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 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.

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.

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.

scholarly journals Ultrasound Elastography: another piece in the puzzle of carotid plaque vulnerability?

2021 ◽  
Author(s):  
Andjoli Davidhi ◽  
Vasileios Rafailidis ◽  
Evangelos Destanis ◽  
Panos Prassopoulos ◽  
Stefanos Foinitsis
Keyword(s):  
Shear Wave ◽  
Carotid Plaque ◽  
Diagnostic Yield ◽  
Imaging Modality ◽  
Shear Wave Elastography ◽  
Ultrasound Elastography ◽  
Intraplaque Hemorrhage ◽  
Plaque Vulnerability ◽  
Carotid Plaques ◽  
Increased Risk

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.

scholarly journals The relationship of the shear wave elastography findings of patients with unilateral lumbar disc herniation and clinical characteristics

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Qingyuan Wang ◽  
Hao Zhang ◽  
Jinxin Zhang ◽  
Hanqi Zhang ◽  
Hui Zheng
Keyword(s):  
Sciatic Nerve ◽  
Shear Wave ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Clinical Characteristics ◽  
Lumbar Disc ◽  
Shear Wave Elastography ◽  
Control Group ◽  
Symptom Duration ◽  
Foraminal Stenosis

Abstract Background The aim of this study was to find out whether the shear wave elastography (SWE) findings of patients with unilateral lumbar disc herniation (LDH) were related to clinical characteristics. Methods For this purpose, the study group included patients (N = 20; 13 male, 7 female) with complaints of unilateral sciatica, with foraminal stenosis caused by one level of LDH (L4-L5 or L5-S1). An gender-and age-matched control group (N = 27; 16 male, 11 female) was included. All the patients were examined on both the axial and longitudinal planes bilaterally at the same level using a convex array probe (1- 6 MHz, Supersonic Imagine, Aix en Provence, France). Results The sciatic nerve stiffness measured on longitudinal planes of the affected side was significantly higher than unaffected side (p < 0.001) and the control group (P < 0.05). Furthermore, the symptom duration of unilateral LDH is positively correlated with the stiffness the sciatic nerve (r = 0.52, p = 0.019). Conclusion According to these findings, ultrasound imaging can be considered as a useful tool to detect changes in the sciatic nerve due to disc herniation. This technique will have a promising prospect for many patients with unilateral LDH in monitoring stiffness during rehabilitation and before or after surgery.

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 Point shear wave ultrasound elastography with Esaote compared to real-time 2D shear wave elastography with supersonic imagine for the quantification of liver stiffness

2017 ◽  
Vol 20 (3) ◽  
pp. 213-225 ◽  
Author(s):  
L. Mulazzani ◽  
V. Salvatore ◽  
F. Ravaioli ◽  
G. Allegretti ◽  
F. Matassoni ◽  
...  
Keyword(s):  
Real Time ◽  
Shear Wave ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Ultrasound Elastography

scholarly journals Strain Elastography - How To Do It?

2017 ◽  
Vol 03 (04) ◽  
pp. E137-E149 ◽  
Author(s):  
Christoph Dietrich ◽  
Richard Barr ◽  
André Farrokh ◽  
Manjiri Dighe ◽  
Michael Hocke ◽  
...  
Keyword(s):  
Shear Wave ◽  
Wave Speed ◽  
Shear Wave Elastography ◽  
Ultrasound Elastography ◽  
Tissue Stiffness ◽  
Shear Wave Speed ◽  
Strain Elastography ◽  
Advantages And Disadvantages ◽  
Similar Information ◽  
Qualitative Technique

AbstractTissue stiffness assessed by palpation for diagnosing pathology has been used for thousands of years. Ultrasound elastography has been developed more recently to display similar information on tissue stiffness as an image. There are two main types of ultrasound elastography, strain and shear wave. Strain elastography is a qualitative technique and provides information on the relative stiffness between one tissue and another. Shear wave elastography is a quantitative method and provides an estimated value of the tissue stiffness that can be expressed in either the shear wave speed through the tissues in meters/second, or converted to the Young’s modulus making some assumptions and expressed in kPa. Each technique has its advantages and disadvantages and they are often complimentary to each other in clinical practice. This article reviews the principles, technique, and interpretation of strain elastography in various organs. It describes how to optimize technique, while pitfalls and artifacts are also discussed.

scholarly journals Evaluation of tendinosis of the long head of the biceps tendon by strain and shear wave elastography

2018 ◽  
Vol 20 (2) ◽  
pp. 192 ◽  
Author(s):  
Mehmet Hamdi Sahan ◽  
Mikail Inal ◽  
Veysel Burulday ◽  
Turgut Kultur
Keyword(s):  
Shear Wave ◽  
Biceps Tendon ◽  
Shear Wave Elastography ◽  
Tissue Type ◽  
Diagnostic Tools ◽  
Control Group ◽  
Type I ◽  
Color Mapping ◽  
Significant Difference ◽  
Long Head

Aim: To investigate strain (SE) and shear wave elastography (SWE) characteristics of the long head of the biceps tendon (LHBT) tendinosis in comparison with magnetic resonance imaging (MRI) findings.Material and methods: Twenty patients with a MRI diagnosis of tendinosis and twenty healthy subjects with normal LHBT in MRI were prospectively examined by SE and SWE. SE color mapping was divided into four types in accordance with elasticity designs: type I predominantly blue (hardest tissue), type II predominantly blue-green (hard tissue), type III predominantly green (intermediate tissue), type IV predominantly green-yellow-red (soft tissue). Quantitative measurements of LHBT hardness with SWE were analyzed in kilopascals (kPa).Results: In the tendinosis group SE types in transverse scan were I in 24% of tendons, II in 50%, III in 25%, and in longitudinal scan I in 15%, II in 75%, and III in 10%. In the control group SE types in transversescan were II in 10% of tendons, III in 55%, IV in 35%, and in longitudinal scan II in 10%, III in 55%, and IV in 35%. SWE values in transverse scan were 38.32±7.2 kPa in the tendinosis group and 18.6±3.1 kPa in the control groupand in longitudinal scan 39.42±7.4 kPa in the tendinosis group, and 20.62±4.6 in the control group. There was a statistically significant difference in terms of elasticity patterns between the tendinosis and control groups (p<0.001). The receiver operating characteristic curve analysis was perfect and a cut-off value of tranverse 25.8 kPa and longitudinal, 24.6 kPa shear values had very high sensitivity and specificity for tendinosis.Conclusion: SE and SWE may be useful diagnostic tools for LHBT tendinosis when considering usability, cost effectiveness, and patient preference compared to MRI.

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