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.

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.

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 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 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 Optimization of diagnostic studies in patients with adenomiosis and/or hyperplastic processes of endometrium

2021 ◽  
pp. 34-39
Author(s):  
T.V. Mielikhova ◽  
O.V. Gryshchenko ◽  
V.V. Lazurenko ◽  
R.A. Safonov ◽  
O.S. Alekseeva
Keyword(s):  
Shear Wave ◽  
Shear Wave Elastography ◽  
Antigen Expression ◽  
Transitional Zone ◽  
Endometrial Biopsy ◽  
Ultrasound Elastography ◽  
Proliferation Index ◽  
Control Group ◽  
Ki 67 ◽  
Study Objective

Study objective: to optimize diagnostic measures in patients with adenomyosis and/or hyperplastic endometrial processes (HEP).Material and methods. The study included 128 patients aged from 27 to 53 years. The first group included 38 (29.6%) patients with a grade I–II adenomyosis, the second group included 41 (32.1%) patients with a combination of grade I–II adenomyosis and HEP and/or uterine leiomyoma, the third group included 39 (30.5%) women with only HEP, the fourth (control) group included 10 (7,8%) women without endometrial pathology. Patients underwent hysteroscopy with targeted biopsy, elucidated the pathomorphological features of connective tissue component of the endometrium and uterus transitional zone, studied specific markers of adenomyosis progression, namely vascular endothelial growth factor and Ki-67 proliferation index, and also determined the parameters of shear wave ultrasound elastography.Results. Routine histological examination of adenomyosis was confirmed only in 11 (30.6%) cases out of 36 suspected, while HEP (polyps, glandular hyperplasia) and hyperplastic pathology of endocervix (polyps) – in 34 (97.1%) cases out of 35 suspected. Ki-67 antigen expression was positive in the nuclei of epithelial cells in the adenomyosis glands and in the cytogenic stroma cells. A greater value of expression was in the epithelium of glands in superficially located heterotopies – with grade I–II adenomyosis compared with other studied groups. Shear wave elastography showed significant differences in the myometrium color between the first, third and control groups. The unchanged myometrium in all patients of the control group was characterized by staining in shades of blue, while in 9 (90%) patients the color was uniform.Conclusion. It is recommended to use a shear wave ultrasound elastography in laboratory and instrumental examination with determination of Ki-67 proliferation protein expression and intensification of the neovascularization process in endometrial biopsy specimens to improve the diagnosis of adenomyosis.

Ultrasound Elastography for Rapid, Real-time Detection of Localized Muscular Reaction in Malignant Hyperthermia–susceptible Pigs

2018 ◽  
Vol 129 (5) ◽  
pp. 989-999
Author(s):  
Stephan Johannsen ◽  
Ismail Türkmeneli ◽  
Susanne Isbary ◽  
Norbert Roewer ◽  
Frank Schuster
Keyword(s):  
Malignant Hyperthermia ◽  
Real Time ◽  
Shear Wave ◽  
Intramuscular Injection ◽  
Shear Wave Elastography ◽  
Ultrasound Elastography ◽  
Temporary Increase ◽  
Maximum Effect ◽  
Tissue Elasticity ◽  
Real Time Detection

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Halothane and caffeine induce excessive sarcoplasmic calcium liberation and skeletal muscle contracture in patients susceptible to malignant hyperthermia (MH) and are utilized for diagnosis in the in vitro contracture test. Intramuscular injection previously caused a marked local lactate increase in MH-susceptible but not in MH-nonsusceptible individuals in vivo. Using shear-wave elastography, this study evaluated localized changes in muscle stiffness after intramuscular injection of halothane and caffeine. Methods Microdialysis probes were placed into the gracilis muscle of 16 pigs (9 MH-susceptible and 7 MH-nonsusceptible). After local injection of either halothane or caffeine in different concentrations, changes of tissue elasticity surrounding the probe were examined by quantitative shear-wave elastography. Local lactate concentrations were analyzed spectrophotometrically. Results Ultrasound elastography detected a temporary increase in local muscle rigidity in MH-susceptible but not in MH-nonsusceptible pigs after 2.5 and 5 vol% halothane and after 10, 40, and 80 mM caffeine, whereas there were no differences in the control groups (median [interquartile range] for maximum effect after 5 vol% halothane: MH-susceptible: 97 [31 to 148] vs. MH-nonsusceptible: 5 [−6 to 18] kPa; P = 0.0006; maximum effect after 80 mM caffeine: 112 [64 to 174] vs. −3 [−6 to 35] kPa; P = 0.0002). These effects were seen rapidly within 5 min. Local lactate concentrations were higher in MH-susceptible versus nonsusceptible pigs after 1 and 2.5 vol% halothane and 10, 40, and 80 mM caffeine (2.5 vol% halothane: MH-susceptible: 2.8 [1.9 to 4.4] vs. MH-nonsusceptible: 0.6 [0.6 to 0.7] mmol/l; P &lt; 0.0001; 80 mM caffeine: 5.2 [4.1 to 6.3] vs. 1.6 [1.2 to 2.4] mmol/l; P &lt; 0.0001). After 10 vol% halothane, rigidity and lactate levels were increased in both MH-susceptible and MH-nonsusceptible animals. Conclusions This pilot study revealed shear-wave elastography as a suitable technique for real-time detection of altered tissue elasticity in response to pharmacologic stimulation. By considering the variability of these results, further test protocol optimization is required before elastography could serve as a minimally invasive MH diagnostic test.

scholarly journals Аpplication of shear wave elastography for differential diagnosis of clinical and morphological types of acute pancreatitis

2021 ◽  
Vol 12 (3) ◽  
pp. 72-79
Author(s):  
T. P. Kabanenko ◽  
A. A. Kinzerskiy
Keyword(s):  
Acute Pancreatitis ◽  
Differential Diagnosis ◽  
Shear Wave ◽  
Imaging Techniques ◽  
Necrotizing Pancreatitis ◽  
Shear Wave Elastography ◽  
Control Group ◽  
Elasticity Imaging Techniques ◽  
Elasticity Imaging ◽  
Acute Necrotizing

Introduction. The incidence of acute pancreatitis increases every year. Early diagnosis of the necrotic type of acute pancreatitis is still relevant.Purpose. To reveal the informativeness of Elasticity Imaging Techniques for differential diagnosis of clinical and morphological types of acute pancreatitis.Material and methods. Shear wave sonoelastometry (ElastPQ-pSWE) was performed for 19 patients with acute edematous pancreatitis, and 13 patients with acute necrotizing pancreatitis. The control group consisted of 30 healthy volunteers.Results. In comparison with the control group, the stiffness of the pancreatic parenchyma was 1,3 times higher in the edematous form of AP (p3=0,0013, p6=0,007, p8=0,0024) and 5,3 times in the necrotic form of AP (p3=3,3e-5, p6=8e-07, p8=7,1e-8) and amounted to 5,16±1,34 kPa and 20,55±8,39 kPa, respectively, versus 3,86±1,04 kPa.Conclusions. Elasticity Imaging Techniques with shear wave technology provides an additional criterion for differential diagnosis of clinical and morphological types of acute pancreatitis.

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 Elastic Modulus and Elasticity Ratio of Malignant Breast Lesions with Shear Wave Ultrasound Elastography: Variations with Different Region of Interest and Lesion Size

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1015
Author(s):  
Antonio Bulum ◽  
Gordana Ivanac ◽  
Eugen Divjak ◽  
Iva Biondić Špoljar ◽  
Martina Džoić Dominković ◽  
...  
Keyword(s):  
Elastic Modulus ◽  
Shear Wave ◽  
Large Diameter ◽  
Small Diameter ◽  
Shear Wave Elastography ◽  
Lesion Size ◽  
Ultrasound Elastography ◽  
Breast Lesions ◽  
Malignant Breast ◽  
The Impact

Shear wave elastography (SWE) is a type of ultrasound elastography with which the elastic properties of breast tissues can be quantitatively assessed. The purpose of this study was to determine the impact of different regions of interest (ROI) and lesion size on the performance of SWE in differentiating malignant breast lesions. The study included 150 female patients with histopathologically confirmed malignant breast lesions. Minimal (Emin), mean (Emean), maximal (Emax) elastic modulus and elasticity ratio (e-ratio) values were measured using a circular ROI size of 2, 4 and 6 mm diameters and the lesions were divided into large (diameter ≥ 15 mm) and small (diameter < 15 mm). Highest Emin, Emean and e-ratio values and lowest variability were observed when using the 2 mm ROI. Emax values did not differ between different ROI sizes. Larger lesions had significantly higher Emean and Emax values, but there was no difference in e-ratio values between lesions of different sizes. In conclusion, when measuring the Emin, Emean and e-ratio of malignant breast lesions using SWE the smallest possible ROI size should be used regardless of lesion size. ROI size has no impact on Emax values while lesion size has no impact on e-ratio values.

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