1
|
Yue C, Cai-Hong W. Study of the optic nerve in patients with type 2 diabetic retinopathy by shear-wave elastography. Clin Radiol 2024; 79:e574-e581. [PMID: 38278740 DOI: 10.1016/j.crad.2023.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 11/26/2023] [Accepted: 12/24/2023] [Indexed: 01/28/2024]
Abstract
AIM To investigate the clinical value of two-dimensional shear-wave elastography (2D-SWE) in detecting optic nerve elasticity and in-frame adipose tissue elasticity in patients with type 2 diabetic retinopathy (DR). MATERIALS AND METHODS 2D-SWE was used to detect SWE values of the optic nerve and adipose tissue in adjacent optic nerve frames in 30 healthy participants, 30 patients with diabetic non-retinopathy (NDR), 35 patients with non-proliferative diabetic retinopathy (NPDR), and 30 patients with proliferative diabetic retinopathy (PDR). The correlation between SWE values and blood glucose, blood lipid, age, body mass index (BMI) was analysed. Receiver operating characteristic (ROC) curve analysis was performed for SWE values. RESULTS The SWE values of the optic nerve and in-frame adipose tissue increased with the progression of DR, and analysis of variance was compared with groups: the SWE values of the optic nerve and in-frame adipose tissue in each group were significantly different (all p<0.001). The SWE values of the optic nerve and in-frame adipose tissue correlated positively with BMI, age, triglyceride, and fasting blood glucose, and correlated negatively with high-density lipoprotein. The SWE values of the optic nerve and in-frame adipose tissue had higher diagnostic efficacy. The combination of the two had higher diagnostic accuracy. CONCLUSION The elastic modulus of optic nerve and in-frame adipose tissue can effectively predict and grade of DR, that is, 2D-SWE can be used as a non-invasive imaging diagnostic method for DR. The combined diagnostic efficacy of optic nerve SWE value and in-frame adipose tissue SWE value is significantly better than that of single use. This study found that increased BMI, age, triglyceride, and fasting blood glucose, and decreased high-density lipoprotein are risk factors for DR.
Collapse
Affiliation(s)
- C Yue
- Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou City, Inner Mongolia Autonomous Region, 014010, China.
| | - W Cai-Hong
- Department of Ultrasound, The Second Affiliated Hospital of Inner Mongolia University of Science and Technology, Baotou City, Inner Mongolia Autonomous Region, 014031, China
| |
Collapse
|
2
|
Su S, Zhong H, Wang X, Huang Y, Su Q. Shear wave elastography combined with two-dimensional ultrasonography for detecting optic nerve sheath: An effective tool for assessing preeclampsia. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:1412-1418. [PMID: 37643987 DOI: 10.1002/jcu.23551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/08/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE/OBJECTIVE This study aimed to investigate two-dimensional ultrasound and shear-wave elastography (SWE) in evaluating optic neuropathy in preeclampsia. METHODS Ninety-one singleton pregnant women (51 with preeclampsia [observation group]; 40 without complications [control group]) admitted between January 2022 and April 2022 participated in this study. Optic nerve sheath diameter (ONSD) and optic nerve stiffness measurement (ONSM) were measured using two-dimensional ultrasound and SWE, respectively, and compared between the two groups. Receiver operating characteristic curves were employed to evaluate the performance of ONSD, ONSM, and combination (ONSD + ONSM) for diagnosing preeclampsia. RESULTS The observation (preeclampsia) group ONSD and ONSM were significantly higher than those in the control group (p < 0.05). Optimal diagnostic values for ONSD and ONSM were 4.10 mm and 11.20 kPa, respectively. Areas under the curve for diagnosing preeclampsia were 0.958 (95% confidence interval [CI], 0.926-0.990) for ONSD, 0.939 (95% CI, 0.894-0.985) for ONSM, and 0.982 (95% CI, 0.962-1.000) for ONSD + ONSM. There was no significant difference between ONSD and ONSM in diagnosing preeclampsia (p = 0.436). However, ONSD + ONSM was significantly advantageous over ONSD or ONSM alone in diagnosing preeclampsia (p = 0.033; p = 0.014). CONCLUSIONS Ultrasonic evaluation of the optic nerve can quantitatively assess optic nerve changes in pregnant women with preeclampsia.
Collapse
Affiliation(s)
- Shanshan Su
- Department of Ultrasound, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Huohu Zhong
- Department of Ultrasound, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Xiaohua Wang
- Department of Anesthesiology, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yanyan Huang
- Department of Ultrasound, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
- Department of Reproductive in Medicine, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Qichen Su
- Department of Ultrasound, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| |
Collapse
|
3
|
Yilmaz BK, Ozdemir S, Diracoglu A, Selcuk Can T, Turkay R. Utilizing shear wave elastography for the evaluation of optical nerve involvement in Behçet's disease. Photodiagnosis Photodyn Ther 2022; 40:103096. [PMID: 36049717 DOI: 10.1016/j.pdpdt.2022.103096] [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: 07/27/2022] [Revised: 08/22/2022] [Accepted: 08/26/2022] [Indexed: 12/14/2022]
Abstract
In this study, we investigated the elasticity of the optic nerve using shear wave elastography (SWE) in patients with Behçet's Disease (BD) and compare findings with a healthy control group. Optic nerve measurements of 40 eyes in the BD group and 38 eyes in the control group were performed by SWE (SWE-right and SWE-left). The mean age of the individuals in the BD group was higher than controls (p = 0.022). The SWE measurement results in the right eye were significantly higher in the BD group (p = 0.005), while SWE-left values were similar in the two groups (p = 0.206). There was a moderate positive correlation between age and SWE-right (r = 0.347, p = 0.031), there was no correlation between SWE-left and age (p = 0.756). It was found that SWE-right had significant value in distinguishing between BD and healthy controls (sensitivity: 75%, specificity: 78.9%; p = 0.005); whereas, SWE-left did not (p = 0.206). In the multiple logistic regression analysis, after adjusting for age and sex, the performance of SWE-right to distinguish BD patients from controls was found to remain significant (OR: 15.045, 95% CI: 2.33-97.120, p = 0.004). Due to the fact that only SWE-right values appear to have significant discriminatory performance for BD, it is feasible to suggest that the frequency and severity of BD involvement are associated with SWE-related changes in the optic nerve. This finding indicates the need for more comprehensive studies evaluating optic nerve SWE values in this context.
Collapse
Affiliation(s)
- Behice Kaniye Yilmaz
- Department of Radiology, University of Health Sciences, Haseki Research and Training Hospital, Istanbul, Turkey.
| | - Sevim Ozdemir
- Department of Radiology, University of Health Sciences, Haseki Research and Training Hospital, Istanbul, Turkey
| | - Aynur Diracoglu
- Department of Ophtalmology, University of Health Sciences, Haseki Research and Training Hospital, Istanbul, Turkey
| | - Tuba Selcuk Can
- Department of Radiology, University of Health Sciences, Haseki Research and Training Hospital, Istanbul, Turkey
| | - Rustu Turkay
- Department of Radiology, University of Health Sciences, Haseki Research and Training Hospital, Istanbul, Turkey
| |
Collapse
|
4
|
Xu G, Wu X, Yu J, Ding H, Ni Z, Wang Y. Non-invasive intracranial pressure assessment using shear-wave elastography in neuro-critical care patients. J Clin Neurosci 2022; 99:261-267. [PMID: 35306456 DOI: 10.1016/j.jocn.2022.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/24/2022] [Accepted: 03/05/2022] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To determine if Young's modulus of the optic nerve (ON) structure as measured by shear-wave elastography can suggest changes in intracranial pressure (ICP) in neuro-critical care patients. MATERIALS AND METHODS Thirty-one healthy volunteers and twenty-two neuro-critical care patients were enrolled. ON sheath (ONS) diameter (ONSD) values and Young's modulus measurements of volunteers were collected in a calm state and during a Valsalva maneuver (VM). Ultrasound measurements and ICP values of patients were collected on operation day and at 24 and 48 h after the operation; measurements were thereafter assigned to three groups: severely elevated (ICP greater than 22 mmHg), mildly elevated (ICP = 14-22 mmHg), and normal (ICP ≤ 13 mmHg). RESULTS ONSD and Young's modulus for the ON and ONS of volunteers during VM were higher than those in the calm state (all P < 0.001). In contrast to ONSD, Young's modulus for ON and ONS did not correlate with age, body mass index, or sex. The best cutoff values of Young's modulus for ON for predicting elevated and severely elevated ICP were 16.67 kPa and 22.74 kPa, respectively. Accordingly, the sensitivity values were 96.7% and 88.9%, and the specificity values were 86.1% and 73.7%, which had the same diagnostic performance as ONSD. CONCLUSION Young's modulus of the ON accurately reflects changes in ICP. It is not confounded by age, sex, or body mass index compared to ONSD.
Collapse
Affiliation(s)
- Guohui Xu
- Department of Ultrasonic Medicine, Fudan University Affiliated Huashan Hospital, No 12, Middle Wulumuqi Road, Shanghai 200040, China
| | - Xuehai Wu
- Department of Neurosugery, Fudan University Affiliated Huashan Hospital, No 12, Middle Wulumuqi Road, Shanghai 200040, China
| | - Jian Yu
- Department of Neurosugery, Fudan University Affiliated Huashan Hospital, No 12, Middle Wulumuqi Road, Shanghai 200040, China
| | - Hong Ding
- Department of Ultrasonic Medicine, Fudan University Affiliated Huashan Hospital, No 12, Middle Wulumuqi Road, Shanghai 200040, China
| | - Zilong Ni
- Department of Ultrasound Clinical Market, Simens Healthineers, No 399, West Haiyang Road, Shanghai 200126, China
| | - Yong Wang
- Department of Ultrasonic Medicine, Fudan University Affiliated Huashan Hospital, No 12, Middle Wulumuqi Road, Shanghai 200040, China.
| |
Collapse
|
5
|
Elsaid N, Belal T, Batouty N, Razek AAKA, Azab A. Effect of changes in optic nerve elasticity on central retinal artery blood flow in patients with idiopathic intracranial hypertension. J Neuroradiol 2021; 49:357-363. [PMID: 34111478 DOI: 10.1016/j.neurad.2021.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 01/22/2023]
Abstract
PURPOSE To assess changes in central retinal artery (CRA) blood flow by orbital color-coded Doppler ultrasonography in patients with idiopathic intracranial hypertension (IIH) and their relation with optic nerve (ON) elasticity assessed by shear wave elastography (SWE). METHODS This study was carried out on 68 eyes of patients diagnosed with IIH and 32 eyes of healthy controls. The severity of papilledema in IIH patients was sub-classified into mild and moderate/severe groups. Color-coded Doppler was used to measure peak systolic velocity (PSV), end diastolic velocity (EDV), mean velocity (Vmean) and pulsatility index (PI) of the CRA. RESULTS PSV, Vmean, and SWE were significantly higher in patients with IIH than in controls (p = 0.001). The optimal cut-off values of PSV and Vmean for differentiating IIH patients from controls were 11.25 and 6.75 cm/s with AUC 0.81 and 0.785 respectively. AUC was 0.92 and accuracy 91% for combined PSV, Vmean and SWE differentiation between IIH patients and controls. PSV, Vmean and SWE were significantly different between mild versus moderate/severe papilledema (p = 0.001). PSV and Vmean were correlated with papilledema (r = 0.790 and 0.722 respectively) and SWE (r = 0.818 and 0.761 respectively). CONCLUSION IIH is associated with decreased ON elasticity and reduced CRA blood flow. Individual and combined color-coded Doppler of the CRA and SWE help in diagnosis of IIH. CRA hemodynamic changes are correlated with papilledema severity and with the extent of biomechanical changes in the ON represented by SWE.
Collapse
Affiliation(s)
- Nada Elsaid
- Department of Neurology, Faculty of Medicine, Mansoura University, Egypt.
| | - Tamer Belal
- Department of Neurology, Faculty of Medicine, Mansoura University, Egypt
| | - Nihal Batouty
- Department of Radiology, Faculty of Medicine, Mansoura University, Egypt
| | | | - Ahmed Azab
- Department of Neurology, Faculty of Medicine, Mansoura University, Egypt
| |
Collapse
|
6
|
Razek AAKA, Elsaid N, Belal T, Batouty N, Azab A. Combined accuracy of optic nerve sheath diameter, strain ratio, and shear wave elastography of the optic nerve in patients with idiopathic intracranial hypertension. Ultrasonography 2021; 41:106-113. [PMID: 34218606 PMCID: PMC8696137 DOI: 10.14366/usg.20165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 04/20/2021] [Indexed: 11/03/2022] Open
Abstract
PURPOSE This study assessed the combined accuracy of optic nerve sheath diameter (ONSD), strain ratio (SR), and shear wave elastography (SWE) of the optic nerve (ON) in patients with idiopathic intracranial hypertension (IIH). METHODS This prospective study was carried out on both ONs of 34 consecutive patients diagnosed with IIH and 16 age- and sex-matched healthy volunteers. All of the study participants were women. The ONSD, SR, and SWE of the ON were measured. The severity of papilledema of IIH patients was sub-classified into mild papilledema and moderate/severe papilledema. RESULTS The mean ONSD (5.6±1.1 mm), SR (0.7±0.1), and SWE (30.1±16.7 kPa) of the IIH patients were significantly different (P=0.001) from the ONSD (4.1±0.5 mm), SR (0.9±0.1), and SWE (8.2±3.4 kPa) of controls. The cutoff values of ONSD, SR, and SWE of the ON for differentiating IIH patients from controls were 5.45 mm, 0.8, and 10.3 kPa with areas under the curve (AUCs) of 0.91, 0.86, and 0.96 and accuracy values of 91%, 81%, and 93%, respectively. Combined SWE and ONSD and combined SWE, ONSD, and SR for differentiating IIH patients from controls revealed AUCs of 0.98 and 0.99 and accuracy values of 96% and 96%, respectively. ONSD, SR, and SWE showed significant differences between mild and moderate/severe papilledema (P=0.001). Papilledema was correlated with SWE (r=0.8, P=0.001), ONSD (r=0.4, P=0.001), and SR (r=-0.4, P=0.001). CONCLUSION The combination of ONSD, SR, and SWE may be helpful for diagnosing IIH, and a good indicator of the degree of papilledema.
Collapse
Affiliation(s)
| | - Nada Elsaid
- Department of Neurology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Tamer Belal
- Department of Neurology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Nihal Batouty
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Ahmed Azab
- Department of Neurology, Mansoura Faculty of Medicine, Mansoura, Egypt
| |
Collapse
|
7
|
Elsaid N, Ahmed O, Belal T, Razek A, Azab A. Pathogenesis and Evaluation of the Effects of Idiopathic Intracranial Hypertension on the Optic Nerves. Neuroophthalmology 2020; 44:281-289. [DOI: 10.1080/01658107.2020.1751859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Nada Elsaid
- Faculty of Medicine, Department of Neurology, Mansoura University, Mansoura, Egypt
| | - Omar Ahmed
- Faculty of Medicine, Department of Neurology, Mansoura University, Mansoura, Egypt
| | - Tamer Belal
- Faculty of Medicine, Department of Neurology, Mansoura University, Mansoura, Egypt
| | - Ahmed Razek
- Faculty of Medicine, Department of Radiology, Mansoura University, Mansoura, Egypt
| | - Ahmed Azab
- Faculty of Medicine, Department of Neurology, Mansoura University, Mansoura, Egypt
| |
Collapse
|
8
|
Özdemir A, Şahan MH, Asal N, İnal M, Güngüneş A. Evaluation of the medial rectus muscle and optic nerve using strain and shear wave elastography in Graves' patients. Jpn J Radiol 2020; 38:1028-1035. [PMID: 32638278 DOI: 10.1007/s11604-020-01014-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 06/27/2020] [Indexed: 01/25/2023]
Abstract
PURPOSE The purpose of this study was to describe the elastic properties of the medial rectus muscle and optic nerve in Graves' patients without clinically apparent ophthalmopathy using strain elastography (SE) and shear wave elastography (SWE) and to determine whether these elastic properties could be used to aid in the diagnosis of the medial rectus muscle or optic nerve involvement. MATERIALS AND METHODS Thirty participants diagnosed with Graves' disease without ophthalmopathy and 30 healthy volunteers (control group) were prospectively examined between November 2018 and August 2019. SE and SWE findings in both groups were compared using the χ2 test and the independent samples t test. RESULTS A statistically significant softening of the medial rectus muscle was observed in the SE patterns of the Graves' patients (p = 0.009). A statistically appreciable distinction was observed between the medial rectus muscle (7.64 ± 2.1 and 9.20 ± 1.7 kPa, p = 0.000) and the optic nerve (8.35 ± 2.8 and 9.37 ± 1.5 kPa, p = 0.019) in the SWE modulus of the Graves' patients and healthy volunteers. CONCLUSION SE and SWE can be used to identify structural alterations to the medial rectus muscle and optic nerve before clinically apparent Graves' ophthalmopathy has developed.
Collapse
Affiliation(s)
- Adnan Özdemir
- Faculty of Medicine, Radiology Department, Kirikkale University, Kirikkale, Turkey.
| | - Mehmet H Şahan
- Faculty of Medicine, Radiology Department, Gaziantep University, Gaziantep, Turkey
| | - Neşe Asal
- Faculty of Medicine, Radiology Department, Kirikkale University, Kirikkale, Turkey
| | - Mikail İnal
- Faculty of Medicine, Radiology Department, Kirikkale University, Kirikkale, Turkey
| | - Aşkın Güngüneş
- Faculty of Medicine, Endocrinology and Metabolism Department, Kirikkale University, Kirikkale, Turkey
| |
Collapse
|
9
|
Asal N, İnal M, Şahan MH, Say B. Assessment of the optic nerve using strain and shear-wave elastography in patients with pseudotumour cerebri. Clin Radiol 2020; 75:629-635. [PMID: 32381345 DOI: 10.1016/j.crad.2020.03.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 03/31/2020] [Indexed: 12/18/2022]
Abstract
AIM To evaluate the optic nerve using strain elastography (SE) and shear-wave elastography (SWE) in idiopathic intracranial hypertension (IIH) patients in comparison to participants in the control group. MATERIALS AND METHODS Eighty eyes were evaluated in 40 cases consisting of 20 IIH patients and 20 participants in the control group. This study was conducted using SE and SWE in addition optic nerve sonography measurements of participants in the IIH patient group and the control group. SE patterns were categorised using three main types and two subtypes. Quantitative measurements of optic nerve stiffness with SWE were expressed in kilopascals. RESULTS In the IIH patient group, type 2 and type 1 elasticity patterns were primarily observed, followed by type 3 patterns. In the control group, type 3 elasticity patterns were most often observed, while type 2 elasticity patterns were seen less frequently. Statistically significance differences in the types of elasticity strain patterns were observed between the groups (p<0.01). Quantitative analysis was also performed, and the SWE moduli were obtained for the control group (10.1±0.28 kPa) and the IIH patient group (26.97±1 kPa). A statistically significant difference in the SWE modulus was found between the groups (p<0.01). CONCLUSION Biomechanical changes may have occurred in the optic nerve secondary to increased intracranial pressure in IIH patients. Strain and shear elastography may have potential as assistive diagnostic techniques for the detection and follow-up of these changes.
Collapse
Affiliation(s)
- N Asal
- Department of Radiology, Kirikkale University School of Medicine, Kirikkale, Turkey.
| | - M İnal
- Department of Radiology, Kirikkale University School of Medicine, Kirikkale, Turkey
| | - M H Şahan
- Department of Radiology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - B Say
- Department of Neurology, Kirikkale University School of Medicine, Kirikkale, Turkey
| |
Collapse
|