Evaluation of Ovaries in Patients with Polycystic Ovary Syndrome using Shear Wave Elastography

2020 ◽  
Vol 16 (5) ◽  
pp. 578-583
Author(s):  
Aysegul Altunkeser ◽  
Zeynep Ozturk Inal ◽  
Nahide Baran
Keyword(s):  
Shear Wave ◽  
Large Scale ◽  
Polycystic Ovary ◽  
Shear Wave Elastography ◽  
Left Ovary ◽  
Control Group ◽  
Tissue Elasticity ◽  
Group I ◽  
Pcos Group ◽  
The Right

Background: Shear wave electrography (SWE) is a novel non-invasive imaging technique which demonstrate tissue elasticity. Recent research evaluating the elasticity properties of normal and pathological tissues emphasize the diagnostic importance of this technique. Aims: Polycystic ovarian syndrome (PCOS), which is characterized by menstrual irregularity, hyperandrogenism, and polycystic overgrowth, may cause infertility. The aim of this study was to evaluate the elasticity of ovaries in patients with PCOS using SWE. Methods: 66 patients diagnosed with PCOS according to the Rotterdam criteria (PCOS = group I) and 72 patients with non-PCOS (Control = group II), were included in the study. Demographic and clinical characteristics of the participants were recorded. Ovarian elasticity was assessed in all patients with SWE, and speed values were obtained from the ovaries. The elasticity of the ovaries was compared between the two groups. Results: While there were statistically significant differences between the groups in body mass index (BMI), right and left ovarian volumes, luteinizing hormone and testosterone levels (p<0.05), no significant differences were found between groups I and II in the velocity (for the right ovary 3.89±1.81 vs. 2.93±0.72, p=0.301; for the left ovary 2.88±0.65 vs. 2.95±0.80, p=0.577) and elastography (for the right ovary 36.62±17.78 vs. 36.79±14.32, p=0.3952; for the left ovary 36.56±14.15 vs. 36.26±15.10, p=0.903) values, respectively. Conclusion: We could not obtain different velocity and elastography values from the ovaries of the patients with PCOS using SWE. Therefore, further large-scale studies are needed to elucidate this issue.

scholarly journals Is shear wave elastography relevant in the diagnosis of polycystic ovarian syndrome?

2019 ◽  
Vol 21 (2) ◽  
pp. 158 ◽  
Author(s):  
Ersen Ertekin ◽  
Ozgür Deniz Turan ◽  
Ozum Tuncyurek
Keyword(s):  
Shear Wave ◽  
Polycystic Ovarian Syndrome ◽  
Imaging Finding ◽  
Shear Wave Elastography ◽  
Left Ovary ◽  
Control Group ◽  
Diagnostic Efficacy ◽  
Significant Difference ◽  
The Right ◽  
Ovarian Syndrome

Aim: The aim of this study was to determine the contribution of Shear Wave Elastography (SWE) to the diagnosis of polycystic ovarian syndrome (PCOS).Material and methods: Thirty-seven patients with PCOS diagnosis criteria were included in the study. Sixteen volunteer patients without hormonal disturbances and with normal menstrual cycles were evaluated as the control group. Gray scale ultrasonography (US) and SWE measurements in both ovaries were performed by a single radiologist who was blinded to the clinical and laboratory results.Results: The SWE measurements in PCOS group were 8.4±2.0 kPafor the right ovary and 9.4±3.9 kPa for the left ovary and in the control group 7.8±4.1 for the right ovary and 8.6±2.5 kPa for the left ovary. There was no statistically significant difference between the PCOS and the control group according to the SWE results (for right ovary p=0.356, for left ovary p=0.258, and total ovary p=0.293).Conclusions: The ovarian morphology isstill the most reliable imaging finding in the diagnosis of PCOS, although it is controversial especially among adolescents. Although the diagnostic efficacy of SWE is demonstrated in a variety of soft tissue lesions, we did not find any significant contribution of SWE to the diagnosis PCOS. Therefore, the promising value of elastography is yet to be defined for the diagnosis of PCOS.

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 Measured Hyperelastic Properties of Cervical Tissue with Shear-Wave Elastography

Sensors ◽  
2021 ◽  
Vol 22 (1) ◽  
pp. 302
Author(s):  
Weirong Ge ◽  
Graham Brooker ◽  
Ritu Mogra ◽  
Jon Hyett
Keyword(s):  
Shear Wave ◽  
Clinical Setting ◽  
Large Scale ◽  
Shear Wave Elastography ◽  
Hyperelastic Material ◽  
Nonlinear Behaviour ◽  
Cervical Tissue ◽  
Tissue Elasticity ◽  
Material Models ◽  
Shear Wave Speed

The nonlinear mechanical behaviour of cervical tissue causes unpredictable changes in measured elastograms when pressure is applied. These uncontrolled variables prevent the reliable measurement of tissue elasticity in a clinical setting. Measuring the nonlinear properties of tissue is difficult due to the need for both shear modulus and strain to be taken simultaneously. A simulation-based method is proposed in this paper to resolve this. This study describes the nonlinear behaviour of cervical tissue using the hyperelastic material models of Demiray–Fung and Veronda–Westmann. Elastograms from 33 low-risk patients between 18 and 22 weeks gestation were obtained. The average measured properties of the hyperelastic material models are: Demiray–Fung—A1α = 2.07 (1.65–2.58) kPa, α = 6.74 (4.07–19.55); Veronda–Westmann—C1C2 = 4.12 (3.24–5.04) kPa, C2 = 4.86 (2.86–14.28). The Demiray–Fung and Veronda–Westmann models performed similarly in fitting to the elastograms with an average root mean square deviation of 0.41 and 0.47 ms−1, respectively. The use of hyperelastic material models to calibrate shear-wave speed measurements improved the consistency of measurements. This method could be applied in a large-scale clinical setting but requires updated models and higher data resolution.

scholarly journals Quantitative Evaluation of Real-Time Shear-Wave Elastography under Deep Learning in Children with Chronic Kidney Disease

2022 ◽  
Vol 2022 ◽  
pp. 1-9
Author(s):  
Jie Zhang ◽  
Cuirong Duan ◽  
Xingxing Duan ◽  
Yuan Hu ◽  
Jinqiao Liu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Deep Learning ◽  
Kidney Disease ◽  
Real Time ◽  
Shear Wave ◽  
Left Kidney ◽  
Shear Wave Elastography ◽  
Control Group ◽  
The Difference ◽  
The Right

Objective. This research was to study the application value of real-time shear wave elastography (SWE) quantitative evaluation based on deep learning (DL) in the diagnosis of chronic kidney disease (CKD) in children. Methods. 60 children with pathological diagnoses of CKD were selected as a CKD group. During the same period, 45 healthy children for physical examination were selected as the control group. The application value of real-time shear-wave elastography based on DL in the evaluation of CKD in children was explored by comparing the differences between the two groups. Results. It was found that the elastic modulus values of the middle and lower parenchyma of the left kidney and right kidney in the case group were (22.02 ± 10.98) kPa and (21.99 ± 11.87) kPa, respectively, which were substantially higher compared with (4.61 ± 0.47) kPa and (4.50 ± 0.59) kPa in the control group. Young’s modulus (YM) of the middle and lower parenchyma of the left kidney in patients with CKD stages 3 to 5 was 13.27 ± 0.83, 24.21 ± 5.69, and 31.67 ± 3.82, respectively, and that of the right kidney was 17.26 ± 0.98, 26.76 ± 7.22, and 32.37 ± 4.27, respectively, and the difference was significant ( P  < 0.05). In patients with moderate and severe CKD, the YM values of the middle and lower parenchyma of the left kidney were 17.27 ± 0.83, 27.93 ± 6.49, and those of the right kidney were 17.26 ± 0.98, 29.56 ± 6.49, respectively, and the difference was statistically significant ( P  < 0.05). The serum creatinine (Scr) of the CKD group was substantially higher than that of the control group, and the estimated glomerular filtration rate (eGFR) level of the former was lower than that of the latter. However, there was no statistical difference between the YM values of the middle and lower parts of the left and right kidneys of the CKD group and the control group. Conclusion. The DL-based SWE is a new noninvasive, real-time, and quantitative detection method, which can effectively evaluate the stiffness of the kidney and help to better detect the progress of CKD as a clinical reference.

Anamnestic factors that shape reproductive health of women with repeated unsuccessful popygamy in vitro fertilization

2016 ◽  
pp. 140-143
Author(s):  
N.V. Cotsabin ◽  
◽  
O.M. Makarchuk ◽  
Keyword(s):  
High Risk ◽  
Risk Group ◽  
Polycystic Ovary ◽  
High Risk Group ◽  
Stress Factors ◽  
Control Group ◽  
Fertilization In Vitro ◽  
Infertile Women ◽  
Group I

The proportion of patients with multiple unsuccessful attempts of assisted reproductive technology (ART) is about 30% of all patients treated with the use of ART. Women with history of unsuccessful ART attempts - a special category of patients who require emergency attention and a thorough examination at the stage of preparation for superovulation stimulation,the selection of embryos and endometrium preparation for embryo transfer. The objective: to distinguish high-risk group of unsuccessful attempts based on a detailed analysis of anamnestic and clinical data of infertile women with repeated unsuccessful ART attempts that requires more in-depth study of hormonal features, ovarian reserve and condition of the endometrium. Materials and methods. For better understanding of the problem of repeated unsuccessful ART attempts and сreation of efficient infertility treatment algorithms for these couples we conducted a thorough analysis of anamnestic data of three groups of infertile women (105 patients), which were distributed by age: group I – younger than 35, the II group – from 35 to 40, the III group - over 40 years. These groups of patients were compared with each other and with the control group of healthy women (30 persons). Results. Leading stress factors in the percentage three times prevailed in the group of infertile women and had a direct connection with the fact of procedure «fertilization in vitro» and chronic stressors caused by prolonged infertility. Primary infertility was observed significantly more frequent in patients younger than 35 years (p <0.05), secondary infertility - mostly in the second and third experimental groups (p <0.05). Noteworthy significant percentage of wellknown causes of infertility and idiopathic factor in all groups, and the prevalence of tubal-peritoneal factor in the second and third experimental groups, and endocrine dysfunction in the I experimental group. The most common disorder among this category of woman was polycystic ovary syndrome. Frequency of usual miscarriage among patients of I ana II groups was two times higher than in the third group (p <0.05). Among the experimental groups the leading place belongs urinary tract infection, respiratory tract diseases, pathologies of the cardiovascular system. Data of the stratified analysis show an increase likelihood of repeated unsuccessful ART attempts under the influence of constant chronic stress (odds ratio OR=2.06; 95% CI: 0.95–3.17; p<0.05). Conclusions. Among infertile patients with repeated unsuccessful ART attempts must be separated a high risk group of failures. The identity depends on the duration of infertility, female age and leading combination of factors. Key words: repeated unsuccessful ART attempts, anamnesis, infertility, high risk.

Diagnostic Value of Real-Time Shear Wave Elastography in Diagnosing Thyroid Cancer

2018 ◽  
Vol 68 (12) ◽  
pp. 2818-2822
Author(s):  
Maria Cristina Oprea ◽  
Mihaela Vlad ◽  
Ioana Golu ◽  
Ioan Sporea ◽  
Lazar Fulger
Keyword(s):  
Shear Wave ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Imaging Techniques ◽  
Area Under The Curve ◽  
Thyroid Volume ◽  
Shear Wave Elastography ◽  
Maximum Diameter ◽  
Diagnostic Tools ◽  
Tissue Elasticity

Thyroid nodules are a common pathology found in 50 to 60% of otherwise healthy people. Diagnostic imaging techniques are help discriminating between benign and malignant nodules, while fine needle aspiration is still a gold standard. Shear wave elastography, a recent imaging technique, holds the promise to become reliable diagnostic tools and is currently used in combination with ultrasound. We here report data obtained in a series of 52 thyroid nodules analysed by means of elastography, as well as conventional and Doppler ultrasound. We found no differences in age, nodule and thyroid volume, length, width, thickness and maximum diameter between benign and malignant lesions. Several sonographic patterns are considered to be predictive of malignancy, out of which we only found the intranodular blood flow to be statistically significant. By the means of shear wave elastography we have first assessed tissue elasticities, which are shown in a range of colours, depending on tissue elasticity/stiffness. Then, we have measured and recorded four parameters automatically displayed by the system, namely SWE-mean, SWE-max, SWE-SD and SWE-ratio. Data analysis showed all these quantitative parameters had good sensitivity, specificity, positive predictive value, negative predictive value and area under the curve, as calculated by the ROC curve. As with these parameters, the cut-off points were lower than in literature, still able to indicate reliable diagnoses, which were confirmed by histopathological exam. Our conclusion is that shear wave elastography has great potential for reliably and accurately diagnosing thyroid malignancies.

scholarly journals Age-specific cut-off levels of anti-Müllerian hormone can be used as diagnostic markers for polycystic ovary syndrome

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Fahimeh Ramezani Tehrani ◽  
Maryam Rahmati ◽  
Fatemeh Mahboobifard ◽  
Faezeh Firouzi ◽  
Nazanin Hashemi ◽  
...  
Keyword(s):  
Bayesian Method ◽  
Polycystic Ovary ◽  
Characteristic Curve ◽  
Generalized Additive Models ◽  
Additive Models ◽  
Control Group ◽  
Age Group ◽  
Predictive Values ◽  
Pcos Group

Abstract Background The majority of available studies on the AMH thresholds were not age-specific and performed the receiver operating characteristic curve (ROC) analysis, based on variations in sensitivity and specificity rather than positive and negative predictive values (PPV and NPV, respectively), which are more clinically applicable. Moreover, all of these studies used a pre-specified age categorization to report the age-specific cut-off values of AMH. Methods A total of 803 women, including 303 PCOS patients and 500 eumenorrheic non-hirsute control women, were enrolled in the present study. The PCOS group included PCOS women, aged 20–40 years, who were referred to the Reproductive Endocrinology Research Center, Tehran, Iran. The Rotterdam consensus criteria were used for diagnosis of PCOS. The control group was selected among women, aged 20–40 years, who participated in Tehran Lipid and Glucose cohort Study (TLGS). Generalized additive models (GAMs) were used to identify the optimal cut-off points for various age categories. The cut-off levels of AMH in different age categories were estimated, using the Bayesian method. Main results and the role of chance Two optimal cut-off levels of AMH (ng/ml) were identified at the age of 27 and 35 years, based on GAMs. The cut-off levels for the prediction of PCOS in the age categories of 20–27, 27–35, and 35–40 years were 5.7 (95 % CI: 5.48–6.19), 4.55 (95 % CI: 4.52–4.64), and 3.72 (95 % CI: 3.55–3.80), respectively. Based on the Bayesian method, the PPV and NPV of these cut-off levels were as follows: PPV = 0.98 (95 % CI: 0.96–0.99) and NPV = 0.40 (95 % CI: 0.30–0.51) for the age group of 20–27 years; PPV = 0.96 (95 % CI: 0.91–0.99) and NPV = 0.82 (95 % CI: 0.78–0.86) for the age group of 27–35 years; and PPV = 0.86 (95 % CI: 0.80–0.94) and NPV = 0.96 (95 % CI: 0.93–0.98) for the age group of 35–40 years. Conclusions Application of age-specific cut-off levels of AMH, according to the GAMs and Bayesian method, could elegantly assess the value of AMH in discriminating PCOS patients in all age categories.

Shear wave elastography of thyroid nodules for the prediction of malignancy in a large scale study

2015 ◽  
Vol 84 (3) ◽  
pp. 407-412 ◽  
Author(s):  
Ah Young Park ◽  
Eun Ju Son ◽  
Kyunghwa Han ◽  
Ji Hyun Youk ◽  
Jeong-Ah Kim ◽  
...  
Keyword(s):  
Shear Wave ◽  
Large Scale ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Large Scale Study

ASSOCIATION OF OVARIAN VITAMIN D AND HORMONE RECEPTORS EXPRESSION IN WOMEN WITH POLYCYSTIC OVARY SYNDROME

2021 ◽  
Vol 10 (4) ◽  
pp. 36-42
Author(s):  
S. T. Aigul ◽  
G. A. Demyashkin ◽  
M. R. Orazov ◽  
S. Yu. Kalinchenko ◽  
G. M. Shaimardanova ◽  
...  
Keyword(s):  
Vitamin D ◽  
Hormone Receptors ◽  
Polycystic Ovary ◽  
Married Couples ◽  
Ovarian Cysts ◽  
Control Group ◽  
Endocrine Disorders ◽  
Social Burden ◽  
Metabolism Disorder ◽  
Group I

Infertility is one of the most common diseases of the reproductive system, which carries a significant medical and social burden, affecting from 10 to 15% of married couples, and one of the causes of which is polycystic ovarian syndrome (PCOS), associated with menstrual and endocrine disorders. Changes in the concentration of key enzymes of the metabolic pathway of vitamin D in PCOS may affect the regulation of local tissue homeostasis. Mechanisms of inhibition of cell proliferation under the action of vitamin D have not been fully explored. The aim of the study is to investigate the expression of VDR and hormone receptors in the ovaries of women with PCOS. Material and methods. Patients were divided into main (I) and control groups (II), that included women (n=60) aged 18 to 44 years (mean age - 29.1±3.3 years), who at diagnostic laparoscopy due to infertility of unknown cause. Immunohistochemical (IHC) study of ovarian cysts was performed according to a standard protocol using antibodies to VDR, AR, ERß, PR. The expression of VRD, 1α-OH, 24-OH in samples of ovarian cysts was determined by polymerase chain reaction in real time (PCR-RT). Results. The following IHC expression of the studied markers was observed in the samples of the 1st group cysts of women with PCOS: VDR - 67.7±2.1%; AR - 51.7±1.3%; ERß - 23.1±1.2%; PR - 89.3±2.1%. According to PCR-RT data, the relative VDR expression in group I was 4,31±0,18 arb. u., vs 2,17±0,11 arb. u. in the control group. Conclusions. The key role in PCOS pathogenesis is played by complex metabolism disorder of vitamin D and androgen-estrogen balance as well as decrease of ERß and increase of PR expression level.

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

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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