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

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.

Application of Elasticity Imaging Techniques Based on Ultrasound in Breast Tumor Activity, Blood Supply, and Benign and Malignant Tumor Diagnosis

Objective: The purpose of the study is to discuss the application of ultrasound elasticity imaging techniques in the diagnosis of breast tumor activity, blood supply, benign and malignant tumor diagnosis, and help better diagnosing. Methods: 94 lesions of 84 femalebreast lesions patients were evaluated by conventional ultrasound and static ultrasound elasticity imaging techniques, including 29 malignant lesions and 65 benign lesions. The ultrasonic image was processed by image denoising algorithm. 5-point scale criteria were used to evaluate the elasticity of each lesion, and measure the strain rate (SR) and the mean value of strain color histogram of each lesion. The receiver operating characteristic curve (ROC) was used to analyze the diagnostic sensitivity, specificity, and area under the curve (Az) of various indicators, and evaluate the diagnostic value of conventional ultrasound, static ultrasound elastic imaging, and the combination of the two. Results: the highest Az value of 0.941 was obtained by combining the three static ultrasound elasticity imaging techniques, namely, scoring method, SR method, and strain color histogram method with conventional ultrasound. It was higher than that (0.891) based on conventional ultrasound breast image report and data system (BI-RADS). Moreover, the diagnosis sensitivity was significantly improved, and the specificity was basically unchanged. Conclusion: the combination of static ultrasound elasticity imaging techniques and conventional ultrasound can reduce the number of benign breast lesions and avoid the omission of malignant lesions requiring biopsy. Static ultrasound elasticity imaging techniques are helpful to distinguish the breast lesions. It can be used as a supplement to conventional ultrasound and improve the diagnostic efficiency of ultrasound.

Acoustic radiation force-based elasticity imaging methods

Conventional diagnostic ultrasound images portray differences in the acoustic properties of soft tissues, whereas ultrasound-based elasticity images portray differences in the elastic properties of soft tissues (i.e. stiffness, viscosity). The benefit of elasticity imaging lies in the fact that many soft tissues can share similar ultrasonic echogenicities, but may have different mechanical properties that can be used to clearly visualize normal anatomy and delineate pathological lesions. Acoustic radiation force-based elasticity imaging methods use acoustic radiation force to transiently deform soft tissues, and the dynamic displacement response of those tissues is measured ultrasonically and is used to estimate the tissue's mechanical properties. Both qualitative images and quantitative elasticity metrics can be reconstructed from these measured data, providing complimentary information to both diagnose and longitudinally monitor disease progression. Recently, acoustic radiation force-based elasticity imaging techniques have moved from the laboratory to the clinical setting, where clinicians are beginning to characterize tissue stiffness as a diagnostic metric, and commercial implementations of radiation force-based ultrasonic elasticity imaging are beginning to appear on the commercial market. This article provides an overview of acoustic radiation force-based elasticity imaging, including a review of the relevant soft tissue material properties, a review of radiation force-based methods that have been proposed for elasticity imaging, and a discussion of current research and commercial realizations of radiation force based-elasticity imaging technologies.