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Vainieri AFM, Brando E, De Vincentis A, Di Pasquale G, Flagiello V, Gallo P, Barone F, Massaro Cenere T, Di Matteo E, Picardi A, Galati G. Acoustic Radiation Forced Impulse of the Liver and the Spleen, Combined with Spleen Dimension and Platelet Count in New Ratio Scores, Identifies High-Risk Esophageal Varices in Well-Compensated Cirrhotic Patients. Diagnostics (Basel) 2024; 14:685. [PMID: 38611598 PMCID: PMC11011753 DOI: 10.3390/diagnostics14070685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
Acoustic radiation forced impulse (ARFI) is an integrated ultrasound method, measuring stiffness by point shear wave elastography. To evaluate the diagnostic performance of the ARFI of the liver and the spleen, combined with spleen dimension and platelet count, in predicting high-risk esophageal varices (HRVs) in cirrhotic patients, a prospective and cross-sectional study was conducted between February 2017 and February 2021. The following ratio scores were calculated based on ARFI measurements: ALSDP (ARFI Liver-Spleen Diameter-to-Platelet Ratio Score), ASSDP (ARFI Spleen-Spleen Diameter-to-Platelet Ratio Score), ASSAP (ARFI Spleen-Spleen Area-to-Platelet Ratio Score), and ALSAP (ARFI Liver-Spleen Area-to-Platelet Ratio Score). In 100 enrolled subjects, spleen ARFI, ASSDP, and ASSAP were significantly associated with HRVs in the prospective short- and long-term follow-ups and in the cross-sectional study (p < 0.05), while ALSDP and ALSAP were associated with HRVs only in the prospective long-term follow-up and cross-sectional study (p< 0.05). ASSAP was the best ARFI ratio score for HRVs at the long-term follow-up [value of area under curve (AUC) = 0.88], although all the ARFI ratio scores performed better than individual liver and spleen ARFI (AUC > 0.7). In our study, ARFI ratio scores can predict, in well-compensated cirrhotic patients, the risk of developing HVRs in short- and long-term periods.
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Affiliation(s)
| | - Elisa Brando
- Operative Research Unit of Clinical Medicine and Hepatology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (E.B.); (G.D.P.); (V.F.); (P.G.); (F.B.); (E.D.M.); (A.P.)
| | - Antonio De Vincentis
- Operative Research Unit of Internal Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy;
- Research Unit of Internal Medicine, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Giulia Di Pasquale
- Operative Research Unit of Clinical Medicine and Hepatology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (E.B.); (G.D.P.); (V.F.); (P.G.); (F.B.); (E.D.M.); (A.P.)
| | - Valentina Flagiello
- Operative Research Unit of Clinical Medicine and Hepatology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (E.B.); (G.D.P.); (V.F.); (P.G.); (F.B.); (E.D.M.); (A.P.)
- Reasearch Unit of Clinical Medicine and Hepatology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Paolo Gallo
- Operative Research Unit of Clinical Medicine and Hepatology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (E.B.); (G.D.P.); (V.F.); (P.G.); (F.B.); (E.D.M.); (A.P.)
- Reasearch Unit of Clinical Medicine and Hepatology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Francesca Barone
- Operative Research Unit of Clinical Medicine and Hepatology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (E.B.); (G.D.P.); (V.F.); (P.G.); (F.B.); (E.D.M.); (A.P.)
| | | | - Evelyn Di Matteo
- Operative Research Unit of Clinical Medicine and Hepatology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (E.B.); (G.D.P.); (V.F.); (P.G.); (F.B.); (E.D.M.); (A.P.)
| | - Antonio Picardi
- Operative Research Unit of Clinical Medicine and Hepatology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (E.B.); (G.D.P.); (V.F.); (P.G.); (F.B.); (E.D.M.); (A.P.)
- Reasearch Unit of Clinical Medicine and Hepatology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Giovanni Galati
- Operative Research Unit of Clinical Medicine and Hepatology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (E.B.); (G.D.P.); (V.F.); (P.G.); (F.B.); (E.D.M.); (A.P.)
- Reasearch Unit of Clinical Medicine and Hepatology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
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Wang Y, Tian XF, Cheng J, Xu XL, Cao JY, Dong Y, Dietrich CF. Normal value of virtual touch imaging quantification elastography in measurements of pancreas. Clin Hemorheol Microcirc 2024:CH232092. [PMID: 38393894 DOI: 10.3233/ch-232092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
OBJECTIVE To evaluate pancreatic tissue stiffness and provide a normal reference shear wave velocity (SWV) value of pancreas from healthy adults by Virtual Touch Imaging Quantification (VTIQ) measurements. METHODS Healthy adult volunteers without known history of hepatobiliary or pancreatic diseases were included. VTIQ elastography (Siemens ACUSON Sequoia, 5C-1 transducer) was used. SWV values were measured at the cephalic, corpus and tail of pancreas and replicated different operators' obtained data. Subgroups were classified according to the volunteers' gender, age, body mass index (BMI), depth of measurements and the echogenicity of the pancreas. RESULTS From February 2023 to July 2023, 33 healthy adult volunteers were included. The success rate of VTIQ measurements in cephalic, corpus and tail regions was 90.90 % (30/33), 96.97 % (32/33) and 90.90 % (30/33) respectively. The color elastograms of healthy adult pancreas showed uniform blue or simultaneously blue and green. The average SWV values were 0.97±0.26 m/s for cephalic, 0.91±0.24 m/s for corpus and 0.97±0.25 m/s for pancreatic tail respectively (P = 0.198). The mean SWV values of pancreas did not show significant difference with age, gender or depth (P > 0.05). BMI was an influence factor in the measurements of SWV values of cephalic and tail of pancreas (P < 0.05). Pancreas with hyperechoic parenchyma showed higher mean SWV values (P < 0.05). The intra-observer (ICC = 0.938 [95% CI: 0.869-0.971]) and the inter-observer (ICC = 0.887 [95% CI: 0.760-0.947]) agreements of VTIQ measurements were excellent. CONCLUSIONS The mean SWV value of the pancreas in healthy adults was 0.96±0.20 m/s (range: 0.52-1.74 m/s). VTIQ technique can be used in pancreatic stiffness measurements with good reliability.
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Affiliation(s)
- Ying Wang
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiao-Fan Tian
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Juan Cheng
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xin-Liang Xu
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jia-Ying Cao
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yi Dong
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Christoph F Dietrich
- Department Allgemeine Innere Medizin, Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
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Du L, Deng H, Wu X, Liu F, Yin T, Zheng J. Relationship Between Spleen Pathologic Changes and Spleen Stiffness in Portal Hypertension Rat Model. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:216-223. [PMID: 37919143 DOI: 10.1016/j.ultrasmedbio.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/16/2023] [Accepted: 10/01/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE The aim of the study described here was to explore the influence of splenic pathology and hemodynamic parameters on spleen stiffness in portal hypertension (PH). METHODS A Sprague‒Dawley rat model of PH (n = 34) induced by CCl4 was established, and 9 normal rats were used as controls. All animals underwent a routine ultrasound examination, spleen stiffness measurement (SSM), liver stiffness measurement (LSM), portal vein pressure (PVP) measurement and histopathologic assessment. The diagnostic performance of SSM and LSM in PH was evaluated. SSMs were compared among the groups at different pathologic and hemodynamic levels. Multiple linear regression was used to analyze the factors affecting SSM. RESULTS SSM had excellent diagnostic efficacy for PH (area under the receiver operating characteristic curve [AUC] = 0.900) and was superior to LSM (AUC = 0.794). In a rat model of PH, pathologic changes such as splenic sinus widening, thickening of the splenic capsule and an increase in collagen fibers were observed in the spleen. There were significant differences in SSM at different splenic capsule thicknesses and splenic sinus widths (all p values <0.05), but there were no significant differences in the SSM at different levels of the splenic collagen fiber area and red pulp area (all p values >0.05). In addition, there were significant differences in SSM at different levels of portal vein diameter, blood flow and congestion index (all p values <0.05). Multiple linear regression analysis revealed that PVP, portal vein congestion index and splenic capsule thickness were significantly associated with SSM. CONCLUSION SSM is a good non-invasive way to assess PH. PVP, splenic capsule thickness and portal vein congestion index are responsible for spleen stiffness but not the proliferation of splenic fibrous tissue.
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Affiliation(s)
- Lingyue Du
- Department of Second Affiliated Hospital, School of Medicine, Chinese University of Hong Kong, Shenzhen & Longgang District People's Hospital of Shenzhen, Shenzhen, China; Department of Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Huan Deng
- Department of Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Xiaoting Wu
- Department of Second Affiliated Hospital, School of Medicine, Chinese University of Hong Kong, Shenzhen & Longgang District People's Hospital of Shenzhen, Shenzhen, China
| | - Fan Liu
- Department of Second Affiliated Hospital, School of Medicine, Chinese University of Hong Kong, Shenzhen & Longgang District People's Hospital of Shenzhen, Shenzhen, China
| | - Tinghui Yin
- Department of Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Jian Zheng
- Department of Second Affiliated Hospital, School of Medicine, Chinese University of Hong Kong, Shenzhen & Longgang District People's Hospital of Shenzhen, Shenzhen, China; Department of Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
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Hristov B, Nacheva-Georgieva E, Stanchev D, Kraev K, Uchikov P, Kostov G, Valova S, Tilkiyan E, Doykova K, Doykov M. Estimating reference values of parenchymal stiffness of normal pancreatic parenchyma by means of point shear wave elastography. Folia Med (Plovdiv) 2023; 65:958-968. [PMID: 38351786 DOI: 10.3897/folmed.65.e106764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/21/2023] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION There are numerous imaging modalities available to describe pancreatic parenchyma. None of the broadly accepted diagnostic methods uses elasticity as an indicator of tissue damage.
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Arslan H, Küçükbaş GN, Türkoğlu S, Akdemir Z, Yokuş A, Gündüz AM, Karaman E, Şahin HG. Use of Virtual Touch Tissue Quantification Elastography Technique in Fetal Lung Maturation: A Preliminary Study. Ultrasound Q 2023; 39:134-137. [PMID: 37093671 DOI: 10.1097/ruq.0000000000000642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
ABSTRACT This study is an analysis of fetal lung stiffness by virtual touch tissue quantification (VTTQ) elastography to predict fetal lung maturation. Evaluation of fetal lungs was first performed in B mode, and fetal lungs were analyzed at 3 different periods at third trimester in each pregnant woman, at 28 to 31, 32 to 36, and 37 to 41 weeks. Fetal lung elastography was performed at regions with the least acoustic shadow and far from ribs and heart. Each fetal lung assessment were done by taking mean lung stiffness obtained by measuring stiffness of both left and right fetal lungs. T test analysis showed no significant difference in fetal lung stiffness between male and female fetuses among 3 gestational periods. Analysis of variance was performed to evaluate fetal lung stiffness of the fetuses at 3 different gestational periods (28-31, 32-36, and 37-41 weeks). This analysis showed significant difference ( P < 0.01). Duncan multiple comparison analysis did not show significant difference in fetal lung stiffness between 28 and 31 weeks and 32 and 36 weeks, whereas fetal lung stiffness of fetuses at 37 to 41 weeks were significantly greater ( P < 0.01). This study is first step to analyze fetal lung maturation noninvasively using VTTQ elastography technique by measuring fetal lung stiffness.
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Affiliation(s)
| | - Gökçe Naz Küçükbaş
- Obstetrics and Gynecology, Van Yuzuncu Yil University, Faculty of Medicine
| | - Saim Türkoğlu
- Department of Radiology, Van Training and Research Hospital, Van, Turkey
| | | | | | | | - Erbil Karaman
- Obstetrics and Gynecology, Van Yuzuncu Yil University, Faculty of Medicine
| | - Hanım Güler Şahin
- Obstetrics and Gynecology, Van Yuzuncu Yil University, Faculty of Medicine
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Ozmen Z, Kasap T, Aktas F, Ozmen ZC. Shear wave elastography evaluation of kidneys in children with familial mediterranean fever. Niger J Clin Pract 2023; 26:957-962. [PMID: 37635580 DOI: 10.4103/njcp.njcp_698_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Background and Aim Familial Mediterranean fever (FMF) is an autosomal recessive disorder. Typical clinical manifestations are self-limiting attacks of recurrent fever, abdominal pain, arthralgia, and chest pain due to aseptic polyserositis. Renal involvement is common in FMF patients. Shear wave elastography (SWE) is a noninvasive method that provides the measurement of tissue stiffness. In this study, we aimed to show that SWE can be used as an adjunctive method for evaluating renal involvement in children with FMF. Materials and Methods Our study group consists of 79 pediatric FMF patients and 79 control individuals. The study was planned prospectively. The variables, such as age, height, weight, and body mass index (BMI) of the patient and control groups, were kept in a similar way in order not to be affected by the differences. The right and left kidney sizes, parenchymal thicknesses, and SWE values in both groups were compared. The parenchymal stiffness degrees of the kidneys were quantified by shear modulus values in kilopascals. Results In our study, no statistically significant difference was found between the control and patient groups in terms of the right and left kidney longitudinal dimensions, transverse dimensions, and parenchymal thicknesses. When the kidneys were evaluated in terms of the right and left kidney stiffness values, the stiffness values in the patient group were significantly higher in both kidneys compared with those in the control group (P < 0.001). Conclusions SWE can be a noninvasive quantitative imaging method that can be used to evaluate kidney involvement by detecting changes in kidney stiffness in children with FMF.
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Affiliation(s)
- Z Ozmen
- Department of Radiology, School of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - T Kasap
- Department of Pediatric Diseases, School of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - F Aktas
- Department of Radiology, School of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Z C Ozmen
- Department of Biochemistry, School of Medicine, Gaziosmanpasa University, Tokat, Turkey
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Rohrer GE, Premo H, Lentz AC. Current Techniques for the Objective Measures of Erectile Hardness. Sex Med Rev 2022; 10:648-659. [PMID: 37051971 DOI: 10.1016/j.sxmr.2022.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 03/12/2022] [Accepted: 05/10/2022] [Indexed: 10/15/2022]
Abstract
INTRODUCTION One of the most discussed topics in the urology provider's office is that of the male penile erection. Moreover, this is also a frequent basis for consultation by primary care practitioners. As such, it is essential that urologists are familiar with the various means by which the male erection may be evaluated. OBJECTIVES This article describes several techniques presently available that may serve to objectively quantify the rigidity and hardness of the male erection. These techniques are meant to bolster information gathered from the patient interview and physical examination to better guide patient management. METHODS An extensive literature review was performed examining publications in PubMed on this subject, including corresponding contextual literature. RESULTS While validated patient questionnaires have been routinely employed, the urologist has many additional means available to uncover the extent of the patient's pathology. Many of these tools are noninvasive techniques that involve virtually no risk to the patient and take advantage of pre-existing physiologic properties of the phallus and its blood supply to estimate corresponding tissue stiffness. Specifically, Virtual Touch Tissue Quantification which precisely quantifies axial and radial rigidity, can provide continuous data on how these forces change over time, thus providing a promising comprehensive assessment. CONCLUSION Quantification of the erection allows for the patient and provider to assess response to therapy, aids the surgeon in choice of appropriate procedure, and guides effective patient counseling regarding expectation management. Rohrer GE, Premo H, Lentz AC. Current Techniques for the Objective Measures of Erectile Hardness. Sex Med Rev 2022;XX:XXX-XXX.
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Affiliation(s)
- Gabrielle E Rohrer
- Department of Surgery, Division of Urology, Duke University Medical Center, Durham, NC, USA
| | - Hayley Premo
- Duke University School of Medicine, Durham, NC, USA
| | - Aaron C Lentz
- Division of Urologic Surgery, Department of Surgery, Duke University School of Medicine, Durham, NC, USA.
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Renal Acoustic Radiation Force Impulse Elastography in Hypertensive Nephroangiosclerosis Patients. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app112210612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective: Hypertensive nephroangiosclerosis (HN) represents the second most common cause of chronic kidney disease. Kidney damage secondary to high blood pressure favors the appearance of serum and urinary changes, but also imaging, highlighted by ultrasonography (B-mode, Doppler, Acoustic Radiation Force Impulse Elastography). Acoustic Radiation Force Impulse Elastography (ARFI) represents a new imagistic method which characterizes renal stiffness in the form of shear wave velocity (SWV). Aim: This study aims to investigate renal stiffness in HN patients, and to assess the correlations between it and urinary albumin/creatinine ratio (UACR), estimated glomerular filtration rate (eGFR), and intrarenal resistive index (RRI). Material and Methods: This cross-sectional study was performed on a group of 80 HN patients and 50 healthy, sex and age-matched, as controls. UACR (urinary immunoturbidimetry), eGFR (Jaffe method), RRI, and renal SWV (Siemens Acuson 2000) were determined in all patients and controls. Data were expressed as mean ± standard deviation. Statistical analysis was done by means Pearson’s test and t-Student test, p values of less than 0.05 were considered statistically significant. Results: UACR, eGFR, RRI and SWV showed statistically significant differences between the HN patients and controls (p < 0.0001). In the hypertensive patients group, statistically significant correlations were observed between the SWV and UACR (r = −0.7633, p < 0.00001), eGFR (r = 0.7822, p = 0.00001), and RRI (r = −0.7978, p = 0.00001). Conclusions: Kidney sonoelastography characterizes imagistically the existence of intrarenal lesions associated with essential hypertension, offering a new diagnosis method for these patients.
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Zhou W, Zhang Y, Li L, Gao J, Zheng H, Huang M, Zhao S, Xie X, Zhang C, Zhang X. Evaluation of Arterial Erectile Dysfunction Using Shear Wave Elastography: A Feasibility Study. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:1209-1216. [PMID: 32926432 DOI: 10.1002/jum.15502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 08/12/2020] [Accepted: 08/16/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To explore the feasibility of shear wave elastography (SWE) in the evaluation of arterial erectile dysfunction (ED). METHODS From November 2018 to November 2019, 26 patients with arterial ED and 30 patients with non-vascular ED were prospectively included. SWE values of corpus cavernosum penis (CCP) and the flow velocity of cavernous artery for all patients in both before intracavernous injection (ICI) (flaccid state) and after ICI (erectile state) were measured. Performance of SWE value in assessing arterial ED was studied. Correlation between SWE value of CCP and the age of patients was also investigated. RESULTS ICI significantly reduced SWE values in both arterial and non-vascular group (from 19.57 ± 6.33 KPa to 12.17 ± 3.64 KPa in the first, and from 19.91 ± 6.69 KPa to 8.04 ± 3.13 KPa in the former, both P < .001). SWE values of CCP after ICI in arterial ED were significantly larger than that in non-vascular ED (P < .001). SWE values of CCP before ICI negatively correlated with age of patients in arterial ED (r = - 0.601, P < .001). With a cutoff value of 7.75 KPa, the area under curve, specificity, sensitivity, PPV, and NPV of SWE values of CCP after ICI in distinguishing arterial ED from non-vascular ED were 0.810, 63.3%, 96.2%, 96.2%, and 70%, respectively. CONCLUSIONS SWE was expected to be a potential technique for the noninvasive, simply operated, repeatable and quantitative evaluation of arterial ED.
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Affiliation(s)
- Wang Zhou
- Department of Ultrasound, the First Affiliated Hospital of Anhui Medical University, Shushan District, Hefei, Anhui, China
| | - Yuyang Zhang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Shushan District, Hefei, Anhui, China
- Institute of Urology, Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Shushan District, Hefei, Anhui, China
| | - Liang Li
- Department of Ultrasound, the First Affiliated Hospital of Anhui Medical University, Shushan District, Hefei, Anhui, China
| | - Jingjing Gao
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Shushan District, Hefei, Anhui, China
- Institute of Urology, Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Shushan District, Hefei, Anhui, China
| | - Hui Zheng
- Department of Ultrasound, the First Affiliated Hospital of Anhui Medical University, Shushan District, Hefei, Anhui, China
| | - Meng Huang
- Department of Ultrasound, the First Affiliated Hospital of Anhui Medical University, Shushan District, Hefei, Anhui, China
| | - Sheng Zhao
- Department of Ultrasound, the First Affiliated Hospital of Anhui Medical University, Shushan District, Hefei, Anhui, China
| | - Xinxin Xie
- Department of Ultrasound, the First Affiliated Hospital of Anhui Medical University, Shushan District, Hefei, Anhui, China
| | - Chaoxue Zhang
- Department of Ultrasound, the First Affiliated Hospital of Anhui Medical University, Shushan District, Hefei, Anhui, China
| | - Xiansheng Zhang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Shushan District, Hefei, Anhui, China
- Institute of Urology, Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Shushan District, Hefei, Anhui, China
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Nowotny F, Schmidberger J, Schlingeloff P, Binzberger A, Kratzer W. Comparison of point and two-dimensional shear wave elastography of the spleen in healthy subjects. World J Radiol 2021; 13:137-148. [PMID: 34141093 PMCID: PMC8188838 DOI: 10.4329/wjr.v13.i5.137] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/31/2021] [Accepted: 05/22/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Few systematic comparative studies of the different methods of physical elastography of the spleen are currently available.
AIM To compare point shear wave and two-dimensional elastography of the spleen considering the anatomical location (upper, hilar, and lower pole).
METHODS As part of a prospective clinical study, healthy volunteers were examined for splenic elasticity using four different ultrasound devices between May 2015 and April 2017. The devices used for point shear wave elastography were from Siemens (S 3000) and Philips (Epiq 7), and those used for two-dimensional shear wave elastography were from GE (Logiq E9) and Toshiba (Aplio 500). In addition, two different software versions (5.0 and 6.0) were evaluated for the Toshiba ultrasound device (Aplio 500). The study consisted of three arms: A, B, and C.
RESULTS In study arm A, 200 subjects were evaluated (78 males and 122 females, mean age 27.9 ± 8.1 years). In study arm B, 113 subjects were evaluated (38 men and 75 women, mean age 26.0 ± 6.3 years). In study arm C, 44 subjects were enrolled. A significant correlation of the shear wave velocities at the upper third of the spleen (r = 0.33088, P < 0.0001) was demonstrated only for the Philips Epiq 7 device compared to the Siemens Acuson S 3000. In comparisons of the other ultrasound devices (GE, Siemens, Toshiba), no comparable results could be obtained for any anatomical position of the spleen. The influencing factors age, gender, and body mass index did not show a clear correlation with the measured shear wave velocities.
CONCLUSION The absolute values of the shear wave elastography measurements of the spleen and the two different elastography methods are not comparable between different manufacturers or models.
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Affiliation(s)
- Friederike Nowotny
- Department of Internal Medicine I, University Hospital Ulm, Ulm 89081, Germany
| | - Julian Schmidberger
- Department of Internal Medicine I, University Hospital Ulm, Ulm 89081, Germany
| | | | - Andreas Binzberger
- Department of Internal Medicine I, University Hospital Ulm, Ulm 89081, Germany
| | - Wolfgang Kratzer
- Department of Internal Medicine I, University Hospital Ulm, Ulm 89081, Germany
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Pancreas ultrasound two-dimensional shear wave elastography in healthy children. Pediatr Radiol 2021; 51:403-409. [PMID: 33156431 DOI: 10.1007/s00247-020-04863-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/26/2020] [Accepted: 09/29/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Pancreas shear wave speed might be a biomarker of pancreatic disease in children. OBJECTIVE This study aimed to measure pancreas shear wave speed by two-dimensional (2-D) ultrasound shear wave elastography (SWE) in a balanced cohort of presumed healthy children. MATERIALS AND METHODS This was a prospective study of 120 children (<18 years of age) without a known history of pancreatic disease, who underwent ultrasound 2-D SWE of the pancreas. Five shear wave speed measurements in the pancreas body and/or tail were obtained for each participant using a Canon Aplio i800 system, i8CX1 transducer. The Mann-Whitney U test or Kruskal-Wallis test were used to compare continuous distributions. Spearman's correlation was used to assess univariate relationships between continuous variables. Multivariable regression with stepwise selection was used to evaluate independent predictors of pancreas shear wave speed. RESULTS The median age for the study population was 5.0 years (range: 7 days to 17.8 years) and 61 (50.8%) of the participants were female. The median depth of shear wave speed measurement was 4.7 cm (interquartile range [IQR]: 4.2-5.3). The median pancreas shear wave speed was 1.31 m/s (IQR: 1.21-1.40). On multivariable analysis, female biological sex (P=0.051), the number of hours nil per os (P=0.097), the median depth of measurement (P=0.001) and the median liver shear wave speed (P=0.020) were positively associated with pancreas shear wave speed. CONCLUSION We report pancreas shear wave speed in a large, balanced cohort of children without a known history of pancreatic disease, providing reference values for normal.
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Spleen elastography in patients with Systemic sclerosis. Rheumatol Int 2021; 41:633-641. [PMID: 33495915 DOI: 10.1007/s00296-020-04772-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 12/12/2020] [Indexed: 12/17/2022]
Abstract
Systemic sclerosis (SSc) is an autoimmune inflammatory connective tissue disease. It is characterized by varying degrees of fibrosis of the skin and internal organs. Tissue fibrosis is the final phase of a complex biological process of immune activation and vascular damage. The spleen is one of the organs thought to be involved in a systemic fibrosing process. Yet, there is a lack of research that provides evidence about splenic involvement in patients with SSc through objective instrumental techniques. Ultrasound elastography is a modern method which detects changes in the stiffness and elasticity of different organs. To assess the elasticity and stiffness of the spleen in healthy subjects and patients with SSc, the study included 34 patients with SSc and 35 healthy volunteers. Point SWE spleen elastography was performed on all participants in the two study groups through an Esaote MyLab 9 eXP with a C1-8 iQ appleprobe transducer. The mean age in the SSc patient group was 47.35 ± 11.48 years vs. 46.20 ± 14.55 years in the healthy controls, with no significant age difference, p = 0.717. The mean Body Mass Index (BMI) in the SSc patient group was 22.42 ± 2.12 kg/m2 vs. 24.23 ± 4.29 kg/m2 in the healthy control group with no significant difference, p = 0.410. Among the SSc patients, 18(53%) were with dcSSc and 16 (47%) with lcSSc. The mean disease duration was 59 ± 28 months, ranging between 18 and 118 months. Spleen stiffness median was significantly higher in the SSc patient group (3.19 m/s) in comparison with the healthy controls (2.40 m/s), p < 0.001. Spleen size was normally distributed and did not differ significantly between the SSc patients (105.84 ± 7.87 mm) and the healthy controls (104.16 ± 8.99 mm), p = 0.410. A significantly higher mean of spleen stiffness was observed in the dcSSc patients (3.38 ± 0.20 m/s) in comparison with the lcSSc group (2.81 ± 0.38 m/s), p < 0.001. Spleen size did not show a significant association with the type of SSc. Spleen size in the dcSSc subgroup had a mean value of 103.45 ± 5.56 mm vs. 108.51 ± 9.30 in the lcSSc subgroup, p = 0.071. pSWE is an objective, reliable, and easy-to-implement method for detecting early fibrous changes in the spleen in patients with SSc. A good approach in patients with SSc could be the search for similar processes in other internal organs, such as the liver and thyroid gland.
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Zhang DL, Liu XX, Tang JQ, Wu SS, Lin N, Ding GS, Pan XL, Chen S. The value of acoustic radiation force impulse imaging in preoperative prediction for efficacy of high-Intensity focused ultrasound uterine fibroids ablation. Int J Hyperthermia 2020; 37:423-429. [PMID: 32354241 DOI: 10.1080/02656736.2020.1758803] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Objective: To investigate the application value of acoustic radiation force impulse imaging in preoperative prediction for efficacy of High-Intensity Focused Ultrasound uterine fibroids ablationMethods: A prospective study was conducted on 32 women (41 fibroids) undergoing HIFU uterine fibroids ablation between January 2019 and September 2019. The virtual touch tissue quantification (VTQ) technique was used for the preoperative determination of uterine fibroids shear wave velocity (SWV). The stiffness of the preoperative uterine fibroids was graded on a virtual touch tissue image (VTI). All uterine fibroids were ablated with a single point ablation acoustic power of 400 W. All patients underwent pelvic cavity MRI examination for the measurement of the size, volume and non-perfused volume (NPV) of fibroids within the first month after HIFU ablation. The ablation rate of uterine fibroids was calculated according to the formula: ablation rate = NPV × 100/target fibroid volume. The patients were divided into two groups based on the postoperative ablation rate: ≥70% ablation rate group, and<70% ablation rate group. The preoperative SWV and VTI grade of uterine fibroids were compared between the two groups. The correlation of preoperative uterine fibroids' SWV and VTI grade with HIFU ablation rate were analyzed using the Spearman's correlation coefficient. The optimal cutoff points in preoperative uterine fibroids SWV of 70% ablation rate were determined by receiver operating curve (ROC) analysis.Results: A total of 30 patients (73.17%, 30/41) showed ablation rate ≥70%, with preoperative uterine fibroids' SWV values of (3.42 ± 0.71) m/s. Of these, 24 patients (80%, 24/30) had VTI grades II-III. On the other hand, 26.83% (11/41) showed ablation rate <70%, with preoperative uterine fibroids' SWV values of (4.02 ± 0.69) m/s; of these, 63.6% (7/11) had VTI grade IV. The SWV values and VTI grades of preoperative uterine fibroids were significantly different in the two groups (p < 0.05). Interestingly, postoperative ablation rate was negatively correlated with preoperative uterine fibroids' SWV values (r= -0.536, p = 0.0003) and VTI grades (r= -0.511, p = 0.001). The area under the ROC curve of preoperative uterine fibroids' SWV values with ablation rate <70% was 0.75 at a cutoff value of 3.915 m/s (p < 0.05). Specificity was 72.7% and sensitivity was 80.1%; the positive predictive value was 72.7%, and the negative predictive value was 80%.Conclusion: ARFI technique is an effective and feasible noninvasive ultrasound technique for the preoperative prediction of the efficacy of HIFU uterine fibroids ablation.
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Affiliation(s)
- Dan-Ling Zhang
- Department of Ultrasonography, Shengli Clinical College of Fujian Medical University, Fuzhou No.7 Hospital, Fuzhou, China
| | - Xin-Xiu Liu
- Department of Ultrasonography, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Jian-Qing Tang
- Department of Pathology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Song-Song Wu
- Department of Ultrasonography, Shengli Clinical College of Fujian Medical University, Fuzhou, China
| | - Ning Lin
- Department of Ultrasonography, Shengli Clinical College of Fujian Medical University, Fuzhou, China
| | - Gui-Sheng Ding
- Department of Ultrasonography, Shengli Clinical College of Fujian Medical University, Fuzhou, China
| | - Xiao-Li Pan
- Department of Ultrasonography, Shengli Clinical College of Fujian Medical University, Fuzhou, China
| | - Sheng Chen
- Department of Ultrasonography, Shengli Clinical College of Fujian Medical University, Fuzhou, China
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Aghaghazvini L, Maheronnaghsh R, Soltani A, Rouzrokh P, Chavoshi M. Diagnostic value of shear wave sonoelastography in differentiation of benign from malignant thyroid nodules. Eur J Radiol 2020; 126:108926. [PMID: 32171916 DOI: 10.1016/j.ejrad.2020.108926] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 01/27/2020] [Accepted: 02/27/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE To study the efficacy of shear wave elastography (SWE), using both qualitative and quantitative methods, alone and in conjunction with other B-mode features. METHOD 117 patients with 123 nodules were studied both by conventional ultrasonography and SWE. Size, echogenicity, margins, internal calcification (micro- or macro-calcification), composition, shape and color Doppler were assessed for each nodule. The elasticity was assessed both qualitatively and quantitatively. Velocity in the ROI (Region of Interest) was calculated in the stiffest portions for 3 times, and maximum and mean velocity were obtained. ROC curve was analyzed to calculate the best cut-off value of the SWV (Shear Wave Velocity). Univariate logistic regression was used to examine the maximum and mean SWV as discrete variables and the results were compared to key variables of conventional US (Ultrasound) features. RESULT 123 nodules in 117 patients were evaluated. Poor margins, hypoechogenicity, micro-calcification, color Doppler grades III and IV, color map grades IV and V, maximum and minimum velocity had significant correlation with malignancy. The highest Nagelkerke R2 belonged to maximum and mean velocity (R2 = 41.2 and 39 respectively) which propose them as the strongest predictors of malignancy. The best cut-off point for differentiation of benign from malignant nodules was 3.63 m/s for maximum velocity (sensitivity of 90 %, specificity of 78.2 %,) and 3.44 m/s for mean velocity (sensitivity of 90 %, specificity of 76.4 %). CONCLUSION The Real-time SWE is a promising test for the preoperative malignancy risk stratification of patients and maximum velocity has the strongest predictive value for both conventional and elastography variables.
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Affiliation(s)
- Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Aleahmed Highway, Tehran, Iran.
| | - Radin Maheronnaghsh
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Aleahmed Highway, Tehran, Iran.
| | - Akbar Soltani
- Evidence Based Medicine Research Center, Endocrinology and Metabolism Clinical Science Institute, Tehran University of Medical Sciences, Shariati Hospital, Aleahmed Highway, Tehran, Iran.
| | - Pouria Rouzrokh
- Evidence Based Medicine Research Center, Endocrinology and Metabolism Clinical Science Institute, Tehran University of Medical Sciences, Shariati Hospital, Aleahmed Highway, Tehran, Iran.
| | - Mohammadreza Chavoshi
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Aleahmed Highway, Tehran, Iran.
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A comparative study of the pancreas in pediatric patients with cystic fibrosis and healthy children using two-dimensional shear wave elastography. J Ultrasound 2020; 23:535-542. [PMID: 32034705 DOI: 10.1007/s40477-020-00432-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 01/23/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE To compare sonographic parameters of the pancreas between healthy children and pediatric cystic fibrosis (CF) patients with pancreatic involvement using shear wave elastography (SWE) and to investigate the efficacy of SWE in the diagnosis of pancreatic involvement in pediatric CF patients. METHODS The pancreas was evaluated in 38 patients with CF and 38 healthy children using conventional B-mode ultrasonography (US) and two-dimensional (2D)-SWE. RESULTS The pancreatic 2D-SWE values of the CF group were significantly lower than those of the healthy control group (1.01 ± 0.16 vs. 1.31 ± 0.01 m/s for the head, 1.03 ± 0.05 vs. 1.28 ± 0.08 m/s for the pancreatic body, and 1.02 ± 0.05 vs. 1.30 ± 0.10 m/s for the tail; p < 0.005 for all the comparisons). When the threshold values were obtained for the pancreatic head, body, and tail segments for the differentiation of the CF patients and healthy controls, the sensitivity of the test was determined as 81.5%, 76.3%, and 73.3%, respectively, and the specificity as 97.3%, 100%, and 100%, respectively. When the patients were divided into two groups based on the presence of B-mode US characteristics (homogeneity, sharp demarcation, and hyperechoic pancreas), there was a significant difference in the 2D-SWE values of the pancreatic head between the patients with and the patients without these characteristics (p = 0.048 for homogeneity, p = 0.021 for sharp demarcation, and p = 0.006 for hyperechoic pancreas). CONCLUSION The measurement of 2D-SWE values was found to be an easily applicable non-invasive test with high sensitivity and specificity for the demonstration of changes in the pancreas of pediatric CF patients.
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Xu Y, Cai X, Shi Y, Yin M, Lan G, Zhang X, Ji R, Chang Liu. Normative Pancreatic Stiffness Levels and Related Influences Established by Magnetic Resonance Elastography in Volunteers. J Magn Reson Imaging 2020; 52:448-458. [PMID: 31943515 DOI: 10.1002/jmri.27052] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 12/24/2019] [Accepted: 12/27/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Large-scale normative studies of pancreatic stiffness and potential influences have yet to be pursued via magnetic resonance elastography (MRE). PURPOSE To determine normative MRE-based pancreatic stiffness values and to examine related influential factors. STUDY TYPE Prospective. SUBJECTS In all, 361 volunteers (men, 199; women, 162) with a median age of 54.0 years and a median body mass index (BMI) of 22.86 kg/m2 were prospectively recruited. Those with no histories of smoking, alcohol abuse, and diabetes mellitus (DM) were grouped as healthy volunteers, designating all others as positive controls. FIELD STRENGTH/SEQUENCE Each volunteer underwent 3.0T pancreatic MRI at a frequency of 40 Hz. ASSESSMENT Pancreatic stiffness values, pancreatic width and volume, waist circumference, and wave distance were measured in all subjects. STATISTICAL TESTS Multiple linear regression analyses were performed to determine variables that influence MRE-determined stiffness. RESULTS The mean pancreatic stiffness in all volunteers was 1.20 ± 0.16 kPa. Stiffness levels in positive control volunteers proved significantly greater than levels in healthy volunteers (1.29 ± 0.17 kPa vs. 1.14 ± 0.13 kPa; P < 0.001). In multiple linear regression analysis, sex (P = 0.004), BMI (P < 0.001), pancreatic width (P = 0.005), smoking (P < 0.001), alcohol abuse (P < 0.001), and DM (P = 0.001) emerged as significant independent factors impacting pancreatic stiffness. Smoking, alcohol abuse, DM, and wide pancreas were associated with greater pancreatic stiffness (coefficients = 0.202, 0.183, 0.149, and 0.160, respectively), while reduced pancreatic stiffness corresponded with female sex and larger BMI (coefficient = -0.155 and -0.192, respectively). DATA CONCLUSION MRE-based pancreatic stiffness values are impacted by sex, BMI, pancreatic width, smoking, alcohol abuse, and DM. Reference values are essential for future clinical studies. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;52:448-458.
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Affiliation(s)
- Youli Xu
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiaoli Cai
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu Shi
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Meng Yin
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Gongyu Lan
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xianyi Zhang
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ruoyun Ji
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chang Liu
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
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Abstract
Ultrasound elastography (USE) of the pancreas allows pancreatic tissue stiffness assessment by virtual palpation. Two main types of USE are used. For the pancreas strain elastography applying by endoscopic ultrasound has been established for the characterisation of small solid pancreatic lesions (SPL). In larger SPL >30 mm the results are less convincing mainly due to the heterogenicity of the lesions but also by concomitant changes of the surrounding pancreatic parenchyma. The current role of shear wave elastography has to be determined. This article reviews the current use of elastography of the pancreas.
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Affiliation(s)
- Christoph F Dietrich
- Ultrasound Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Department of Internal Medicine, Caritas Hospital Bad Mergentheim, Bad Mergentheim, Germany
| | - Michael Hocke
- Department of Internal Medicine, HELIOS Klinikum Meiningen, Meiningen, Germany
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Measurement of Spleen Stiffness by Shear-Wave Elastography for Prediction of Splenomegaly Etiology. Ultrasound Q 2019; 35:153-156. [DOI: 10.1097/ruq.0000000000000403] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ciaravino V, D'Onofrio M. Pancreatic Ultrasound: State of the Art. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:1125-1137. [PMID: 30835881 DOI: 10.1002/jum.14978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 02/03/2019] [Accepted: 02/05/2019] [Indexed: 06/09/2023]
Abstract
An ultrasound (US) study is often the first imaging approach in patients with abdominal symptoms or signs related to abdominal diseases, and it is often part of the routine workup. The pancreatic gland, despite its retroperitoneal site, can be efficiently examined with US thanks to advances in US technologies. Nowadays, a pancreatic US study could be considered complete if multiparametric, including the use of Doppler imaging, US elastography, and contrast-enhanced imaging for the study of a pancreatic mass. A complete US examination could contribute to a faster diagnosis, especially if the pancreatic lesion is incidentally detected, addressing second-step imaging modalities correctly.
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Affiliation(s)
| | - Mirko D'Onofrio
- Department of Radiology, G. B. Rossi University Hospital, University of Verona, Verona, Italy
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Ahmed OA, Elhossary YA, Hamid RSA, Khalifa MO. Measurement of liver and spleen stiffness by acoustic radiation force impulse elastography for noninvasive detection of esophageal varices in Egyptian cirrhotic patients. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2019. [DOI: 10.4103/ejim.ejim_62_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Akdoğan E, Yılmaz FG. The role of acoustic radiation force impulse elastography in the differentiation of benign and malignant focal liver masses. TURKISH JOURNAL OF GASTROENTEROLOGY 2019; 29:456-463. [PMID: 30249561 DOI: 10.5152/tjg.2018.11710] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND/AIMS The aim of this study was to evaluate elasticity of benign and malign focal liver lesions and surrounding parenchyma as measured by acoustic radiation force impulse (ARFI). MATERIALS AND METHODS 34 hemangiomas, 4 focal nodular hyperplasia (FNH), 10 hepatocellular carcinoma (HCC) and 22 metastatic lesions from a total of 62 patients were examined with ARFI elastography. ARFI measurements for each tumor type were expressed as mean ± standard deviation for liver mass and surrounding parenchyma. ARFI values were compared between tumor types and surrounding parencyhma. RESULTS The mean stiffness values were 2.15±0.73 m/s for hemangiomas (n=34), 3.22±0.18 m/s for FNH (n=4), 2.75±0.53 m/s for HCC (n=10) and 3.59±0.51 m/s for metastasis (n=22). Although there was not a significant difference between hemangiomas and HCC lesions in ARFI values (p>0.05), hemangiomas showed significantly different ARFI values from FNH and metastases (p<0.05). Also, there were significant differences in ARFI values between malignant and benign masses. The area under the receiver-operating characteristics curves for discriminating the malignant from benign liver masses was 0.826 (p<0.001). An ARFI value of 2.32 m/s was selected as cut-off value to differentiate malignant liver masses from benign ones (sensitivity: 0.93, specificity: 0.60). CONCLUSION Although currently ARFI is not a definitive method for the primary diagnosis of focal solid liver lesions, it provides additional important information non-invasively for differential diagnosis.
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Affiliation(s)
- Emin Akdoğan
- Department of Radiology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Feyza Gelebek Yılmaz
- Department of Radiology, Gaziantep University School of Medicine, Gaziantep, Turkey
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The relationship of spleen stiffness value measured by shear wave elastography with age, gender, and spleen size in healthy volunteers. J Med Ultrason (2001) 2019; 46:195-199. [PMID: 30689067 DOI: 10.1007/s10396-019-00929-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 12/05/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE The aim of this study is to evaluate spleen stiffness values with shear wave elastography (SWE) quantitatively in healthy adults and investigate the relationship of spleen stiffness with age, gender, and spleen size. METHODS This study included 65 healthy individuals. Spleen stiffness measurement was obtained with 2 dimensional (2-D) SWE method from the middle portion of spleen and calculated in kilopascals by taking the average of three valid measurements. Longitudinal and transverse spleen sizes were measured. The relationship of spleen stiffness with age, gender, and spleen size was investigated. The association between spleen size and age and gender was also evaluated. RESULTS The mean spleen stiffness value was 13.82 ± 2.91 kPa, and the spleen stiffness was not affected by age, gender, or spleen size. Longitudinal spleen size was significantly lower in females than that in males. Moreover, there was a significant negative correlation between longitudinal spleen size and age (r = 0.247, p = 0.048). CONCLUSION Spleen stiffness can be quantitatively measured by 2-D SWE, and the spleen stiffness is not affected by age, gender, and spleen size. The values obtained in this study can be used as normal base values in examination of different spleen pathologies.
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Barreto SG, Dirkzwager I, Windsor JA, Pandanaboyana S. Predicting post‐operative pancreatic fistulae using preoperative pancreatic imaging: a systematic review. ANZ J Surg 2018; 89:659-665. [DOI: 10.1111/ans.14891] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/19/2018] [Accepted: 09/02/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Savio G. Barreto
- Hepatobiliary and Oesophagogastric Unit, Division of Surgery and Perioperative MedicineFlinders Medical Centre Adelaide South Australia Australia
- School of Medicine, Faculty of Medicine, Nursing and Health SciencesFlinders University Adelaide South Australia Australia
| | - Ilse Dirkzwager
- Department of RadiologyAuckland City Hospital Auckland New Zealand
| | - John A. Windsor
- Department of Surgery, Faculty of Medical and Health SciencesThe University of Auckland Auckland New Zealand
- HBP Unit, Department of General SurgeryAuckland City Hospital Auckland New Zealand
| | - Sanjay Pandanaboyana
- Department of Surgery, Faculty of Medical and Health SciencesThe University of Auckland Auckland New Zealand
- HBP Unit, Department of General SurgeryAuckland City Hospital Auckland New Zealand
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Wang L, Wan CF, Du J, Li FH. Preliminary Results of Acoustic Radiation Force Impulse Imaging by Combined Qualitative and Quantitative Analyses for Evaluation of Breast Lesions. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:2405-2412. [PMID: 29656388 DOI: 10.1002/jum.14599] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 01/07/2018] [Accepted: 01/15/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate the application of a new elastographic technique, acoustic radiation force impulse (ARFI) imaging, and its diagnostic performance for characterizing breast lesions. METHODS One hundred consecutive female patients with 126 breast lesions were enrolled in our study. After routine breast ultrasound examinations, the patients underwent ARFI elasticity imaging. Virtual Touch tissue imaging (VTI) and Virtual Touch tissue quantification (Siemens Medical Solutions, Mountain View, CA) were used to qualitatively and quantitatively analyze the elasticity and hardness of tumors. A receiver operating characteristic curve analysis was performed to evaluate the diagnostic performance of ARFI for discrimination between benign and malignant breast lesions. RESULTS Pathologic analysis revealed 40 lesions in the malignant group and 86 lesions in the benign group. Different VTI patterns were observed in benign and malignant breast lesions. Eighty lesions (93.0%) of benign group had pattern 1, 2, or 3, whereas all pattern 4b lesions (n = 20 [50.0%]) were malignant. Regarding the quantitative analysis, the mean VTI-to-B-mode area ratio, internal shear wave velocity, and marginal shear wave velocity of benign lesions were statistically significantly lower than those of malignant lesions (all P < .001). The cutoff point for a scoring system constructed to evaluate the diagnostic performance of ARFI was estimated to be between 3 and 4 points for malignancy, with sensitivity of 77.5%, specificity of 96.5%, accuracy of 90.5%, and an area under the curve of 0.933. CONCLUSIONS The application of ARFI technology has shown promising results by noninvasively providing substantial complementary information and could potentially serve as an effective diagnostic tool for differentiation between benign and malignant breast lesions.
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Affiliation(s)
- Lin Wang
- Department of Ultrasound, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Cai-Feng Wan
- Department of Ultrasound, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Jing Du
- Department of Ultrasound, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Feng-Hua Li
- Department of Ultrasound, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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Odéen H, de Bever J, Hofstetter LW, Parker DL. Multiple-point magnetic resonance acoustic radiation force imaging. Magn Reson Med 2018; 81:1104-1117. [PMID: 30257059 PMCID: PMC6642829 DOI: 10.1002/mrm.27477] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 07/09/2018] [Accepted: 07/11/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE To implement and evaluate an efficient multiple-point MR acoustic radiation force imaging pulse sequence that can volumetrically measure tissue displacement and evaluate tissue stiffness using focused ultrasound (FUS) radiation force. METHODS Bipolar motion-encoding gradients were added to a gradient-recalled echo segmented EPI pulse sequence with both 2D and 3D acquisition modes. Multiple FUS-ON images (FUS power > 0 W) were interleaved with a single FUS-OFF image (FUS power = 0 W) on the TR level, enabling simultaneous measurements of volumetric tissue displacement (by complex subtraction of the FUS-OFF image from the FUS-ON images) and proton resonance frequency shift MR thermometry (from the OFF image). Efficiency improvements included partial Fourier acquisition, parallel imaging, and encoding up to 4 different displacement positions into a single image. Experiments were performed in homogenous and dual-stiffness phantoms, and in ex vivo porcine brain. RESULTS In phantoms, 16-point multiple-point magnetic resonance acoustic radiation force imaging maps could be acquired in 5 s to 10 s for a 2D slice, and 60 s for a 3D volume, using parallel imaging and encoding 2 displacement positions/image. In ex vivo porcine brain, 16-point multiple-point magnetic resonance acoustic radiation force imaging maps could be acquired in 20 s for a 3D volume, using partial Fourier and parallel imaging and encoding 4 displacement positions/image. In 1 experiment it was observed that tissue displacement in ex vivo brain decreased by approximately 22% following FUS ablation. CONCLUSION With the described efficiency improvements it is possible to acquire volumetric multiple-point magnetic resonance acoustic radiation force imaging maps, with simultaneous proton resonance frequency shift MR thermometry maps, in clinically acceptable times.
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Affiliation(s)
- Henrik Odéen
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah
| | - Joshua de Bever
- Department of Radiology, Stanford University, Palo Alto, California
| | - Lorne W Hofstetter
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah
| | - Dennis L Parker
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah
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Saadi R, LaRusso S, Vijay K, Goldenberg D. Elastography as a potential modality for screening cervical lymph nodes in patients with papillary thyroid cancer: A review of literature. EAR, NOSE & THROAT JOURNAL 2018; 97:31-39. [PMID: 29493721 DOI: 10.1177/0145561318097001-224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Papillary thyroid cancer often presents with cervical lymph node involvement and has a high incidence of recurrence, which requires routine follow-up with ultrasound imaging. Elastography is a novel ultrasound technique that has been demonstrated to be effective clinically in detecting tissue pathology in areas such as the liver and breast. Preliminary data suggest that it may be effective in screening tissues in the neck for malignancy, specifically cervical lymph nodes. However, diagnostic criteria and elastographic techniques vary significantly among the studies we have reviewed, which all tend to focus on populations of patients with many different types of primary malignancies. Further research is required on the feasibility of creating standardized and reproducible clinical criteria in a specific patient population. To study the clinical utility of elastography in cervical lymph nodes, patients with diagnosed papillary thyroid carcinoma may serve as an ideal population because of their need for ultrasound surveillance and the propensity of papillary thyroid cancer to metastasize to and recur in cervical lymph nodes. We will review the limitations, techniques, and reported clinical utility of elastography on cervical lymph nodes and its potential as a screening modality for papillary thyroid cancer.
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Affiliation(s)
- Robert Saadi
- Division of Otolaryngology-Head and Neck Surgery, The Pennsylvania State University, College of Medicine, 500 University Dr., H091, Hershey, PA 17033-0850, USA
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Minkara A, Dhanda-Patil R, Patil Y. Syncope caused by a pleomorphic adenoma: Case report and literature review. EAR, NOSE & THROAT JOURNAL 2018; 97:E23-E26. [PMID: 29493727 DOI: 10.1177/0145561318097001-206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Pleomorphic adenomas are considered the most common salivary gland tumors, although they rarely occur in the parapharyngeal space. To the best of our knowledge, this is the first case report of a parapharyngeal parotid pleomorphic adenoma causing syncope. A 57-year-old man was admitted for left-sided blurred vision, left-sided weakness, dysarthria, lightheadedness, and syncope. Upon his admission, an electrocardiogram showed sinus bradycardia, and computed tomography of the neck with contrast showed a large parapharyngeal mass involving the prestyloid compartment, leading to compression of blood flow through the internal carotid artery. The mass was biopsied via intraoral fine-needle aspiration, which revealed cytology consistent with pleomorphic adenoma. The mass was resected via a transcervical approach, and a total parotidectomy was performed. The patient's hypotensive and bradycardic episodes disappeared after surgery. Surgical pathology showed a benign pleomorphic adenoma with a hemorrhagic and necrotic center and without capsular invasion or malignant transformation.
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Affiliation(s)
- Anas Minkara
- Department of Otolaryngology Head and Neck Surgery, University of Cincinnati College of Medicine, PO Box 670528, 231 Albert Sabin Way, Cincinnati, OH 45267-0528, USA
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Sandhu RS, Shin J, Wehrli NE, Gao J. Establishing Normal Values for Shear-Wave Elastography of the Renal Cortex in Healthy Adults. J Med Ultrasound 2018; 26:81-84. [PMID: 30065524 PMCID: PMC6029207 DOI: 10.4103/jmu.jmu_9_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 07/04/2017] [Indexed: 11/04/2022] Open
Abstract
Background Shear-wave elastography of the kidney has emerged as a potential clinical application of this novel imaging tool. However, normal velocity values for shear-wave elastography involving the cortex of healthy kidneys have not been definitively established, and both inter- and intraobserver reliability has yet to be comprehensively evaluated. Methods This prospective study involved ultrasound examination of 11 healthy adults. Shear-wave velocity values were obtained at the renal cortex in the longitudinal and transverse planes by both junior (fellow) and senior (attending) radiologists. Results The mean shear-wave velocity values ranged between 2.82 and 2.9 m/s, which did not vary significantly between observers (junior vs. senior) or method of measurement (longitudinal vs. transverse planes), P = 0.533. However, there was a wide variation for these measurements (0.51-4.99 m/s). Separate analysis of the measurement depth demonstrated no statistically significant association with the shear-wave velocity values, P = 0.477. Conclusion Our results agree with previous publications and help establish normal shear-wave velocity values and their range for the renal cortex in adults.
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Affiliation(s)
- Ranjit S Sandhu
- Department of Radiology, Weill Cornell Medical College, NY 10065, USA
| | - James Shin
- Department of Radiology, Weill Cornell Medical College, NY 10065, USA
| | - Natasha E Wehrli
- Department of Radiology, Weill Cornell Medical College, NY 10065, USA
| | - Jing Gao
- Department of Radiology, Weill Cornell Medical College, NY 10065, USA
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Bastard C, Miette V, Calès P, Stefanescu H, Festi D, Sandrin L. A Novel FibroScan Examination Dedicated to Spleen Stiffness Measurement. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:1616-1626. [PMID: 29731186 DOI: 10.1016/j.ultrasmedbio.2018.03.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 03/08/2018] [Accepted: 03/29/2018] [Indexed: 06/08/2023]
Abstract
Esophageal varices (EVs) are among the most severe complications of cirrhosis, with a prevalence of 50% to 60% among cirrhotic patients. International guidelines therefore recommend that cirrhotic patients should be screened for the presence of EVs. The main objective of this study was to introduce a new spleen-dedicated FibroScan (Echosens, Paris, France) examination and to assess its performance in detecting large EVs (grade 2 and 3). This novel examination has been validated in simulation and phantom studies and has been used in a population of patients with chronic liver disease. The study described here suggests that the novel spleen-dedicated FibroScan examination performs better than the standard FibroScan for the detection of large EVs (area under the curve = 0.70 for the standard examination and 0.79 [p <0.01] for the spleen examination), but further clinical studies are needed to investigate the role of spleen stiffness in the management of cirrhotic patients.
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Affiliation(s)
| | | | - Paul Calès
- Hepato-Gastroenterology Department, Angers University Hospital, Angers, France
| | - Horia Stefanescu
- Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
| | - Davide Festi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Yang X, Yu N, Yu J, Wang H, Li X. Virtual Touch Tissue Quantification for Assessing Renal Pathology in Idiopathic Nephrotic Syndrome. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:1318-1326. [PMID: 29650267 DOI: 10.1016/j.ultrasmedbio.2018.02.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 02/05/2018] [Accepted: 02/22/2018] [Indexed: 06/08/2023]
Abstract
The aim of this study was to evaluate Virtual Touch tissue quantification in assessing renal interstitial fibrosis in patients with idiopathic nephrotic syndrome. Ninety patients with idiopathic nephrotic syndrome were assigned to mild, moderate and severe groups depending on the degree of renal interstitial fibrosis on histopathologic examination of renal biopsy specimens. Thirty healthy patients were also selected as the control group. Virtual Touch tissue quantification was performed to measure the shear wave velocity of the renal parenchyma. There was no statistically significant difference in shear wave velocity between the mild and control groups (p > 0.05); however, the moderate and severe groups did significantly differ compared with the control (p <0.001). The area under the receiver operating characteristic curve value for the shear wave velocity of renal interstitial fibrosis in the moderate group versus the control and mild groups together was 0.869 (95% confidence interval: 0.791-0.947) and that in the severe group versus the control, mild and moderate groups together was 0.954 (95% confidence interval: 0.917-0.998). The corresponding best cutoff points were 2.41 and 2.77 m/s, with sensitivities of 91.7% and 86.8%, specificities of 78.0% and 92.0%, negative predictive values 0.907 and 0.907, positive predictive values 0.800 and 0.971 and Youden index values of 0.697 and 0.788, respectively. Virtual Touch tissue quantification may non-invasively and quantitatively estimate the degree of renal interstitial fibrosis in patients with idiopathic nephrotic syndrome as a baseline for monitoring progression and treatment response.
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Affiliation(s)
- Xue Yang
- Department of Ultrasound, Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Ning Yu
- Department of Ultrasound, Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China.
| | - Jing Yu
- Department of Ultrasound, Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Hongqiao Wang
- Department of Ultrasound, Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Xiumei Li
- Department of Ultrasound, Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
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Lin ZM, Wang Y, Liu CM, Yan CX, Huang PT. Role of Virtual Touch Tissue Quantification in Hashimoto's Thyroiditis. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:1164-1169. [PMID: 29551221 DOI: 10.1016/j.ultrasmedbio.2018.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 02/07/2018] [Accepted: 02/09/2018] [Indexed: 06/08/2023]
Abstract
We investigated the role of the virtual touch tissue quantification (VTQ) technique in diagnosing Hashimoto's thyroiditis (HT) and in distinguishing various HT-related thyroid dysfunctions. Two hundred HT patients and 100 healthy volunteers (the control group) were enrolled. The diagnostic performance of VTQ in predicting HT was calculated as the area under the receiver operating characteristic curve (AZ). The HT patients were further classified into three subgroups on the basis of serologic tests of thyroid function: hyperthyroidism, euthyroidism and hypothyroidism. Comparisons of shear wave velocity (SWV) between three subgroups were evaluated by analysis of variance. The mean SWV of the control group was significantly lower than that of the HT group (1.93 ± 0.33 m/s vs. 2.32 ± 0.49 m/s, p <0.001). Az was 0.734 with a cut-off value of 1.86 m/s for performance of SWV in distinguishing between HT and a healthy thyroid; the sensitivity and specificity were 82.5% and 50.0%, respectively. Mean SWV values in the three HT subgroups (hyperthyroidism [2.07 ± 0.37 cm/s] vs. euthyroidism [2.20 ± 0.40 cm/s] vs. hypothyroidism [2.49 ± 0.46 cm/s]) were significantly different (p <0.05). Our results suggest that VTQ is a promising technique for assessing HT and HT-related thyroid dysfunction.
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Affiliation(s)
- Zi-Mei Lin
- Department of Ultrasound, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Yao Wang
- Department of Ultrasound, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Chun-Mei Liu
- Department of Ultrasound, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Cao-Xin Yan
- Department of Ultrasound, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Pin-Tong Huang
- Department of Ultrasound, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
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Mazur R, Celmer M, Silicki J, Hołownia D, Pozowski P, Międzybrodzki K. Clinical applications of spleen ultrasound elastography - a review. J Ultrason 2018; 18:37-41. [PMID: 29844939 PMCID: PMC5911717 DOI: 10.15557/jou.2018.0006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 12/24/2017] [Accepted: 12/28/2017] [Indexed: 12/22/2022] Open
Abstract
In the last few years, notable technical progress has taken place in ultrasound elastography. Qualitative methods have been replaced by quantitative ones, such as: transient elastography, acoustic radiation force impulse and shear wave elastography. Owing to the fact that the spleen is superficially located, it is possible to obtain reliable measuring accuracy of its hardness using sonoelastography. Lately, many researchers have been investigating how spleen elasticity changes in patients infected with hepatitis B virus or hepatitis C virus and in patients suffering from liver fibrosis, portal hypertension, esophageal varices or myelofibrosis. In this article, we review the role and current status of accessible qualitative ultrasound elastography methods, including recent advances in the evaluation of spleen stiffness and its clinical utility. As study results demonstrate, spleen stiffness correlates with liver fibrosis and is helpful in determining the level of fibrosis in the METAVIR scoring system. In patients infected with hepatitis B virus or hepatitis C virus, spleen stiffness increases even when liver elasticity remains unaltered. Furthermore, it is useful in diagnosing portal hypertension or predicting existence of esophageal varices. Moreover, in patients suffering from biliary atresia after Kasai portoenterostomy, spleen sonoelastography may be helpful in selecting patients for liver transplantation as well as for choosing the best strategy for portal vein reconstruction before liver transplantation. In myelofibrosis, spleen stiffness correlates with bone marrow fibrosis and may be used to assess the response to treatment. Spleen sonoelastography is also useful in the monitoring of transjugular intrahepatic portosystemic shunt function.
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Affiliation(s)
- Rafał Mazur
- Department of General and Pediatric Radiology, University Teaching Hospital, Wrocław, Poland
- Department of Radiology, Wrocław Medical University, Wroclaw, Poland
| | - Milena Celmer
- Department of General and Pediatric Radiology, University Teaching Hospital, Wrocław, Poland
- Department of Radiology, Wrocław Medical University, Wroclaw, Poland
| | - Jurand Silicki
- Department of General and Pediatric Radiology, University Teaching Hospital, Wrocław, Poland
- Department of Radiology, Wrocław Medical University, Wroclaw, Poland
| | - Daniel Hołownia
- Department of General and Pediatric Radiology, University Teaching Hospital, Wrocław, Poland
| | - Patryk Pozowski
- Faculty of Medicine, Wrocław Medical University, Wrocław, Poland
| | - Krzysztof Międzybrodzki
- Department of General and Pediatric Radiology, University Teaching Hospital, Wrocław, Poland
- Department of Radiology, Wrocław Medical University, Wroclaw, Poland
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Arslan H, Tolunay HE, Cim N, Boza B, Yavuz A, İlik İ, Sahin HG, Yildizhan R. Shear-wave elastography – virtual touch tissue quantification of fetal placentas with a single umbilical artery. J Matern Fetal Neonatal Med 2018; 32:2481-2485. [DOI: 10.1080/14767058.2018.1439007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Harun Arslan
- Department of Radiology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Harun Egemen Tolunay
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Numan Cim
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Barış Boza
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Alpaslan Yavuz
- Department of Radiology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - İbrahim İlik
- Department of Radiology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Hanim Guler Sahin
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Recep Yildizhan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
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Iyama T, Takata T, Koda M, Fukuda S, Hoi S, Mae Y, Fukui T, Munemura C, Isomoto H. Renal shear wave elastography for the assessment of nephron hypertrophy: a cross-sectional study in chronic kidney disease. J Med Ultrason (2001) 2018; 45:571-576. [PMID: 29411183 DOI: 10.1007/s10396-018-0866-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 01/10/2018] [Indexed: 12/28/2022]
Abstract
PURPOSE To investigate the association of renal elasticity to microscopic findings of nephron hypertrophy and nephrosclerosis. METHODS Patients who underwent renal biopsy were enrolled. Renal elasticity was measured by acoustic radiation force impulse, and nephron size (glomerular volume, non-sclerotic glomerular density, and mean profile tubular area) and nephrosclerosis (globally sclerotic glomeruli and interstitial fibrosis) were estimated. Nephron hypertrophy was indicated by larger glomerular volume, larger tubular area, and lower non-sclerotic glomerular density. Nephrosclerosis was indicated by a higher percentage of globally sclerotic glomeruli and higher severity of fibrosis. RESULTS Renal elasticity was negatively correlated with glomerular volume (r = - 0.480, P = 0.024) and mean tubular area (r = - 0.469, P = 0.028), but it was not correlated with non-sclerotic glomerular density (r = 0.205, P = 0.359), percentage of globally sclerotic glomeruli (r = 0.057, P = 0.800), and severity of fibrosis (r = 0.014, P = 0.950). In a multiple linear regression analysis, glomerular volume and mean tubular area were independently associated with renal elasticity (std β = - 0.454, P = 0.015 and std β = - 0.577, P = 0.007, respectively). CONCLUSION Renal elasticity was correlated with microstructural findings of nephron hypertrophy. Measuring renal elasticity could help in detecting kidney disease.
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Affiliation(s)
- Takuji Iyama
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan
| | - Tomoaki Takata
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan.
| | - Masahiko Koda
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan
| | - Satoko Fukuda
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan
| | - Shotaro Hoi
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan
| | - Yukari Mae
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan
| | - Takeaki Fukui
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan
| | - Chishio Munemura
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan
| | - Hajime Isomoto
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan
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Chang N, Zhang X, Wan W, Zhang C, Zhang X. The Preciseness in Diagnosing Thyroid Malignant Nodules Using Shear-Wave Elastography. Med Sci Monit 2018; 24:671-677. [PMID: 29391387 PMCID: PMC5806774 DOI: 10.12659/msm.904703] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Our study aimed to identify more accurate results about the diagnostic role of shear-wave elastography (SWE) for thyroid malignant nodules through a meta-analysis. Potential articles were searched in PubMed, Embase, and the Cochrane Library databases. Overall sensitivity and specificity with 95% confidence intervals (CIs) was used to represent the diagnostic accuracy of SWE. Summary receiver operating characteristic (ROC) curve was constructed to illustrate the results. In addition, χ2 and I2 tests were performed to assess heterogeneity. A value of p≤0.05 indicated significant heterogeneity. All the analysis was conducted in Meta-DiSc version 1.4 software. Twenty studies were included in the analysis. There were a total of 2,907 patients and 3,397 thyroid nodules included in the meta-analysis. Overall sensitivity and specificity were 0.68 (95% CI: 0.66–0.70) and 0.85 (95% CI: 0.84–0.87), respectively. The results showed the area under curve (AUC) was 0.9041, suggesting high accuracy of SWE for differentiating benign and malignant thyroid nodules. SWE showed high accuracy in identifying thyroid malignant nodules, suggesting it could serve as a diagnostic biomarker in thyroid nodules.
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Affiliation(s)
- Na Chang
- Department of Medical Imaging, Shandong University, Jinan, Shandong, China (mainland).,Department of Medical Imaging, Jinan Vocational College of Nursing, Jinan, Shandong, China (mainland)
| | - Xianchao Zhang
- Department of Oncology, Xintai People's Hospital, Xintai, Shandong, China (mainland)
| | - Wenjing Wan
- Department of Nephrology, Xintai People's Hospital, Xintai, Shandong, China (mainland)
| | - Chengqi Zhang
- Department of Medical Imaging, Qianfoshan Hospital, Shandong University, Jinan, Shandong, China (mainland)
| | - Xianqi Zhang
- Department of Thoracic Surgery, Qianfoshan Hospital, Shandong University, Jinan, Shandong, China (mainland)
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Gao J, Perlman A, Kalache S, Berman N, Seshan S, Salvatore S, Smith L, Wehrli N, Waldron L, Kodali H, Chevalier J. Multiparametric Quantitative Ultrasound Imaging in Assessment of Chronic Kidney Disease. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:2245-2256. [PMID: 28407281 PMCID: PMC5640470 DOI: 10.1002/jum.14209] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 02/06/2017] [Indexed: 05/18/2023]
Abstract
OBJECTIVES To evaluate the value of multiparametric quantitative ultrasound imaging in assessing chronic kidney disease (CKD) using kidney biopsy pathologic findings as reference standards. METHODS We prospectively measured multiparametric quantitative ultrasound markers with grayscale, spectral Doppler, and acoustic radiation force impulse imaging in 25 patients with CKD before kidney biopsy and 10 healthy volunteers. Based on all pathologic (glomerulosclerosis, interstitial fibrosis/tubular atrophy, arteriosclerosis, and edema) scores, the patients with CKD were classified into mild (no grade 3 and <2 of grade 2) and moderate to severe (at least 2 of grade 2 or 1 of grade 3) CKD groups. Multiparametric quantitative ultrasound parameters included kidney length, cortical thickness, pixel intensity, parenchymal shear wave velocity, intrarenal artery peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index. We tested the difference in quantitative ultrasound parameters among mild CKD, moderate to severe CKD, and healthy controls using analysis of variance, analyzed correlations of quantitative ultrasound parameters with pathologic scores and the estimated glomerular filtration rate (GFR) using Pearson correlation coefficients, and examined the diagnostic performance of quantitative ultrasound parameters in determining moderate CKD and an estimated GFR of less than 60 mL/min/1.73 m2 using receiver operating characteristic curve analysis. RESULTS There were significant differences in cortical thickness, pixel intensity, PSV, and EDV among the 3 groups (all P < .01). Among quantitative ultrasound parameters, the top areas under the receiver operating characteristic curves for PSV and EDV were 0.88 and 0.97, respectively, for determining pathologic moderate to severe CKD, and 0.76 and 0.86 for estimated GFR of less than 60 mL/min/1.73 m2 . Moderate to good correlations were found for PSV, EDV, and pixel intensity with pathologic scores and estimated GFR. CONCLUSIONS The PSV, EDV, and pixel intensity are valuable in determining moderate to severe CKD. The value of shear wave velocity in assessing CKD needs further investigation.
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Affiliation(s)
- Jing Gao
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Alan Perlman
- Rogosin Institute, New York Presbyterian Hospital, Weill Cornell Medicine, New York, New York, USA
| | - Safa Kalache
- Rogosin Institute, New York Presbyterian Hospital, Weill Cornell Medicine, New York, New York, USA
| | - Nathaniel Berman
- Rogosin Institute, New York Presbyterian Hospital, Weill Cornell Medicine, New York, New York, USA
| | - Surya Seshan
- Department of Pathology, Weill Cornell Medicine, New York, New York, USA
| | - Steven Salvatore
- Department of Pathology, Weill Cornell Medicine, New York, New York, USA
| | - Lindsey Smith
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Natasha Wehrli
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Levi Waldron
- School of Public Health, City University of New York, New York, USA
| | - Hanish Kodali
- School of Public Health, City University of New York, New York, USA
| | - James Chevalier
- Rogosin Institute, New York Presbyterian Hospital, Weill Cornell Medicine, New York, New York, USA
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Zhang F, Zhao X, Ji X, Han R, Li P, Du M. Diagnostic value of acoustic radiation force impulse imaging for assessing superficial lymph nodes: A diagnostic accuracy study. Medicine (Baltimore) 2017; 96:e8125. [PMID: 29068984 PMCID: PMC5671817 DOI: 10.1097/md.0000000000008125] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The aim of this study was to assess the diagnostic value of acoustic radiation force impulse (ARFI) imaging for differentiating superficial lymph nodes.Virtual touch tissue imaging (VTI) grade and shear wave velocity (SWV) were analyzed and compared in 97 patients (65 women, 32 men; mean age, 49 y; range, 23-72 y) with 97 lymph nodes [23 chronic nonspecific reactive lymph nodes (CLNs), 38 metastatic lymph nodes (MLNs), and 36 blood and lymphatic system diseases lymph nodes (BLLNs)]. The elastography characteristics in patients with CLNs, MLNs, and BLLNs were compared using the nonparametric Kruskal-Wallis test and Mann-Whitney U test for continuous variables and categorical variables. The diagnostic performance of VTI grade and SWV were evaluated using the area under the receiver operating characteristic curve (AUC).The median of SWV of MLNs was significantly higher (2.90 m/s) than those of CLNs (2.15 m/s) and BLLNs (2.52 m/s). The VTI grade of MLNs was significantly higher than those of CLNs (P < .001) and BLLNs (P < .001). The sensitivity, specificity, accuracy, and AUC were 81.58%, 95.65%, 86.89%, and 0.904, respectively, at a cutoff level of grade IV for VTI grade in differentiating MLNs from CLNs, whereas those of SWV were 57.89%, 86.96%, 68.85%, and 0.752, respectively, at a cutoff level of 2.76 m/s.The diagnostic performance of VTI grade was significantly higher than that of SWV in differentiating MLNs from CLNs. The diagnostic performance of VTI grade and SWV were lower intermediate in differentiating MLNs from BLLNs and in differentiating BLLNs from CLNs, and there was no significant difference between VTI grade and SWV. ARFI imaging may be a feasible method for differentiating MLNs from CLNs.
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Affiliation(s)
- Fengjuan Zhang
- Department of Ultrasound, the Fourth Hospital of Hebei Medical University
| | - Xinming Zhao
- Department of Nuclear Medicine and Medical Imaging, the Fourth Hospital of Hebei Medical University, Hebei, Shijiazhuang, China
| | - Xiaohui Ji
- Department of Ultrasound, the Fourth Hospital of Hebei Medical University
| | - Ruoling Han
- Department of Ultrasound, the Fourth Hospital of Hebei Medical University
| | - Ping Li
- Department of Ultrasound, the Fourth Hospital of Hebei Medical University
| | - Min Du
- Department of Ultrasound, the Fourth Hospital of Hebei Medical University
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Acoustic Radiation Force Impulse Elastography in Determining the Effects of Type 1 Diabetes on Pancreas and Kidney Elasticity in Children. AJR Am J Roentgenol 2017; 209:1143-1149. [PMID: 28871805 DOI: 10.2214/ajr.17.18170] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The aim of this study is to determine the effects of type 1 diabetes on pancreas and kidney elasticity in children, using acoustic radiation force impulse ultrasound elastography. SUBJECTS AND METHODS Sixty autoantibody-positive patients with type 1 diabetes (45% girls; mean [± SD] age, 11.7 ± 4.4 years; range, 1.9-19.3 years) admitted to the pediatric endocrinology outpatient clinic and 32 healthy children (50% girls; mean age, 10.2 ± 3.8 years; range, 2.1-17.3 years) were included in the study. Acoustic radiation force impulse elastography measurements were performed of the kidneys and pancreas in both groups. Body mass index, duration of diabetes, HbA1c levels, and insulin dosage of patients with type 1 diabetes were recorded. RESULTS The mean shear-wave velocities of the pancreas were 0.99 ± 0.25 m/s in patients with type 1 diabetes and 1.09 ± 0.22 m/s in healthy control subjects; the difference was not significant (p = 0.08). The median shear-wave velocities of the right and left kidneys in patients with type 1 diabetes were 2.43 ± 0.29 and 2.47 ± 0.25 m/s, respectively. There were no significant differences in the shear-wave velocities of the right and left kidneys between the patients with type 1 diabetes and the healthy control subjects (p = 0.91 and p = 0.73, respectively). Correlation analysis showed no correlation between the shear-wave velocities of the pancreas and kidney versus HbA1c level, duration of diabetes, insulin dosage, height, weight, and body mass index of the patients with type 1 diabetes. CONCLUSION The current study showed no significant difference in the shear-wave velocity of kidneys in children with type 1 diabetes with normoalbuminuria compared with the healthy control subjects. We also observed that the shear-wave velocity of the pancreas in children with type 1 diabetes and healthy control subjects did not differ significantly.
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Hollerieth K, Gaßmann B, Wagenpfeil S, Kemmner S, Heemann U, Stock KF. Does standoff material affect acoustic radiation force impulse elastography? A preclinical study of a modified elastography phantom. Ultrasonography 2017; 37:140-148. [PMID: 29032665 PMCID: PMC5885480 DOI: 10.14366/usg.17002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 07/26/2017] [Accepted: 07/28/2017] [Indexed: 12/21/2022] Open
Abstract
PURPOSE This study was conducted to determine the influence of standoff material on acoustic radiation force impulse (ARFI) measurements in an elasticity phantom by using two different probes. METHODS Using ARFI elastography, 10 observers measured the shear wave velocity (SWV, m/sec) in different lesions of an elasticity phantom with a convex 4C1 probe and a linear 9L4 probe. The experimental setup was expanded by the use of an interposed piece of porcine muscle as standoff material. The probe pressure on the phantom was registered. RESULTS Faulty ARFI measurements occurred more often when quantifying the hardest lesion (74.0 kPa 4.97 m/sec) by the 9L4 probe with the porcine muscle as a standoff material interposed between the probe and the phantom. The success rate for ARFI measurements in these series was 52.4%, compared with 99.5% in the other series. The SWV values measured with the 9L4 probe were significantly higher (3.33±1.39 m/sec vs. 2.60±0.74 m/sec, P<0.001 in the group without muscle) and were closer to the reference value than those measured with the 4C1 probe (0.25±0.23 m/sec vs. 0.85±1.21 m/sec, P<0.001 in the same group). The SWV values measured when using the muscle as a standoff material were lower than those without the muscle (significant for 9L4, P=0.040). The deviation from the reference value and the variance increased significantly with the 9L4 probe if the muscle was in situ (B=0.27, P=0.004 and B=0.32, P<0.001). In our study, the pressure exerted by the operator had no effect on the SWV values. CONCLUSION The presence of porcine muscle acting as a standoff material influenced the occurrence of failed measurements as well as the variance and the accuracy of the measured values. The linear high-frequency probe was particularly affected.
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Affiliation(s)
- Katharina Hollerieth
- Department of Nephrology, Klinikum Rechts der Isar of the Technical University of Munich, Munich, Germany
| | | | - Stefan Wagenpfeil
- Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University, Campus Homburg, Homburg, Saar, Germany
| | - Stephan Kemmner
- Department of Nephrology, Klinikum Rechts der Isar of the Technical University of Munich, Munich, Germany
| | - Uwe Heemann
- Department of Nephrology, Klinikum Rechts der Isar of the Technical University of Munich, Munich, Germany
| | - Konrad Friedrich Stock
- Department of Nephrology, Klinikum Rechts der Isar of the Technical University of Munich, Munich, Germany
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Singh H, Panta OB, Khanal U, Ghimire RK. Renal Cortical Elastography: Normal Values and Variations. J Med Ultrasound 2017; 25:215-220. [PMID: 30065495 PMCID: PMC6029337 DOI: 10.1016/j.jmu.2017.04.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 03/22/2017] [Indexed: 12/20/2022] Open
Abstract
Introduction Renal cortical elastography has shown conflicting but promising results in evaluation of chronic kidney disease and other renal disorders. The purpose of this study was to establish a normogram of renal cortical elasticity values and assess their variation between right and left kidney and their relation with age, gender, body mass index, renal dimensions and skin to cortex distance. Methods The study was a hospital based cross sectional study performed at Tribhuvan University Teaching Hospital, a tertiary care center in Kathmandu, Nepal. All individuals referred for Ultrasound from General Health Check up clinic were included in the study. Patient with abnormal ultrasound findings and abnormal renal function test were excluded from the study. Renal morphometry including length, cortical thickness, and skin to cortex distance were measured in B mode imaging and renal cortical elastography was measured with region of interest box of 1 × 0.5 cm. All analyses were done using Statistical Package for Social Sciences 20.0 soft ware. Results A total of 95 individuals who met the inclusion criteria were included in the study. The mean values of right and left renal cortical shear wave velocity were 1.49 ± 0.19 m/s and 1.54 ± 0.19 m/s respectively. Statistical significant difference was observed between the renal cortical shear wave velocity of right and left kidney. The renal shear wave velocity was seen to decrease with age, however the correlation was not statistically significant. No significant difference was also noted in renal shear wave velocity among various sex or Body mass index groups. Statistically significant negative correlation was noted between skin to cortex distance and renal cortical shear wave velocities. However no statistically significant correlation was noted between renal dimensions and renal cortical shear wave velocities. Conclusions The normal cortical elasticity values in terms of shear wave velocity of right and left kidney were established. Renal elasticity is independent of the age, gender, Body mass index and renal dimensions.
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Affiliation(s)
- Harsh Singh
- Department of Radiodiagnosis, King George Medical University, Lucknow, India
| | - Om Biju Panta
- Department of Intervention Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand
| | - Umesh Khanal
- Department of Radiology and Imaging, Tribhuvan University Teaching Hospital, Nepal
| | - Ram Kumar Ghimire
- Department of Radiology and Imaging, Tribhuvan University Teaching Hospital, Nepal
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Takata T, Koda M, Sugihara T, Sugihara S, Okamoto T, Miyoshi K, Matono T, Hosho K, Mae Y, Iyama T, Fukui T, Fukuda S, Munemura C, Isomoto H. Renal shear wave velocity by acoustic radiation force impulse did not reflect advanced renal impairment. Nephrology (Carlton) 2017; 21:1056-1062. [PMID: 26667380 DOI: 10.1111/nep.12701] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 12/08/2015] [Accepted: 12/10/2015] [Indexed: 01/09/2023]
Abstract
AIM Acoustic radiation force impulse is a noninvasive method for evaluating tissue elasticity on ultrasound. Renal shear wave velocity measured by this technique has not been fully investigated in patients with renal disease. The aim of the present study was to compare renal shear wave velocity in end-stage renal disease patients and that in patients without chronic kidney disease and to investigate influencing factors. METHODS Renal shear wave velocities were measured in 59 healthy young subjects (control group), 31 subjects without chronic kidney disease (non-CKD group), and 39 end-stage renal disease patients (ESRD group). Each measurement was performed 10 times at both kidneys, and the mean value of eight of 10 measurements, excluding the maximum and minimum values, was compared. RESULTS Renal shear wave velocity could be measured in all subjects. Renal shear wave velocity in the control group was higher than in the non-CKD group and in the ESRD group, and no difference was found between the non-CKD group and the ESRD group. Age and depth were negatively correlated to the renal shear wave velocity. In multiple regression analysis, age and depth were independent factors for renal shear wave velocity, while renal impairment was not. There was no difference between the non-CKD group and the ESRD group, even when ages were matched and depth was adjusted. CONCLUSION Renal shear wave velocity was not associated with advanced renal impairment. However, it reflected alteration of renal aging, and this technique may be useful to detect renal impairment in the earlier stages.
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Affiliation(s)
- Tomoaki Takata
- Division of Medicine and Clinical Science, Tottori University Faculty of Medicine, Tottori, Japan
| | - Masahiko Koda
- Division of Medicine and Clinical Science, Tottori University Faculty of Medicine, Tottori, Japan
| | - Takaaki Sugihara
- Division of Medicine and Clinical Science, Tottori University Faculty of Medicine, Tottori, Japan
| | - Shinobu Sugihara
- Division of Medicine and Clinical Science, Tottori University Faculty of Medicine, Tottori, Japan
| | - Toshiaki Okamoto
- Division of Medicine and Clinical Science, Tottori University Faculty of Medicine, Tottori, Japan
| | - Kenichi Miyoshi
- Division of Medicine and Clinical Science, Tottori University Faculty of Medicine, Tottori, Japan
| | - Tomomitsu Matono
- Division of Medicine and Clinical Science, Tottori University Faculty of Medicine, Tottori, Japan
| | - Keiko Hosho
- Division of Medicine and Clinical Science, Tottori University Faculty of Medicine, Tottori, Japan
| | - Yukari Mae
- Division of Medicine and Clinical Science, Tottori University Faculty of Medicine, Tottori, Japan
| | - Takuji Iyama
- Division of Medicine and Clinical Science, Tottori University Faculty of Medicine, Tottori, Japan
| | - Takeaki Fukui
- Division of Medicine and Clinical Science, Tottori University Faculty of Medicine, Tottori, Japan
| | - Satoko Fukuda
- Division of Medicine and Clinical Science, Tottori University Faculty of Medicine, Tottori, Japan
| | - Chishio Munemura
- Division of Medicine and Clinical Science, Tottori University Faculty of Medicine, Tottori, Japan
| | - Hajime Isomoto
- Division of Medicine and Clinical Science, Tottori University Faculty of Medicine, Tottori, Japan
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Chen YP, Han T, Wu R, Yao MH, Xu G, Zhao LX, Liu H, Pu H, Fang Y. Comparison of Virtual Touch Tissue Quantification and Virtual Touch Tissue Imaging Quantification for diagnosis of solid breast tumors of different sizes. Clin Hemorheol Microcirc 2017; 64:235-244. [PMID: 27814284 DOI: 10.3233/ch-16192] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Acoustic radiation force impulse imaging (ARFI) with Virtual Touch Tissue Quantification (VTQ) or Virtual Touch Tissue Imaging Quantification (VTIQ) measures shear wave velocity (SWV), which is proportional to tissue stiffness, a diagnostic parameter for malignancy. OBJECTIVE To compare the performance of VTQ and VTIQ in diagnosing solid breast tumors. METHODS Conventional ultrasound, VTQ and VTIQ were used to examine 246 solid breast tumors from 230 patients. Tumors were grouped according to size: <10 mm, 10-20 mm, >20 mm. Pathological diagnoses were via histological examination of biopsies. ROC curves were used to assess diagnostic performance and optimal cut-off points for VTQ and VTIQ. RESULTS For all sizes, SWVVTQ and SWVVTIQ were higher for malignant versus benign tumors (P < 0.05). SWVVTQ and SWVVTIQ were both higher for tumors≥10 mm (P < 0.05). Areas under the ROC curves (diagnostic performance index; 0.860-0.952) did not differ significantly between VTQ and VTIQ. Optimal cut-off values for SWVVTQ and SWVVTIQ were higher for tumors≥10 mm. CONCLUSION The diagnostic performance of VTQ and VTIQ was moderate to good for solid breast tumors. Although both methods have higher sensitivities in tumors≥10 mm, their overall diagnostic performance was similar for all sizes.
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Affiliation(s)
- Ying-Pei Chen
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Yanchangzhong Road, Shanghai, China.,Ultrasound Research and Education Institute, Tongji University School of Medicine, Yanchangzhong Road, Shanghai, China.,Department of Medical Ultrasound, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Changle Road, Shanghai, China
| | - Ting Han
- Department of Clinical Nutrition, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Yanchangzhong Road, Shanghai, China
| | - Rong Wu
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Yanchangzhong Road, Shanghai, China.,Ultrasound Research and Education Institute, Tongji University School of Medicine, Yanchangzhong Road, Shanghai, China
| | - Ming-Hua Yao
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Yanchangzhong Road, Shanghai, China.,Ultrasound Research and Education Institute, Tongji University School of Medicine, Yanchangzhong Road, Shanghai, China
| | - Guang Xu
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Yanchangzhong Road, Shanghai, China.,Ultrasound Research and Education Institute, Tongji University School of Medicine, Yanchangzhong Road, Shanghai, China
| | - Li-Xia Zhao
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Yanchangzhong Road, Shanghai, China.,Ultrasound Research and Education Institute, Tongji University School of Medicine, Yanchangzhong Road, Shanghai, China
| | - Hui Liu
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Yanchangzhong Road, Shanghai, China.,Ultrasound Research and Education Institute, Tongji University School of Medicine, Yanchangzhong Road, Shanghai, China
| | - Huan Pu
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Yanchangzhong Road, Shanghai, China.,Ultrasound Research and Education Institute, Tongji University School of Medicine, Yanchangzhong Road, Shanghai, China
| | - Yan Fang
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Yanchangzhong Road, Shanghai, China.,Ultrasound Research and Education Institute, Tongji University School of Medicine, Yanchangzhong Road, Shanghai, China
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Cygan S, Januszewicz M. Acoustic radiation force impulse imaging of kidneys - a phantom study. J Ultrason 2017; 16:329-338. [PMID: 28138404 PMCID: PMC5269520 DOI: 10.15557/jou.2016.0033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 03/08/2016] [Accepted: 03/14/2016] [Indexed: 11/22/2022] Open
Abstract
Aim of the study Since there have been only few works reporting the diagnosis of kidneys using Acoustic Radiation Force Impulse technique and those works do not provide consistent results of shear wave velocity measurements in renal tissue, we have decided to use kidney phantoms with known properties to examine the reliability of the method itself in a controlled setup similar to kidneys examination. Materials and methods Four gelatin-based phantoms imitating different clinical situations were manufactured – two with thick and two with thin renal cortex, each type at a depth similar to a normal-weight or overweight patient. For each phantom, a series of interest points was chosen and for each point 20 Shear Wave Velocity measurements were taken using the build-in Virtual Touch Tissue Quantification™ tool in a Siemens Acuson S2000 ultrasound scanner equipped with a 6C1 HD Transducer (Siemens Mountainview, USA). Results Mean Shear Wave Velocity values obtained for all the examined points ranged from 2.445 to 3.941 m/s, with standard deviation exceeding 0.1 in only one case out of 29 points, but differing significantly between all points. Conclusions The obtained results indicate that the method is highly reliable as long as the measurement volume contains a uniform tissue region. If the measurement window covers a region with different properties even partially, the obtained results are affected. The variance of measured values on the other hand is not affected by the said non-uniformity of material under examination. Furthermore, the variance of measured values does not show a clear dependency on the depth at which the shear wave velocities are measured.
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Affiliation(s)
- Szymon Cygan
- Institute of Metrology and Biomedical Engineering, Warsaw University of Technology, Warsaw, Poland
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Onoyama T, Koda M, Fujise Y, Takata T, Kawata S, Okamoto T, Miyoshi K, Matono T, Sugihara T, Matsumoto K, Kawaguchi K, Harada K, Yashima K, Isomoto H. Utility of virtual touch quantification in the diagnosis of pancreatic ductal adenocarcinoma. Clin Imaging 2016; 42:64-67. [PMID: 27886609 DOI: 10.1016/j.clinimag.2016.11.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 10/28/2016] [Accepted: 11/16/2016] [Indexed: 12/21/2022]
Abstract
This study aimed to compare the tissue stiffness of pancreatic ductal adenocarcinoma (PDAC) with that of pancreatic parenchyma using virtual touch quantification (VTQ). SWV was measured in 34 PDAC lesions and in pancreatic parenchyma of both controls and patients. SWVs in PDAC lesions were significantly higher than in pancreatic parenchyma in both healthy controls and in patients with PDAC. The area under the ROC for diagnosis of PDAC was 0.94 for pancreatic parenchyma in healthy controls, and 0.85 for pancreatic parenchyma in patients with PDAC. VTQ can provide a useful and additional information for diagnosis of PDAC.
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Affiliation(s)
- Takumi Onoyama
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Masahiko Koda
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan.
| | - Yuki Fujise
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Tomoaki Takata
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Soichiro Kawata
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Toshiaki Okamoto
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Kennichi Miyoshi
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Tomomitsu Matono
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Takaaki Sugihara
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Kazuya Matsumoto
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Koichiro Kawaguchi
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Kenichi Harada
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Kazuo Yashima
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Hajime Isomoto
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
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Research on pediatric glomerular disease and normal kidney with shear wave based elastography point quantification. Jpn J Radiol 2016; 34:738-746. [PMID: 27659447 DOI: 10.1007/s11604-016-0582-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 09/07/2016] [Indexed: 12/15/2022]
Abstract
PURPOSE To evaluate the renal cortex stiffness in children with glomerular disease by shear wave based elastography point quantification (ElastPQ), and to investigate the association between shear wave velocity (SWV) in the renal cortex and age in normal children, and the inter-gender differences. MATERIALS AND METHODS One hundred and five children who were pathologically confirmed with glomerular diseases were selected as the disease group. Meanwhile, 120 healthy children were selected as the control group. Effective values were measured 5 times at the same kidney sites on each side. RESULTS Comparisons of SWV measurements between left and right kidneys in the disease and control groups all showed significant differences (left kidney t = 6.896, P = 0.004; right kidney t = 7.415, P = 0.001). In the control group, left and right kidney SWV measurements were all positively correlated with age (left kidney r = 0.792, P = 0.003; right kidney r = 0.794, P = 0.004). Moreover, inter-gender difference was present in the right kidney measurements. CONCLUSIONS ElastPQ technology has certain advantages in predicting pediatric glomerular disease compared to conventional ultrasound. ElastPQ technology contributes to the early diagnosis of the disease.
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Correas JM, Anglicheau D, Joly D, Gennisson JL, Tanter M, Hélénon O. Ultrasound-based imaging methods of the kidney-recent developments. Kidney Int 2016; 90:1199-1210. [PMID: 27665116 DOI: 10.1016/j.kint.2016.06.042] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 06/05/2016] [Accepted: 06/14/2016] [Indexed: 12/11/2022]
Abstract
In recent years, several novel ultrasound (US)-based techniques have emerged for kidney diagnostic imaging, including tissue stiffness assessment with elastography, Ultrasensitive Doppler techniques, and contrast-enhanced ultrasonography to assess renal microvascularization. Renal elastography has become available with the development of noninvasive quantitative techniques, following the rapidly growing field of liver fibrosis diagnosis. With the increased incidence of chronic kidney disease, noninvasive diagnosis of renal fibrosis can be of critical value. However, it is difficult to simply extend the application of US elastography from one organ to the other due to anatomic and technical issues. Today, renal elastography appears to be a promising application that, however, still requires optimization and validation. New ultrasensitive Doppler techniques improve the detection of slow blood flow and can be used alone or after administration of US contrast agents. These microbubble-based agents are extremely well tolerated and can be administered even in cases of impaired renal function. Despite the lack of approval, they improve the characterization of atypical renal masses, complex cystic renal masses, and peripheral vascular disorders. Dynamic contrast-enhanced US is based on quantification of the signal intensity from region of interest and mathematical fits of the time-intensity curves. Perfusion-related parameters can be extracted for the monitoring of vascular changes in the renal parenchyma and in tumors in order to evaluate drug response. This estimation of renal perfusion depends on many parameters that should be kept constant for follow-up studies, and, when possible, an internal reference should be used to normalize the measurements.
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Affiliation(s)
- Jean-Michel Correas
- Paris-Descartes Sorbonne University, Paris, France; Department of Adult Radiology, Necker University Hospital, Paris, France; Langevin Institute, ESPCI Paris, PSL Research University CNRS UMR 7587, INSERM ERL U-979, Paris, France.
| | - Dany Anglicheau
- Paris-Descartes Sorbonne University, Paris, France; Department of Adult Nephrology and Transplantation, Necker University Hospital, Paris, France; Necker - Sick Children Institute, INSERM U1151, Paris, France
| | - Dominique Joly
- Paris-Descartes Sorbonne University, Paris, France; Department of Adult Nephrology and Transplantation, Necker University Hospital, Paris, France
| | - Jean-Luc Gennisson
- Langevin Institute, ESPCI Paris, PSL Research University CNRS UMR 7587, INSERM ERL U-979, Paris, France
| | - Mickael Tanter
- Langevin Institute, ESPCI Paris, PSL Research University CNRS UMR 7587, INSERM ERL U-979, Paris, France
| | - Olivier Hélénon
- Paris-Descartes Sorbonne University, Paris, France; Department of Adult Radiology, Necker University Hospital, Paris, France
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Can acoustic radiation force impulse elastography be a substitute for liver biopsy in predicting liver fibrosis? Clin Radiol 2016; 71:869-75. [DOI: 10.1016/j.crad.2016.04.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 02/18/2016] [Accepted: 04/08/2016] [Indexed: 02/08/2023]
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Payen T, Palermo CF, Sastra SA, Chen H, Han Y, Olive KP, Konofagou EE. Elasticity mapping of murine abdominal organs in vivo using harmonic motion imaging (HMI). Phys Med Biol 2016; 61:5741-54. [PMID: 27401609 PMCID: PMC5048218 DOI: 10.1088/0031-9155/61/15/5741] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Recently, ultrasonic imaging of soft tissue mechanics has been increasingly studied to image otherwise undetectable pathologies. However, many underlying mechanisms of tissue stiffening remain unknown, requiring small animal studies and adapted elasticity mapping techniques. Harmonic motion imaging (HMI) assesses tissue viscoelasticity by inducing localized oscillation from a periodic acoustic radiation force. The objective of this study was to evaluate the feasibility of HMI for in vivo elasticity mapping of abdominal organs in small animals. Pathological cases, i.e. chronic pancreatitis and pancreatic cancer, were also studied in vivo to assess the capability of HMI for detection of the change in mechanical properties. A 4.5 MHz focused ultrasound transducer (FUS) generated an amplitude-modulated beam resulting in 50 Hz harmonic tissue oscillations at its focus. Axial tissue displacement was estimated using 1D-cross-correlation of RF signals acquired with a 7.8 MHz diagnostic transducer confocally aligned with the FUS. In vitro results in canine liver and kidney showed the correlation between HMI displacement and Young's moduli measured by rheometry compression testing. HMI was capable of providing reproducible elasticity maps of the mouse abdominal region in vivo allowing the identification of, from stiffest to softest, the murine kidney, pancreas, liver, and spleen. Finally, pancreata affected by pancreatitis and pancreatic cancer showed HMI displacements 1.7 and 2.2 times lower than in the control case, respectively, indicating higher stiffness. The HMI displacement amplitude was correlated with the extent of fibrosis as well as detecting the very onset of stiffening even before fibrosis could be detected on H&E. This work shows that HMI can produce reliable elasticity maps of mouse abdominal region in vivo, thus providing a potentially critical tool to assess pathologies affecting organ elasticity.
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Affiliation(s)
- Thomas Payen
- Biomedical Engineering, Columbia University, USA
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Bert F, Stahmeyer JT, Rossol S. Ultrasound Elastography Used for Preventive Non-Invasive Screening in Early Detection of Liver Fibrosis. J Clin Med Res 2016; 8:650-5. [PMID: 27540438 PMCID: PMC4974834 DOI: 10.14740/jocmr2625w] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2016] [Indexed: 02/07/2023] Open
Abstract
Background Early discovery of liver fibrosis is becoming more popular because of enhanced incidence of hepatocellular carcinoma. Ultrasound-based liver elastography is a method used to approve suspected liver fibrosis or cirrhosis. We assessed the clinical usefulness of acoustic radiation force impulse shear wave elasticity imaging (ARFI-SWEI) as a preventive screening method to uncover fibrosis. Methods We screened 382 patients by native routine sonography for abnormal liver results and divided them into six groups: group 1: normal liver, groups 2-4: fatty liver grade I-III, group 5: liver cirrhosis, and group 6: inhomogenic liver tissue. Then ARFI-SWEI was performed and the results were compared with published shear wave velocity cut-off values that were predictive of each fibrosis stage (F0-4). A control group consisted of 20 healthy volunteers. Results The part of liver fibrosis ≥ F2 was in groups 1-4: 20-32%, group 5: 100%, and group 6: 91%. Main causes for fibrosis stage ≥ F2 were (non)-alcoholic steatohepatitis, chronic viral or autoimmune hepatitis and chronic heart failure. Conclusions Screening of the liver tissue in b-mode ultrasound can underestimate possible liver fibrosis; by using ARFI-SWEI, liver fibrosis can be uncovered early. It is a suitable preventive method comparable to colonoscopy for colon cancer.
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Affiliation(s)
- Florian Bert
- Department of Internal Medicine, Krankenhaus Nordwest, Steinbacher Hohl 2-26, 60488 Frankfurt/Main, Germany
| | - Jona T Stahmeyer
- Institute of Epidemiology, Social Medicine and Health System Research, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Siegbert Rossol
- Department of Internal Medicine, Krankenhaus Nordwest, Steinbacher Hohl 2-26, 60488 Frankfurt/Main, Germany
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Kubo K, Kawakami H, Kuwatani M, Nishida M, Kawakubo K, Kawahata S, Taya Y, Kubota Y, Amano T, Shirato H, Sakamoto N. Liver elasticity measurement before and after biliary drainage in patients with obstructive jaundice: a prospective cohort studya prospective cohort study. BMC Gastroenterol 2016; 16:65. [PMID: 27391646 PMCID: PMC4938950 DOI: 10.1186/s12876-016-0479-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 06/07/2016] [Indexed: 12/12/2022] Open
Abstract
Background Obstructive jaundice has been reported to influence liver elasticity, independent of liver fibrosis. The aim of our prospective study was to evaluate the changes in liver elasticity, before and after biliary drainage, in patients with obstructive jaundice, and to evaluate the correlation between elasticity measures and serum markers of liver fibrosis. Methods This is a prospective cohort study of 20 patients with obstructive jaundice. Liver elasticity was assessed by Transient Elastography (TE) and Virtual Touch™ Quantification (VTQ). Serum total bilirubin (T-Bil) level was measured before biliary drainage (Day 0), with measures repeated at 2 days (Day 2) and 7 days (Day 7) after biliary drainage. Serum levels of the following markers of liver fibrosis were also obtained on Day 0 and Day 7: hyaluronic acid (HA), procollagen-III-peptide (P-III-P). Results T-Bil, TE, and VTQ for the left (VTQ-L) and right (VTQ-R) lobes of the liver were all elevated before biliary drainage, with respective levels, measured at Day 0, of 11.9 ± 1.5 mg/dl, 12.1 ± 0.9 kPa, 2.23 ± 0.10 m/s, and 1.85 ± 0.10 m/s. All values decreased on Day 7 after drainage: T-Bil, 4.7 ± 1.0 mg/dl (P < 0.001); TE, 7.6 ± 0.6 kPa (P < 0.001); VTQ-L, 1.53 ± 0.08 m/s (P < 0.001); and VTQ-R, 1.30 ± 0.05 m/s (P < 0.001). Similar changes were observed in serum markers of liver fibrosis. Liver elasticity measures correlated with serum levels of T-Bil, P-III-P, and HA (r = 0.35-0.67, P < 0.001). Conclusions This study confirmed decreases in liver elasticity, measured by TE and VTQ, after biliary drainage. Measures of liver elasticity correlated to levels of T-Bil and serum markers of liver fibrosis. (UMIN ID: UMIN00001284313). Trial registration Registration number: University Hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN ID: UMIN00001284313); Registration date: 2014-01-14.
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Affiliation(s)
- Kimitoshi Kubo
- Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Hiroshi Kawakami
- Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo, Hokkaido, Japan. .,Department of Gastroenterology and Hepatology, Center for Digestive Disease, University of Miyazaki, 5200 Kihara, Kiyotake-cho, Miyazaki City, 889-1692, Japan.
| | - Masaki Kuwatani
- Division of Endoscopy, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Mutsumi Nishida
- Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Kazumichi Kawakubo
- Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Shuhei Kawahata
- Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Yoko Taya
- Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Yoshimasa Kubota
- Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.,Department of Gastroenterology and Hepatology, Center for Digestive Disease, University of Miyazaki, 5200 Kihara, Kiyotake-cho, Miyazaki City, 889-1692, Japan
| | - Toraji Amano
- Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Hiroki Shirato
- Department of Radiology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Naoya Sakamoto
- Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
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