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Yang Y, Shahryari M, Meyer T, Marticorena Garcia SR, Görner S, Salimi Majd M, Guo J, Braun J, Sack I, Tzschätzsch H. Explorative study using ultrasound time-harmonic elastography for stiffness-based quantification of skeletal muscle function. Z Med Phys 2024:S0939-3889(24)00027-8. [PMID: 38508947 DOI: 10.1016/j.zemedi.2024.03.001] [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: 01/03/2024] [Revised: 02/29/2024] [Accepted: 03/01/2024] [Indexed: 03/22/2024]
Abstract
Time-harmonic elastography (THE) is an emerging ultrasound imaging technique that allows full-field mapping of the stiffness of deep biological tissues. THE's unique ability to rapidly capture stiffness in multiple tissues has never been applied for imaging skeletal muscle. Therefore, we addressed the lack of data on temporal changes in skeletal muscle stiffness while simultaneously covering stiffness of different muscles. Acquiring repeated THE scans every five seconds we quantified shear-wave speed (SWS) as a marker of stiffness of the long head (LHB) and short head (SHB) of biceps brachii and of the brachialis muscle (B) in ten healthy volunteers. SWS was continuously acquired during a 3-min isometric preloading phase, a 3-min loading phase with different weights (4, 8, and 12 kg), and a 9-min postloading phase. In addition, we analyzed temporal SWS standard deviation (SD) as a marker of muscle contraction regulation. Our results (median [min, max]) showed both SWS at preloading (LHB: 1.04 [0.94, 1.12] m/s, SHB: 0.86 [0.78, 0.94] m/s, B: 0.96 [0.87, 1.09] m/s, p < 0.001) and the increase in SWS with loading weight to be muscle-specific (LHB: 0.010 [0.002, 0.019] m/s/kg, SHB: 0.022 [0.017, 0.042] m/s/kg, B: 0.039 [0.019, 0.062] m/s/kg, p < 0.001). Additionally, SWS during loading increased continuously over time by 0.022 [0.004, 0.051] m/s/min (p < 0.01). Using an exponential decay model, we found an average relaxation time of 27 seconds during postloading. Analogously, SWS SD at preloading was also muscle-specific (LHB: 0.018 [0.011, 0.029] m/s, SHB: 0.021 [0.015, 0.027] m/s, B: 0.024 [0.018, 0.037] m/s, p < 0.05) and increased by 0.005 [0.003, 0.008] m/s/kg (p < 0.01) with loading. SWS SD did not change over loading time and decreased immediately in the postloading phase. Taken together, THE of skeletal muscle is a promising imaging technique for in vivo quantification of stiffness and stiffness changes in multiple muscle groups within seconds. Both the magnitude of stiffness changes and their temporal variation during isometric exercise may reflect the functional status of skeletal muscle and provide additional information to the morphological measures obtained by conventional imaging modalities.
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Affiliation(s)
- Yang Yang
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Mehrgan Shahryari
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Tom Meyer
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Stephan Rodrigo Marticorena Garcia
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Steffen Görner
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Mahsa Salimi Majd
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Jing Guo
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Jürgen Braun
- Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Ingolf Sack
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Heiko Tzschätzsch
- Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany.
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Anders M, Meyer T, Warmuth C, Pfeuffer J, Tzschaetzsch H, Herthum H, Shahryari M, Degenhardt K, Wieben O, Schmitter S, Schulz-Menger J, Schaeffter T, Braun J, Sack I. Rapid MR elastography of the liver for subsecond stiffness sampling. Magn Reson Med 2024; 91:312-324. [PMID: 37705467 DOI: 10.1002/mrm.29859] [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: 04/27/2023] [Revised: 08/18/2023] [Accepted: 08/19/2023] [Indexed: 09/15/2023]
Abstract
PURPOSE Depicting the stiffness of biological soft tissues, MR elastography (MRE) has a wide range of diagnostic applications. The purpose of this study was to improve the temporal resolution of 2D hepatic MRE in order to provide more rapid feedback on the quality of the wavefield and ensure better temporal sampling of respiration-induced stiffness changes. METHODS We developed a rapid MRE sequence that uses 2D segmented gradient-echo spiral readout to encode 40 Hz harmonic vibrations and generate stiffness maps within 625 ms. We demonstrate the use of this technique as a rapid test for shear wave amplitudes and overall MRE image quality and as a method for monitoring respiration-induced stiffness changes in the liver in comparison to 3D MRE and ultrasound-based time-harmonic elastography. RESULTS Subsecond MRE allowed monitoring of increasing shear wave amplitudes in the liver with increasing levels of external stimulation within a single breath-hold. Furthermore, the technique detected respiration-induced changes in liver stiffness with peak values (1.83 ± 0.22 m/s) at end-inspiration, followed by softer values during forced abdominal pressure (1.60 ± 0.22 m/s) and end-expiration (1.49 ± 0.22 m/s). The effects of inspiration and expiration were confirmed by time-harmonic elastography. CONCLUSION Our results suggest that subsecond MRE of the liver is useful for checking MRE driver settings and monitoring breathing-induced changes in liver stiffness in near real time.
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Affiliation(s)
- Matthias Anders
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Tom Meyer
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Carsten Warmuth
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Josef Pfeuffer
- Application Development, Siemens Healthcare GmbH, Erlangen, Germany
| | - Heiko Tzschaetzsch
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Helge Herthum
- Berlin Center for Advanced Neuroimaging (BCAN), Berlin, Germany, Corporate Member of Freie Universität Berlin, Berlin Institute of Health and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Mehrgan Shahryari
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Katja Degenhardt
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Berlin, Germany
| | - Oliver Wieben
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA
- Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
| | - Sebastian Schmitter
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Berlin, Germany
| | - Jeanette Schulz-Menger
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Working Group On CMR, Experimental and Clinical Research Center, a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and the Charité-Universitätsmedizin Berlin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
- Department of Cardiology and Nephrology, HELIOS Hospital Berlin-Buch, Berlin, Germany
| | - Tobias Schaeffter
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Berlin, Germany
- Department of Medical Engineering, Technische Universität Berlin, Einstein Centre Digital Future, Berlin, Germany
| | - Juergen Braun
- Institute of Medical Informatics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ingolf Sack
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Meyer T, Tzschätzsch H, Wellge B, Sack I, Kröncke T, Martl A. Valsalva Maneuver Decreases Liver and Spleen Stiffness Measured by Time-Harmonic Ultrasound Elastography. Front Bioeng Biotechnol 2022; 10:886363. [PMID: 35711644 PMCID: PMC9195299 DOI: 10.3389/fbioe.2022.886363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/04/2022] [Indexed: 11/26/2022] Open
Abstract
Ultrasound elastography quantitatively measures tissue stiffness and is widely used in clinical practice to diagnose various diseases including liver fibrosis and portal hypertension. The stiffness of soft organs has been shown to be sensitive to blood flow and pressure-related diseases such as portal hypertension. Because of the intricate coupling between tissue stiffness of abdominal organs and perfusion-related factors such as vascular stiffness or blood volume, simple breathing maneuvers have altered the results of liver elastography, while other organs such as the spleen are understudied. Therefore, we investigated the effect of a standardized Valsalva maneuver on liver stiffness and, for the first time, on spleen stiffness using time-harmonic elastography (THE). THE acquires full-field-of-view stiffness maps based on shear wave speed (SWS), covers deep tissues, and is potentially sensitive to SWS changes induced by altered abdominal pressure in the hepatosplenic system. SWS of the liver and the spleen was measured in 17 healthy volunteers under baseline conditions and during the Valsalva maneuver. With the Valsalva maneuver, SWS in the liver decreased by 2.2% (from a median of 1.36 m/s to 1.32 m/s; p = 0.021), while SWS in the spleen decreased by 5.2% (from a median of 1.63 m/s to 1.51 m/s; p = 0.00059). Furthermore, we observed that the decrease was more pronounced the higher the baseline SWS values were. In conclusion, the results confirm our hypothesis that the Valsalva maneuver decreases liver and spleen stiffness, showing that THE is sensitive to perfusion pressure-related changes in tissue stiffness. With its extensive organ coverage and high penetration depth, THE may facilitate translation of pressure-sensitive ultrasound elastography into clinical routine.
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Affiliation(s)
- Tom Meyer
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Heiko Tzschätzsch
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Brunhilde Wellge
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ingolf Sack
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Kröncke
- Department of Diagnostic and Interventional Radiology and Neuroradiology, Universitätsklinikum Augsburg, Augsburg, Germany
| | - Alma Martl
- Department of Diagnostic and Interventional Radiology and Neuroradiology, Universitätsklinikum Augsburg, Augsburg, Germany
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Han H, Yang J, Jin WK, Li X, Zhang F, Zhuge YZ, Wu M, Yang B. Diagnostic value of conventional ultrasound and shear wave elastography in detecting transjugular intrahepatic portosystemic shunt dysfunction. Acta Radiol 2021; 62:1575-1582. [PMID: 33251812 DOI: 10.1177/0284185120975183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Transjugular intrahepatic portosystemic shunt (TIPS) dysfunction can cause recurrent portal hypertension (PH)-related complications such as ascites and gastroesophageal variceal bleeding. Portography is invasive and costly limits its use as a screening modality. PURPOSE To assess the clinical value of conventional ultrasound in combination with point shear wave elastography (pSWE) to predict TIPS dysfunction. MATERIAL AND METHODS A total of 184 patients with cirrhosis scheduled for TIPS implantation were enrolled in this study and evaluated retrospectively. The splenoportal venous blood flow parameter, liver stiffness (LS), and spleen stiffness (SPS) were measured. Outcome measures included differences in portal vein velocity (PVV), splenic vein velocity (SPVV), LS, and SPS. The accuracy of change in PVV (ΔPVV), SPVV (ΔSPVV), and SPS (ΔSPS) to diagnose TIPS dysfunction was investigated. RESULTS TIPS dysfunction occurred in 28 of 184 patients (15.2%). Eighteen (64.3%) patients had shunt stenoses and 10 (35.7%) had shunt occlusion. Portal vein diameter (PVD), PVV, splenic vein diameter (SPVD), SPVV, LS, and SPS were not significantly different between the TIPS normal and TIPS dysfunction groups. Compared with the TIPS normal group, PVV and SPVV of the TIPS dysfunction group decreased significantly, whereas SPS increased significantly (P < 0.001). The values of areas under the receiver operating characteristic curves of ΔPVV, ΔSPVV, and ΔSPS for the diagnosis of TIPS dysfunction were 0.97, 0.96, and 0.87, respectively. CONCLUSION pSWE showed a diagnostic efficacy comparable to conventional ultrasound for diagnosing TIPS dysfunction and can be used routinely after TIPS procedures.
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Affiliation(s)
- Hao Han
- Department of Ultrasound, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, PR China
| | - Jian Yang
- Department of Ultrasound, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Wei-kui Jin
- Department of Ultrasound, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Xia Li
- Department of Ultrasound, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Feng Zhang
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Yu-zheng Zhuge
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Min Wu
- Department of Ultrasound, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Bin Yang
- Department of Ultrasound, Jinling Hospital, Nanjing Medical University, Nanjing, PR China
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5
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Schaafs LA, Tzschätzsch H, Figiel C, van der Giet M, Reshetnik A, Hamm B, Sack I, Elgeti T. Quantitative Time-Harmonic Ultrasound Elastography of the Abdominal Aorta and Inferior Vena Cava. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:2349-2355. [PMID: 31201021 DOI: 10.1016/j.ultrasmedbio.2019.05.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/18/2019] [Accepted: 05/20/2019] [Indexed: 06/09/2023]
Abstract
The purpose of this study was to evaluate the sensitivity of quantitative time-harmonic ultrasound elastography (THE) of the inferior vena cava (IVC) and abdominal aorta (AA) to changes in central volume status. THE of the IVC and AA was performed in 20 healthy volunteers before and after oral intake of 1 L of water and before or during passive leg raising to augment venous filling. Compound maps of shear wave speed (SWS) as surrogate measures of vessel wall stiffness were generated within the full field of view from multifrequency harmonic wave fields. SWS was measured in regions of the IVC and AA. Blood pressure, stroke volume, cardiac output and pulse wave velocity were recorded. Statistical significance of SWS changes was tested using one-way repeated-measures analysis of variance. SWS measured in the IVC increased from 1.71 ± 0.1 m/s before water intake to 1.82 ± 0.1 m/s during passive leg raising and, further, to 1.87 ± 0.1 m/s after hydration and to 1.95 ± 0.1 m/s with hydration plus passive leg raising (p < 0.001). SWS in the AA did not change significantly after hydration (2.14 ± 0.13 m/s vs. 2.15 ± 0.16 m/s; p = 0.792). SWS was significantly higher in the AA than in the IVC across all experiments (p < 0.001). Water drinking did not significantly influence blood pressure, pulse wave velocity and cardiac output (all p values >0.1), whereas stroke volume increased significantly (p = 0.031). Time-harmonic ultrasound elastography enables quantification of the wall stiffness of the large abdominal vessels and is sensitive to different volume and pressure states in the IVC.
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Affiliation(s)
- Lars-Arne Schaafs
- Department of Radiology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin and Campus Mitte, Berlin, Germany.
| | - Heiko Tzschätzsch
- Department of Radiology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin and Campus Mitte, Berlin, Germany
| | - Christin Figiel
- Department of Radiology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin and Campus Mitte, Berlin, Germany
| | - Markus van der Giet
- Department of Nephrology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Alexander Reshetnik
- Department of Nephrology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin and Campus Mitte, Berlin, Germany
| | - Ingolf Sack
- Department of Radiology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin and Campus Mitte, Berlin, Germany
| | - Thomas Elgeti
- Department of Radiology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin and Campus Mitte, Berlin, Germany; Department of Nuclear Medicine, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany
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6
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Attia D, Rodt T, Marquardt S, Hinrichs J, Meyer BC, Gebel M, Wacker F, Manns MP, Potthoff A. Shear wave elastography prior to transjugular intrahepatic portosystemic shunt may predict the decrease in hepatic vein pressure gradient. Abdom Radiol (NY) 2019; 44:1127-1134. [PMID: 30288582 DOI: 10.1007/s00261-018-1795-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure used to treat portal hypertension complications. Our aim was to evaluate liver and spleen stiffness measurement (LSM and SSM, respectively) changes using acoustic radiation force impulse imaging (ARFI) in comparison to Child-Pugh scores for predicting hepatic venous pressure gradient (HVPG) decreases after TIPS implantation. METHODS This prospective study included 31 consecutive clinically significant portal hypertension patients with TIPS indication. All patients received LSM and SSM before TIPS, at baseline, 2 days (follow-up 1) and 6 weeks (follow-up 2) post-implantation. HVPG was performed during the TIPS procedure. RESULTS The mean decrease in HVPG after TIPS was 63%. LSM and SSM decreased significantly between baseline and follow-up 2 (p < 0.001 and p < 0.001, respectively). At baseline, follow-up 1 and follow-up 2, significant correlations were detected between mean SSM and mean HVPG (p = 0.026; p = 0.018; p = 0.002, respectively). HVPG decreased to ≤ 10 mmHg in 61% of patients for which LSM, SSM, and Child-Pugh score were predictors (p = 0.033, p = 0.002 and p = 0.030, respectively). The area under the curve (AUC) for LSM, SSM, and Child-Pugh was 0.88, 0.90, and 0.84, respectively, with close sensitivity and specificity. SSM had the highest diagnostic accuracy for predicting an HVPG decrease to ≤ 10 mmHg in comparison to LSM and Child-Pugh score. CONCLUSION Spleen stiffness is superior to liver stiffness and Child-Pugh score as a non-invasive surveillance tool for evaluating patients with clinically significant portal hypertension (HVPG ≥ 10 mmHg) prior to TIPS.
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Affiliation(s)
- Dina Attia
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
- Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Beni-Suef University, Mokbel Street, Beni-Suef, 62511, Egypt.
| | - Thomas Rodt
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Steffen Marquardt
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Jan Hinrichs
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Bernhard C Meyer
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Michael Gebel
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Frank Wacker
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Michael P Manns
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Andrej Potthoff
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
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Hudert CA, Tzschätzsch H, Guo J, Rudolph B, Bläker H, Loddenkemper C, Luck W, Müller HP, Baumgart DC, Hamm B, Braun J, Holzhütter HG, Wiegand S, Sack I. US Time-Harmonic Elastography: Detection of Liver Fibrosis in Adolescents with Extreme Obesity with Nonalcoholic Fatty Liver Disease. Radiology 2018; 288:99-106. [DOI: 10.1148/radiol.2018172928] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Christian A. Hudert
- From the Center for Chronically Sick Children (C.A.H., S.W.), Departments of Radiology (H.T., J.G., B.H., I.S.), Pathology (B.R., H.B., C.L.), Pediatric Gastroenterology (W.L.), and Gastroenterology and Hepatology (H.P.M., D.C.B.), and the Institutes for Medical Informatics (J.B.) and Biochemistry (H.G.H.), Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Heiko Tzschätzsch
- From the Center for Chronically Sick Children (C.A.H., S.W.), Departments of Radiology (H.T., J.G., B.H., I.S.), Pathology (B.R., H.B., C.L.), Pediatric Gastroenterology (W.L.), and Gastroenterology and Hepatology (H.P.M., D.C.B.), and the Institutes for Medical Informatics (J.B.) and Biochemistry (H.G.H.), Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Jing Guo
- From the Center for Chronically Sick Children (C.A.H., S.W.), Departments of Radiology (H.T., J.G., B.H., I.S.), Pathology (B.R., H.B., C.L.), Pediatric Gastroenterology (W.L.), and Gastroenterology and Hepatology (H.P.M., D.C.B.), and the Institutes for Medical Informatics (J.B.) and Biochemistry (H.G.H.), Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Birgit Rudolph
- From the Center for Chronically Sick Children (C.A.H., S.W.), Departments of Radiology (H.T., J.G., B.H., I.S.), Pathology (B.R., H.B., C.L.), Pediatric Gastroenterology (W.L.), and Gastroenterology and Hepatology (H.P.M., D.C.B.), and the Institutes for Medical Informatics (J.B.) and Biochemistry (H.G.H.), Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Hendrik Bläker
- From the Center for Chronically Sick Children (C.A.H., S.W.), Departments of Radiology (H.T., J.G., B.H., I.S.), Pathology (B.R., H.B., C.L.), Pediatric Gastroenterology (W.L.), and Gastroenterology and Hepatology (H.P.M., D.C.B.), and the Institutes for Medical Informatics (J.B.) and Biochemistry (H.G.H.), Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Christoph Loddenkemper
- From the Center for Chronically Sick Children (C.A.H., S.W.), Departments of Radiology (H.T., J.G., B.H., I.S.), Pathology (B.R., H.B., C.L.), Pediatric Gastroenterology (W.L.), and Gastroenterology and Hepatology (H.P.M., D.C.B.), and the Institutes for Medical Informatics (J.B.) and Biochemistry (H.G.H.), Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Werner Luck
- From the Center for Chronically Sick Children (C.A.H., S.W.), Departments of Radiology (H.T., J.G., B.H., I.S.), Pathology (B.R., H.B., C.L.), Pediatric Gastroenterology (W.L.), and Gastroenterology and Hepatology (H.P.M., D.C.B.), and the Institutes for Medical Informatics (J.B.) and Biochemistry (H.G.H.), Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Hans-Peter Müller
- From the Center for Chronically Sick Children (C.A.H., S.W.), Departments of Radiology (H.T., J.G., B.H., I.S.), Pathology (B.R., H.B., C.L.), Pediatric Gastroenterology (W.L.), and Gastroenterology and Hepatology (H.P.M., D.C.B.), and the Institutes for Medical Informatics (J.B.) and Biochemistry (H.G.H.), Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Daniel C. Baumgart
- From the Center for Chronically Sick Children (C.A.H., S.W.), Departments of Radiology (H.T., J.G., B.H., I.S.), Pathology (B.R., H.B., C.L.), Pediatric Gastroenterology (W.L.), and Gastroenterology and Hepatology (H.P.M., D.C.B.), and the Institutes for Medical Informatics (J.B.) and Biochemistry (H.G.H.), Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Bernd Hamm
- From the Center for Chronically Sick Children (C.A.H., S.W.), Departments of Radiology (H.T., J.G., B.H., I.S.), Pathology (B.R., H.B., C.L.), Pediatric Gastroenterology (W.L.), and Gastroenterology and Hepatology (H.P.M., D.C.B.), and the Institutes for Medical Informatics (J.B.) and Biochemistry (H.G.H.), Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Jürgen Braun
- From the Center for Chronically Sick Children (C.A.H., S.W.), Departments of Radiology (H.T., J.G., B.H., I.S.), Pathology (B.R., H.B., C.L.), Pediatric Gastroenterology (W.L.), and Gastroenterology and Hepatology (H.P.M., D.C.B.), and the Institutes for Medical Informatics (J.B.) and Biochemistry (H.G.H.), Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Hermann-Georg Holzhütter
- From the Center for Chronically Sick Children (C.A.H., S.W.), Departments of Radiology (H.T., J.G., B.H., I.S.), Pathology (B.R., H.B., C.L.), Pediatric Gastroenterology (W.L.), and Gastroenterology and Hepatology (H.P.M., D.C.B.), and the Institutes for Medical Informatics (J.B.) and Biochemistry (H.G.H.), Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Susanna Wiegand
- From the Center for Chronically Sick Children (C.A.H., S.W.), Departments of Radiology (H.T., J.G., B.H., I.S.), Pathology (B.R., H.B., C.L.), Pediatric Gastroenterology (W.L.), and Gastroenterology and Hepatology (H.P.M., D.C.B.), and the Institutes for Medical Informatics (J.B.) and Biochemistry (H.G.H.), Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Ingolf Sack
- From the Center for Chronically Sick Children (C.A.H., S.W.), Departments of Radiology (H.T., J.G., B.H., I.S.), Pathology (B.R., H.B., C.L.), Pediatric Gastroenterology (W.L.), and Gastroenterology and Hepatology (H.P.M., D.C.B.), and the Institutes for Medical Informatics (J.B.) and Biochemistry (H.G.H.), Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
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8
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Schaafs LA, Tzschätzsch H, van der Giet M, Reshetnik A, Steffen IG, Hamm B, Braun J, Sack I, Elgeti T. Time-Harmonic Ultrasound elastography of the Descending Abdominal Aorta: Initial Results. ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:2550-2557. [PMID: 28818306 DOI: 10.1016/j.ultrasmedbio.2017.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 06/28/2017] [Accepted: 07/07/2017] [Indexed: 06/07/2023]
Abstract
Stiffening of central large vessels is considered a key pathophysiologic factor within the cardiovascular system. Current diagnostic parameters such as pulse wave velocity (PWV) indirectly measure aortic stiffness, a hallmark of coronary diseases. The aim of the present study was to perform elastography of the proximal abdominal aorta based on externally induced time-harmonic shear waves. Experiments were performed in 30 healthy volunteers (25 young, 5 old, >50 y) and 5 patients with longstanding hypertension (PWV >10 m/s). B-Mode-guided sonographic time-harmonic elastography was used for measurement of externally induced shear waves at 30-Hz vibration frequency. Thirty-hertz shear wave amplitudes (SWAs) within the abdominal aorta were measured and displayed in real time and processed offline for differences in SWA between systole and diastole (ΔSWA). Data were analyzed using the Kruskal-Wallis test and receiver operating characteristic curve analysis. The change in SWA over the cardiac cycle was reduced significantly in all patients as assessed with ΔSWA (volunteers: mean = 10 ± 5 μm, patients: mean = 4 ± 1 μm; p < 0.001). The best separation of healthy volunteers from patients was obtained with a ΔSWA threshold of 4.7 μm, resulting in a sensitivity of 0.9 and a specificity of 1.0, with an overall area under the curve of 0.96. Time harmonic elastography of the abdominal aorta is feasible and shows promise for the exploitation of time-varying shear wave amplitudes as a diagnostic marker for aortic wall stiffening. Patients with elevated PWVs suggesting increased aortic wall stiffness were best identified by ΔSWA-a parameter that could be related to the ability of the vessel walls to distend on passages of the pulse wave.
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Affiliation(s)
- Lars-Arne Schaafs
- Klinik und Hochschulambulanz für Radiologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Heiko Tzschätzsch
- Klinik und Hochschulambulanz für Radiologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Markus van der Giet
- Medizinische Klinik mit Schwerpunkt Nephrologie, Transplantationszentrum-Hypertoniezentrum, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Alexander Reshetnik
- Medizinische Klinik mit Schwerpunkt Nephrologie, Transplantationszentrum-Hypertoniezentrum, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ingo G Steffen
- Klinik und Hochschulambulanz für Radiologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Bernd Hamm
- Klinik und Hochschulambulanz für Radiologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Jürgen Braun
- Institut für Medizinische Informatik, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ingolf Sack
- Klinik und Hochschulambulanz für Radiologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Elgeti
- Klinik und Hochschulambulanz für Radiologie, Charité-Universitätsmedizin Berlin, Berlin, Germany.
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