 21 patients with chronic inflammatory conditions of major salivary glands and 21 healthy adult volunteers were included in this study. All participants underwent B-mode sonography and ultrasound elastography. The diagnostic performance of strain ratio and shear wave velocity was evaluated by sensitivity and specificity at the optimum cutoff point and the area under the receiver operating characteristic curve. Results: Cases showed statistically significant higher median strain ratio of parotid and submandibular gland than control group (p-value = 0.001). Total cases showed statistically significant higher median scores than control group (p-value < 0.001). At cut-off value of (1.13); diagnostic accuracy, sensitivity and specificity were 97.6, 95.2 and 100% respectively with AUROC 0.954 and confidence interval: 0.840–0.995. Cases showed statistically significant higher median shear wave velocity of parotid gland than control group (p-value = 0.022), with no statistically significant difference in submandibular gland in the two groups (p-value = 0.216). Total cases showed statistically significant higher median scores than control group (p-value < 0.001). At cut-off value of (23.5), diagnostic accuracy was 78.6% with a sensitivity of 81% and specificity of 76.2% with 0.819 AUROC and onfidence interval :0.669–0.920. Conclusion: Our initial experience suggests that elastography may be potentially useful for diagnosis of chronic inflammatory conditions of the major salivary glands. This conclusion needs to be further validated large sample studies.

scholarly journals Diagnostic value of median nerve shear wave ultrasound elastography in diagnosis and differentiation of carpal tunnel syndrome severity

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Heba Refaat Ibrahim
Keyword(s):  
High Resolution ◽  
Carpal Tunnel Syndrome ◽  
Diagnostic Accuracy ◽  
Median Nerve ◽  
Shear Wave ◽  
Carpal Tunnel ◽  
Diagnostic Value ◽  
Ultrasound Elastography ◽  
Control Group ◽  
Tunnel Syndrome

Abstract Background Carpal tunnel syndrome (CTS) is the commonest type of peripheral nerve entrapment syndromes. The study aimed at evaluation of diagnostic value of median nerve stiffness measured by shear wave ultrasound elastography for diagnosis and differentiation of CTS severity, correlated to electrophysiological studies. This case–control study involved 40 patients (56 wrists) with CTS of different severity and 40 controls (40 wrists). All participants underwent electrophysiological study to assess the CTS severity, high-resolution conventional B-mode ultrasound to assess cross-sectional area “CSA” of median nerve at carpal tunnel, ratio of median nerve CSA at carpal tunnel and forearm, and shear wave ultrasound elastography with measurement of median nerve mean stiffness and correlation to electrophysiological results as the reference standard. Results Mean median nerve stiffness by shear wave US elastography was increased in patients with CTS compared to controls and across the different CTS severity groups (P value < 0.001 & 0.001, respectively). The cutoff value by ROC curve analysis for median nerve stiffness to differentiate between patients with CTS and control group was 65.4 kPa (P value < 0.001, 94.6% sensitivity, 97.3% specificity). Higher diagnostic accuracy was noted with the combination of shear wave elastography and conventional B-mode US with improved AUC (B-mode + shear wave; 0.962, P value < 0.001). Conclusions Shear wave ultrasound elastography of median nerve was able to discriminate different severity subgroups of CTS with high sensitivity, while conventional US couldn’t. The diagnostic accuracy of CTS was improved when combined high-resolution conventional B-mode US and complementary shear wave ultrasound elastography.

scholarly journals Ultrasonic Elastography in the Differential Diagnosis of Thyroid Nodular Patholog

2019 ◽  
Vol 26 (4) ◽  
pp. 45-55
Author(s):  
L. A. Timofeeva ◽  
M. G. Tukhbatullin ◽  
A. N. Sencha
Keyword(s):  
Differential Diagnosis ◽  
Thyroid Cancer ◽  
Shear Wave ◽  
Density Ratio ◽  
Shear Wave Elastography ◽  
Strain Ratio ◽  
Ultrasound Elastography ◽  
Control Group ◽  
Tissue Elasticity ◽  
Patient Groups

Aim.In this study, we set out to determine the informative value of multi-parametric ultrasound examination using ultrasound elastography in the differential diagnosis of thyroid nodular neoplasms.Materialsand methods. We analysed 229 multi-parametric ultrasound examinations of patients in the preoperative period in order to assess the effectiveness of strain elastography (SE) and shear wave elastography (SWE) drawing on the example of ARFI and Strain Ratio. Two patient groups were formed. The fi rst group (N1=93) included patients with thyroid cancer, whereas the second one (N2=136) was composed of patients with benign thyroid nodules (thyroid adenoma and follicular or colloid goitre). The control group consisted of 174 patients with unchanged thyroid parenchyma. SE visualised tissue elasticity as a colour map. Shear wave elastography (SWE) — ARFI and Strain Ratio techniques — was performed using the following ultrasonic apparatuses: Acuson S-2000 (Siemens, Germany), Ultrasonix SP (Sonix, Canada) and Mindray DC-8 (Mindray, China).Results.According to the obtained data (SE technique), the parenchyma of the unchanged thyroid gland exhibited heterogeneous, uneven fi ne / moderately granular, symmetrical staining (96.6%). Thyroid cancer was characterised by a shear wave velocity (ARFI) of greater than 3.57 m/s, as well as a density ratio (elasticity modulus and Strain Ratio) of more than 1.56.Conclusion.The study revealed that the application of ultrasound elastography is highly informative in the comprehensive diagnosis of thyroid nodular neoplasms and should be used when thyroid cancer is suspected to ascertain the size of nodules, as well as the tumour invasion into surrounding tissues.

scholarly journals Successful experience in the use of ultrasound elastography in the differentiating of lymphomatous and metastatic superficial lymphadenopathy

2020 ◽  
Vol 15 (2) ◽  
pp. 42-48
Author(s):  
E. V. Kovaleva ◽  
T. Yu. Danzanova ◽  
G. T. Sinyukova ◽  
E. A. Gudilina ◽  
P. I. Lepedatu ◽  
...  
Keyword(s):  
Shear Wave ◽  
Wave Velocity ◽  
Shear Wave Velocity ◽  
Acoustic Radiation ◽  
Radiation Force ◽  
Area Ratio ◽  
Ultrasound Elastography ◽  
Acoustic Radiation Force Impulse ◽  
Tissue Imaging ◽  
Hodgkin's Lymphomas

The objective: to evaluate the possibilities of ARFI technology (Acoustic Radiation Force Impulse), including Virtual Touch™ Tissue Imaging (VTI) and Virtual Touch™ Tissue Quantification (VTQ) for differentiation of lymphomatous and metastatic superficial lymphadenopathy.Materials and methods. The prospective study included 138 patients with enlarged superficial lymph nodes (LN). Based on a previous histological examination, patients were divided into two groups: 1st group (n = 108) – patients with non-Hodgkin’s lymphomas and Hodgkin’s lymphoma; 2nd group (n = 30) – patients with metastasis of solid tumors in superficial LN. All patients underwent ultrasound elastography of the enlarged LN using ARFI technology. In VTI study the Area Ratio parameter was evaluated, and the minimum and average values of the shear wave velocity were estimated in VTQ study.Results. According to the results of VTI study the Area Ratio parameter for enlarged LN in lymphoma (1st group) and for metastatic lymphadenopathy (2 nd group) were 1.031 ± 0.197 and 0.851 ± 0.15, respectively (p = 0.000009). The cut off value of the Area Ratio parameter was 0.901 with sensitivity, specificity and accuracy 80.6, 70.0 and 78.8 %, respectively. Minimum values of shear wave velocities for 1st and 2 nd groups were 1.980 ± 0.557 and 2.214 ± 0.367 m/s, respectively (p = 0.032). The cut off values of the average shear wave velocity in the differentiating of lymphomatous and metastatic lymphadenopathy are determined at the level of 2.00 m/s, with sensitivity of 70.0 %, specificity of 59.3 %, and accuracy of 61.6 %.Conclusion. Ultrasound elastography with ARFI technology demonstrated statistically significant differences in the Area Ratio parameter and in the minimum shear wave velocity in the enlarged superficial LN in lymphoma and with metastasis that can be used as a preliminary non-invasive differential diagnosis of enlarged superficial LN in these conditions. Moreover, the Area Ratio parameter has a statistically more significant effect on differentiating of lymphomatous and metastatic lymphadenopathy.

scholarly journals Salivary Gland Pathologies

2021 ◽  
pp. 939-973
Author(s):  
Nisheet Anant Agni
Keyword(s):  
Salivary Gland ◽  
Salivary Glands ◽  
Malignant Tumors ◽  
Inflammatory Conditions ◽  
Major Salivary Glands

AbstractSaliva is responsible for various functions from lubrication to digestion. The saliva is secreted by numerous minor and major salivary glands. These salivary glands are sometimes affected by various local and systemic inflammatory conditions, obstructive pathologies with benign and malignant tumors. This chapter deals with various pathologies of salivary glands and their management.

Prospective Evaluation of Semiquantitative Strain Ratio and Quantitative 2D Ultrasound Shear Wave Elastography (SWE) in Association with TIRADS Classification for Thyroid Nodule Characterization

2019 ◽  
Vol 40 (04) ◽  
pp. 495-503 ◽  
Author(s):  
Vito Cantisani ◽  
Emanuele David ◽  
Hektor Grazhdani ◽  
Antonello Rubini ◽  
Maija Radzina ◽  
...  
Keyword(s):  
Thyroid Nodule ◽  
Shear Wave ◽  
Diagnostic Performance ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Strain Ratio ◽  
Ultrasound Elastography ◽  
Prospective Evaluation ◽  
2D Ultrasound

Abstract Purpose To evaluate the diagnostic performance of strain ratio elastography (SRE) and shear wave elastography (SWE) alone and in combination with Thyroid Imaging Reporting and Data System (TIRADS) classification parameters to improve differentiation between benign and malignant thyroid nodules. Materials and Methods In this prospective study benign (n = 191) and malignant (n = 52) thyroid nodules were examined with high-resolution ultrasound (US) features using the TIRADS lexicon and SRE semiquantitative and SWE quantitative findings using histology or cytology as the gold standard with a 12-month follow-up. Sensitivity (Se), specificity (Sp) and the area under the ROC curve (AUROC) were used to evaluate the diagnostic performance of each feature and combinations of the methods. Results TIRADS score showed a sensitivity of 59.6 %, a specificity of 83.8 % with an AUROC of 0.717, a PPV of 50.0 % and an NPV of 88.4 %. SRE yielded the highest performance with a sensitivity of 82.7 %, a specificity of 92.7 % with AUROC of 0.877, a PPV 75.4 % and an NPV of 95.2 %. SWE (kPa) had a sensitivity and specificity of 67.3 % and 82.7 %, respectively, with an AUROC of 0.750, a PPV of 51.5 % and an NPV of 90.3 %. Differences were significant for SRE only but not for SWE. Conclusion Ultrasound elastography may improve thyroid nodule discrimination. In particular, SRE has a better performance than TIRADS classification, while their combination improves sensitivity.

scholarly journals Area Covered for Shear Wave Velocity Calculation Affects the Shear Wave Velocity Values

2019 ◽  
Vol 35 (3) ◽  
pp. 182-187
Author(s):  
Amitabh Dashottar ◽  
Erin Montambault ◽  
Jeffrey R. Betz ◽  
Kevin D. Evans
Keyword(s):  
Shear Wave ◽  
Wave Velocity ◽  
Shear Wave Velocity ◽  
Region Of Interest ◽  
Ultrasound Elastography ◽  
Maximum Area ◽  
Shear Wave Velocities ◽  
Significant Difference ◽  
Technical Specifications ◽  
The Mean

Although ultrasound elastography is established as a reliable and valid tool for assessment of skeletal muscles, guidelines around the technical specifications, data selection, and acquisition parameters still lack consensus. One such parameter is the use of the quantification box (Q-box) that calculates the shear wave velocity/modulus, within a selected region of interest (ROI). Currently, no data compare the effect of the elastographic area within the ROI to the mean shear wave velocity calculations, using a Q-box. In this study, the mean shear wave velocity calculated over a smaller (single Q-box) ROI is compared to the mean shear wave velocity calculated over maximum area of elastogram, within a ROI. Comparison of mean shear wave velocity revealed a significant difference ( t = 2.79, P = .007) between the means calculated over maximum area of elastogram for only nonuniform elastograms. The rater agreement for the classification scheme was assessed (κ = 0.85). To prevent possible overestimation of shear wave velocities, it may be necessary to place the Q-box over the maximum elastographic area.

scholarly journals The Role of Shear Wave Ultrasound Elastography in the Diagnosis of Adenomyosis and / or Hyperplastic Processes of the Endometrium

2020 ◽  
Vol 5 (6) ◽  
pp. 129-135
Author(s):  
V. V. Lazurenko ◽  
◽  
T. V. Melikhova
Keyword(s):  
Shear Wave ◽  
Uterine Leiomyoma ◽  
Diagnostic Errors ◽  
Shear Wave Elastography ◽  
Diagnostic Methods ◽  
Ultrasound Elastography ◽  
Control Group ◽  
Yellow Light ◽  
Light Blue ◽  
The Third

Today, hysteroscopy, ultrasound and magnetic resonance imaging are most often used in clinical practice for the diagnosis of adenomyosis. However, the high frequency of diagnostic errors (from 20 to 40%), depending on the experience of the operator and equipment, detailing the structure of the myometrium and the parameters of ultrasound differentiation of adenomyosis, requires the search for new optimal diagnostic methods. The purpose of our study was to determine the parameters of ultrasound elastography of the shear wave in patients with adenomyosis and / or hyperplastic processes of the endometrium. Material and methods. The study included 128 patients aged from 27 to 53 years (mean 39.4 ± 8.6). The first group included 38 (29.6%) patients diagnosed with grade I-II adenomyosis, the second group had 41 (32.1%) patients with a combination of grade I-II adenomyosis with endometrial hyperplastic processes and / or uterine leiomyoma, the third group consisted of 39 (30.5%) women only with hyperplastic processes of the endometrium. The control fourth group included 10 (7.8%) women without endometrial pathology, who sought women's advice on primary infertility. Results and discussion. When performing shear wave elastography, significant differences in the color of myometrial mapping were found between patients of the first, third and control groups (p <0.001). Unchanged myometrium in all patients of the control group was represented by shades of blue, and the staining was uniform in 9 (90%) subjects. In patients of the first group, the myometrium was stained with shades of red in 31 (81.63%) cases and shades of yellow in 3 (7.8%) cases; in 23 (60.5%) cases there was inhomogeneous red staining and in 14 (36.8%) cases staining was inhomogeneous in shades of red-yellow-light blue. When performing elastography in patients of the second group in the projection of the myoma was more often detected staining in shades of red in 20 (48.8%) cases, yellow in 6 (14.6%) and light blue in 3 (7.3%) cases; in 28 (68.3%) cases there was inhomogeneous red staining and in 19 (46.3%) cases staining was inhomogeneous in shades of red-yellow-light blue. In the third group in the projection of the leiomatous node was more often determined by staining in shades of red in 22 (56.4%) cases, yellow in 8 (20.5%) and light blue in 6 (15.4%) cases, colors on the background of the blue myometrium; inhomogeneous staining of myomatous nodes was detected in 31 (79.5%), and homogeneous staining was in 7 (17.9%) cases. Unchanged myometrium in the control group was characterized by significantly lower values of the Young's modulus 25.2 (17.9-34.1 kPa), while in the group of adenomyosis the average value of Emean reached 71.8 (17.9-281.3 kPa), was maximally high and significantly different from the indicators of the control group and from the indicators of group 3 patients 29.6 (13.5-58.9 kPa). The rates of patients of the second group, in whom grade I-II adenomyosis was combined with endometrial hyperplastic processes and / or uterine leiomyoma 54.7 (15.6-133.9 kPa) were also significantly higher than the values of the control group and the third group. Conclusion. Shear wave ultrasound is a minimally invasive and accessible method of high-quality preoperative diagnosis, necessary to avoid hysterectomy and clarify the diagnosis without surgery, which is recommended for use in practice to improve the accuracy of diagnosis of adenomyosis

scholarly journals The Evaluation of Benign Acute Childhood Myositis by Ultrasound Elastography

2019 ◽  
Vol 6 (9) ◽  
pp. 205-209
Author(s):  
Gülay Güngör ◽  
Olcay Güngör
Keyword(s):  
Muscle Thickness ◽  
Strain Ratio ◽  
Muscle Stiffness ◽  
Ultrasound Elastography ◽  
Radiology Department ◽  
Control Group ◽  
Healthy Children ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Objective:   Herein, we aimed to determine the diagnostic contribution of ultrasound elastography (UE) technique to the assessment of muscle stiffness in pediatric patients with myositis. Material and Methods: This study enrolled 16 patients who presented to our hospital’s Pediatric Neurology Outpatient Clinic with the complaint of inability to walk and who had a clinical presentation of benign acute childhood myositis (BACM). The patients were referred to the Radiology Department to undergo muscle ultrasonography (USG), where they underwent UE of the gastrocnemius muscle (GCM). Results: Children with myositis and healthy children are similar age (7.06 ± 1.52 year (5–11) vs. 7.00 ± 1.59 year (5–11) year) (P: 0.908) and body mass index (BMI) (20.04 ± 1.58 (18.6–24.2) vs. 22.08 ± 1.43 (19.9–24.4) (P: 0.946). The mean serum creatine kinase (CK) was measured as 1520.3 ± 1163.6 U/L (min: 456,  max:4100) in children with myositis. In the children with myositis, the thickness of the medial and lateral GCM increased compared with that in control group (medial; 18.15 ± 3.02 mm vs 13.10 ± 2.26 mm, p<0.001, lateral; 13.51 ± 3.07 mm vs 9.34 ± 1.86 mm, p<0.001). The medial and lateral GCM ratio in group 1 was slight bigger than that in group 2 (medial; 1.10 ± 0.37 vs 1.00 ± 0.34, p: 0.274, lateral; 1.22 ± 0.44 vs 1.10 ± 0.29, p: 0.243). GCM strain values were mildly elevated in patients with myositis compared to controls. Conclusion: In the children with myositis, the thickness of the medial and lateral GCM increased compared with that in control group. GCM strain ratio values were slightly higher in myositis patients compared to the control group. We think that the increase in muscle thickness values is mainly secondary to the edema seen in myositis. In addition, UE is a clinically applicable quantitative analysis for changes in myositis.

scholarly journals Contrast-Induced Sialadenitis of the Sublingual Glands

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Ki Wan Park ◽  
Albert Y. Han ◽  
Christine M. Kim ◽  
Kenric Tam ◽  
Dinesh K. Chhetri
Keyword(s):  
Salivary Glands ◽  
Healthcare Cost ◽  
Conservative Management ◽  
Sublingual Gland ◽  
Inflammatory Conditions ◽  
Full Resolution ◽  
Major Salivary Glands ◽  
First Case ◽  
Iodinated Contrast ◽  
Unnecessary Testing

Contrast-induced sialadenitis (CIS) is a rare, delayed pseudoallergic reaction from iodine containing contrast. Previously reported cases of CIS demonstrated that the two major salivary glands (parotid and submandibular) can be affected. The initial encounter of this entity can raise alarms to physicians as the differential diagnoses include serious infectious and inflammatory conditions such as Ludwig’s angina and angioedema. Subsequently, it may lead to unnecessary testing and increased healthcare cost. Here we present a 60-year-old male who presented with bilateral sublingual gland swelling following exposure to iodinated contrast. With timely diagnosis by the otolaryngologist, the patient received conservative management that led to a full resolution within a few days. To date, this is the first case of CIS only involving the sublingual glands. We conclude that CIS can involve any of the major salivary glands.

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