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Bergsma S, van Gent M, Dam-Vervloet AJ, Lagerweij MCM, van der Wouden EJ, Nijholt IM, Boomsma MF, Poot L. Image-guided point-shear-wave elastography: a valid and reliable technique for liver fibrotic staging. J Ultrasound 2024:10.1007/s40477-023-00854-9. [PMID: 38281292 DOI: 10.1007/s40477-023-00854-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 11/27/2023] [Indexed: 01/30/2024] Open
Abstract
PURPOSE Despite progressive implementation of image-guided point-shear wave elastography (pSWE) in guidelines as an alternative to transient elastography for the staging of fibrotic liver disease, pSWE is not widely adopted in clinical workflow. More information on reliability and validity of pSWE systems is needed. Therefore, we performed a phantom study to evaluate the validity and reliability of pSWE with ultrasound systems. METHODS Validity and reliability of pSWE measurements from three ultrasound systems were evaluated. Measurements were performed on an elasticity phantom with reference elasticities of 7 ± 1 (low) (median ± interquartile range (IQR)), 14 ± 2 (medium) and 26 ± 3 (high) kPa. Measurements were repeated in tenfold for each reference at 2, 3 and 4 cm depth. Results were considered valid when median elasticity ± IQR was between the uncertainty limits (IQR) for each reference elasticity value and reliable when IQR/median < 0.30. RESULTS pSWE with the systems provided valid results for all reference elasticities and focal depths, except for overestimation of high reference elasticity at 2 and 4 cm depth for one system (41.5 ± 4.3 and 39.0 ± 1.2 kPa, respectively). Measurements were reliable with a maximum IQR/median of 0.13, well below the guideline of IQR/median < 0.30. DISCUSSION The results support the use of pSWE as an alternative to invasive or non-image guided noninvasive techniques for liver fibrotic staging. CONCLUSIONS pSWE with ultrasound systems from different vendors is valid and reliable and can therefore be implemented to optimize clinical workflow by performing imaging and elastography simultaneously.
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Affiliation(s)
- Sietske Bergsma
- Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands.
| | - Margo van Gent
- Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Medical Center Leeuwarden, Department of Medical Physics, Leeuwarden, The Netherlands
| | | | | | | | - Ingrid M Nijholt
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands
- Department of Innovation & Science, Isala Hospital, Zwolle, The Netherlands
| | | | - Lieke Poot
- Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands
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Jiang Z, Zhou Y, Cao D, Navab N. DefCor-Net: Physics-aware ultrasound deformation correction. Med Image Anal 2023; 90:102923. [PMID: 37688982 DOI: 10.1016/j.media.2023.102923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 05/22/2023] [Accepted: 08/01/2023] [Indexed: 09/11/2023]
Abstract
The recovery of morphologically accurate anatomical images from deformed ones is challenging in ultrasound (US) image acquisition, but crucial to accurate and consistent diagnosis, particularly in the emerging field of computer-assisted diagnosis. This article presents a novel physics-aware deformation correction approach based on a coarse-to-fine, multi-scale deep neural network (DefCor-Net). To achieve pixel-wise performance, DefCor-Net incorporates biomedical knowledge by estimating pixel-wise stiffness online using a U-shaped feature extractor. The deformation field is then computed using polynomial regression by integrating the measured force applied by the US probe. Based on real-time estimation of pixel-by-pixel tissue properties, the learning-based approach enables the potential for anatomy-aware deformation correction. To demonstrate the effectiveness of the proposed DefCor-Net, images recorded at multiple locations on forearms and upper arms of six volunteers are used to train and validate DefCor-Net. The results demonstrate that DefCor-Net can significantly improve the accuracy of deformation correction to recover the original geometry (Dice Coefficient: from 14.3±20.9 to 82.6±12.1 when the force is 6N). Code:https://github.com/KarolineZhy/DefCorNet.
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Affiliation(s)
- Zhongliang Jiang
- Computer Aided Medical Procedures, Technical University of Munich, Munich, Germany.
| | - Yue Zhou
- Computer Aided Medical Procedures, Technical University of Munich, Munich, Germany
| | | | - Nassir Navab
- Computer Aided Medical Procedures, Technical University of Munich, Munich, Germany; Computer Aided Medical Procedures, Johns Hopkins University, Baltimore, MD, USA
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Zhang H, Meng Z, Ru J, Meng Y, Wang K. Application and prospects of AI-based radiomics in ultrasound diagnosis. Vis Comput Ind Biomed Art 2023; 6:20. [PMID: 37828411 PMCID: PMC10570254 DOI: 10.1186/s42492-023-00147-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/20/2023] [Indexed: 10/14/2023] Open
Abstract
Artificial intelligence (AI)-based radiomics has attracted considerable research attention in the field of medical imaging, including ultrasound diagnosis. Ultrasound imaging has unique advantages such as high temporal resolution, low cost, and no radiation exposure. This renders it a preferred imaging modality for several clinical scenarios. This review includes a detailed introduction to imaging modalities, including Brightness-mode ultrasound, color Doppler flow imaging, ultrasound elastography, contrast-enhanced ultrasound, and multi-modal fusion analysis. It provides an overview of the current status and prospects of AI-based radiomics in ultrasound diagnosis, highlighting the application of AI-based radiomics to static ultrasound images, dynamic ultrasound videos, and multi-modal ultrasound fusion analysis.
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Affiliation(s)
- Haoyan Zhang
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
- School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, 100190, China
| | - Zheling Meng
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
- School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, 100190, China
| | - Jinyu Ru
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
- School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, 100190, China
| | - Yaqing Meng
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
- School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, 100190, China
| | - Kun Wang
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China.
- School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, 100190, China.
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Zhang XY, Zhang D, Han LZ, Pan YS, Wei Q, Lv WZ, Dietrich CF, Wang ZY, Cui XW. Predicting Malignancy of Thyroid Micronodules: Radiomics Analysis Based on Two Types of Ultrasound Elastography Images. Acad Radiol 2023; 30:2156-2168. [PMID: 37003875 DOI: 10.1016/j.acra.2023.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/29/2023] [Accepted: 02/01/2023] [Indexed: 04/03/2023]
Abstract
RATIONALE AND OBJECTIVES To develop a multimodal ultrasound radiomics nomogram for accurate classification of thyroid micronodules. MATERIALS AND METHODS A retrospective study including 181 thyroid micronodules within 179 patients was conducted. Radiomics features were extracted from strain elastography (SE), shear wave elastography (SWE) and B-mode ultrasound (BMUS) images. Minimum redundancy maximum relevance and least absolute shrinkage and selection operator algorithms were used to select malignancy-related features. BMUS, SE, and SWE radiomics scores (Rad-scores) were then constructed. Multivariable logistic regression was conducted using radiomics signatures along with clinical data, and a nomogram was ultimately established. The calibration, discriminative, and clinical usefulness were considered to evaluate its performance. A clinical prediction model was also built using independent clinical risk factors for comparison. RESULTS An aspect ratio ≥ 1, mean elasticity index, BMUS Rad-score, SE Rad-score, and SWE Rad-score were identified as the independent predictors for predicting malignancy of thyroid micronodules by multivariable logistic regression. The radiomics nomogram based on these characteristics showed favorable calibration and discriminative capabilities (AUCs: 0.903 and 0.881 for training and validation cohorts, respectively), all outperforming clinical prediction model (AUCs: 0.791 and 0.626, respectively). The decision curve analysis also confirmed clinical usefulness of the nomogram. The significant improvement of net reclassification index and integrated discriminatory improvement indicated that multimodal ultrasound radiomics signatures might work as new imaging markers for classifying thyroid micronodules. CONCLUSION The nomogram combining multimodal ultrasound radiomics features and clinical factors has the potential to be used for accurate diagnosis of thyroid micronodules in the clinic.
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Affiliation(s)
- Xian-Ya Zhang
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Di Zhang
- Department of Medical Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lin-Zhi Han
- Department of Radiology, Xupu Chengnan Hospital, Huaihua, China
| | - Ying-Sha Pan
- Department of Radiology, The First Affiliated Hospital of University of South China, Hengyang, China
| | - Qi Wei
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wen-Zhi Lv
- Department of Artificial Intelligence, Julei Technology Company, Wuhan, China
| | | | - Zhi-Yuan Wang
- Department of Medical Ultrasound, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Xin-Wu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Nakamura S, Kimoto M, Okada K, Kawanobe U, Sakamoto H. Impact of lower muscle stiffness on ankle dorsiflexion restriction in children with cerebral palsy evaluated using ultrasound elastography. Clin Biomech (Bristol, Avon) 2023; 109:106092. [PMID: 37738919 DOI: 10.1016/j.clinbiomech.2023.106092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 08/21/2023] [Accepted: 09/12/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Plantar flexor muscles always contribute to limiting the range of motion of ankle dorsiflexion in children with spastic cerebral palsy, but the individual contributions of these muscles are not well defined. This study aimed to identify which muscles' stiffness impacts the dorsiflexion range of motion in children with cerebral palsy. METHODS Twenty-five children with cerebral palsy were included. The maximum passive dorsiflexion range of motion was measured in two positions: hip and knee joints in flexion, and both joints in full extension. Strain ratios indicating muscle stiffness were measured using strain elastography of the lateral and medial gastrocnemius, soleus, flexor hallucis longus, peroneus longus, peroneus brevis, and tibialis posterior muscles. To analyze which muscles impact the limitation of the dorsiflexion range, multiple regression analyses were conducted. The values of muscle stiffness were included as independent valuables, and the values of the dorsiflexion range were included as dependent valuables. A p-value <0.05 was considered statistically significant. FINDINGS In the analyses, the soleus and flexor hallucis longus muscle stiffness were significant independent factors for the dorsiflexion range of motion of hip and knee flexion (adjusted R2: 0.50). The lateral gastrocnemius muscle stiffness was a significant independent factor for the dorsiflexion range of motion with both joints in full extension (adjusted R2: 0.61). INTERPRETATION Flexor hallucis longus muscle stiffness, in addition to triceps surae muscle stiffness, was shown to impact dorsiflexion range; attention should be paid to muscle stiffness in children with cerebral palsy.
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Affiliation(s)
- Shinya Nakamura
- Department of Rehabilitation, Akita Prefectural Center on Development and Disability, 1-1-2, Minamigaoka, Akita 010-1409, Japan; Department of Physical Therapy, Akita University Graduate School of Health Sciences, 1-1-1 Hondo, Akita 010-8543, Japan.
| | - Minoru Kimoto
- Department of Rehabilitation, Akita Prefectural Center on Development and Disability, 1-1-2, Minamigaoka, Akita 010-1409, Japan; Department of Physical Therapy, Akita University Graduate School of Health Sciences, 1-1-1 Hondo, Akita 010-8543, Japan
| | - Kyoji Okada
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, 1-1-1 Hondo, Akita 010-8543, Japan
| | - Uki Kawanobe
- Department of Rehabilitation, Akita Prefectural Center on Development and Disability, 1-1-2, Minamigaoka, Akita 010-1409, Japan
| | - Hitoshi Sakamoto
- Department of Medicine, Akita Prefectural Center on Development and Disability, 1-1-2, Minamigaoka, Akita 010-1409, Japan
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Močnik M, Golob Jančič S, Marčun Varda N. Liver and kidney ultrasound elastography in children and young adults with hypertension or chronic kidney disease. Pediatr Nephrol 2023; 38:3379-3387. [PMID: 37154960 DOI: 10.1007/s00467-023-05984-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/06/2023] [Accepted: 04/06/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Ultrasound elastography is a research method increasingly used to measure tissue elasticity. The aim of the study was to assess its usability in pediatric patients with either chronic kidney disease (CKD) or hypertension. METHODS A total of 46 patients with CKD (group 1), 50 patients with hypertension (group 2), and 33 healthy participants as the control group were included. In all, we performed studies assessing their cardiovascular risk along with liver and kidney elastography. RESULTS Liver elastography parameters were increased compared to those in the control group (1.49 m/s, p = 0.007, in group 1 and 1.52 m/s, p < 0.001, in group 2, vs. 1.41 m/s among controls). Kidney elastography parameters were significantly higher in group 2 (1.9 m/s, p = 0.001, and 1.9 m/s, p = 0.003, in each kidney) when compared to group 1 (1.79 m/s and 1.81 m/s). Additionally, all participants were divided according to overweight/obesity and normal weight status, where both liver (1.53 m/s vs. 1.45 m/s, p < 0.001) and kidney parameters (1.96 m/s and 1.92 m/s vs. 1.81 m/s and 1.84 m/s, p = 0.002) were significantly higher in the group of overweight/obese subjects. CONCLUSIONS Ultrasound elastography of the liver and kidney is feasible in pediatric patients with either CKD or hypertension, showing increased liver stiffness parameters in both groups, further aggravated by obesity. In obese patients with CKD, kidney stiffness also increased indicating a negative effect of clustering cardiovascular risk factors leading to decreased kidney elasticity. Further research is warranted. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Mirjam Močnik
- Department of Pediatrics, University Medical Centre Maribor, Ljubljanska Ulica 5, 2000, Maribor, Slovenia.
| | - Sonja Golob Jančič
- Department of Pediatrics, University Medical Centre Maribor, Ljubljanska Ulica 5, 2000, Maribor, Slovenia
| | - Nataša Marčun Varda
- Department of Pediatrics, University Medical Centre Maribor, Ljubljanska Ulica 5, 2000, Maribor, Slovenia
- Faculty of Medicine, University of Maribor, Taborska 8, 2000, Maribor, Slovenia
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Obrist A, Ruby L, Martin A, Frauenfelder T, Rominger M, Paverd C. Influence of Measurement Depth and Acquisition Parameters on Shear Wave Speed and Shear Wave Dispersion in Certified Phantoms Using a Canon Aplio Clinical Ultrasound Scanner. Ultrasound Med Biol 2023; 49:1742-1759. [PMID: 37156674 DOI: 10.1016/j.ultrasmedbio.2023.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/15/2023] [Accepted: 03/28/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE The aim of the work described here was to investigate the relative contribution of confounding factors on liver shear wave speed (SWS) and shear wave dispersion slope (SWDS) measurements in three certified phantoms using a Canon Aplio clinical ultrasound scanner. METHODS A Canon Aplio i800 i-series ultrasound system (Canon Medical Systems Corporation, Otawara, Tochigi, Japan) with i8CX1 convex array (center frequency = 4 MHz) was used to examine dependencies caused by the depth, width and height of the acquisition box (AQB), the depth and size of the region of interest (ROI), the AQB angle and the pressure of the ultrasound probe on the surface of the phantom. RESULTS Results revealed that depth is the most significant confounder in both SWS and SWDS measurements. AQB angle, height and width and ROI size exhibited minimal confounding effects on measurements. For SWS, the most consistent measurement depth is when the top of the AQB is placed between 2 and 4 cm, and the ROI is located between 3 and 7 cm deep. For SWDS, results indicate that measurement values significantly decrease with depth from the surface of the phantom until approximately 7 cm deep, and consequently no stable area of AQB placement or ROI depth exists. CONCLUSION In contrast to SWS, the same ideal acquisition depth range cannot necessarily be applied to SWDS measurements because of a significant depth dependency.
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Affiliation(s)
- Anika Obrist
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zürich, Switzerland
| | - Lisa Ruby
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zürich, Switzerland
| | - Alexander Martin
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zürich, Switzerland
| | - Thomas Frauenfelder
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zürich, Switzerland
| | - Marga Rominger
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zürich, Switzerland
| | - Catherine Paverd
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zürich, Switzerland.
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Cè M, Felisaz PF, Alì M, Re Sartò GV, Cellina M. Ultrasound elastography in chronic kidney disease: a systematic review and meta-analysis. J Med Ultrason (2001) 2023; 50:381-415. [PMID: 37186192 DOI: 10.1007/s10396-023-01304-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/07/2023] [Indexed: 05/17/2023]
Abstract
Ultrasound elastography (USE) is a noninvasive technique for assessing tissue elasticity, and its application in nephrology has aroused growing interest in recent years. The purpose of this article is to systematically review the clinical application of USE in patients with chronic kidney disease (CKD), including native and transplanted kidneys, and quantitatively investigate differences in elasticity values between healthy individuals and CKD patients. Furthermore, we provide a qualitative analysis of the studies included, discussing the potential interplay between renal stiffness, estimated glomerular filtration rate, and fibrosis. In January 2022, a systematic search was carried out on the MEDLINE (PubMed) database, concerning studies on the application of USE in patients with CKD, including patients with transplanted kidneys. The results of the included studies were extracted by two independent researchers and presented mainly through a formal narrative summary. A meta-analysis of nine study parts from six studies was performed. A total of 647 studies were screened for eligibility and, after applying the exclusion and inclusion criteria, 69 studies were included, for a total of 6728 patients. The studies proved very heterogeneous in terms of design and results. The shear wave velocity difference of - 0.82 m/s (95% CI: - 1.72-0.07) between CKD patients and controls was not significant. This result agrees with the qualitative evaluation of included studies that found controversial results for the relationship between renal stiffness and glomerular filtration rate. On the contrary, a clear relationship seems to emerge between USE values and the degree of fibrosis. At present, due to the heterogeneity of results and technical challenges, large-scale application in the monitoring of CKD patients remains controversial.
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Affiliation(s)
- Maurizio Cè
- Postgraduate School in Diagnostic and Interventional Radiology, University of Milan, Milan, Italy.
| | - Paolo Florent Felisaz
- Division of Radiology, ASST Fatebenefratelli Sacco, Fatebenefratelli Hospital, Milan, Italy
| | - Marco Alì
- Centro Diagnostico Italiano, Milan, Italy
- Bracco Imaging S.P.A., Milan, Italy
| | - Giulia Vanessa Re Sartò
- Division of Nephrology and Dialysis, ASST Fatebenefratelli Sacco, Fatebenefratelli Hospital, Milan, Italy
| | - Michaela Cellina
- Division of Radiology, ASST Fatebenefratelli Sacco, Fatebenefratelli Hospital, Milan, Italy
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Muftuoglu O, Akturk ES, Eren H, Gorurgoz C, Karasu HA, Orhan K, Akat B, Memikoglu TUT. Long-term evaluation of masseter muscle activity, dimensions, and elasticity after orthognathic surgery in skeletal class III patients. Clin Oral Investig 2023:10.1007/s00784-023-05004-3. [PMID: 37022528 DOI: 10.1007/s00784-023-05004-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 03/28/2023] [Indexed: 04/07/2023]
Abstract
OBJECTIVE To evaluate changes in the masseter muscle after orthognathic surgery using electromyography (EMG), ultrasonography (US), and ultrasound elastography (USE) in individuals with skeletal class III anomaly over long-term follow-up and compare with a control group. MATERIALS AND METHODS The study group included 29 patients with class III dentofacial deformities scheduled to undergo orthodontic treatment and orthognathic surgery. The control group included 20 individuals with dental class I occlusion. Assessment of the masseter muscles using EMG, US, and USE was performed before orthognathic surgery (T1) and at postoperative 3 months (T2) and 1 year (T3) in the study group, and at a single time point in the control group. All assessments were performed at rest and during maximum clenching. Masseter muscle activity, dimension, and hardness were analyzed. RESULTS Electromyographic activity of the masseter muscle during maximum clenching was increased at postoperative 1 year but did not reach control group values. On ultrasonography, the masseter muscle showed minimal changes in dimension at postoperative 1 year compared to preoperative values and remained below control group values. The postoperative increase in masseter muscle hardness at rest and during maximum clenching persisted at postoperative 1 year. CONCLUSION The results of this study suggest that after orthognathic surgery, additional interventions and much longer follow-up are needed to ensure better muscle adaptation to the new occlusion and skeletal morphology. CLINICAL RELEVANCE All assessment methods are useful for comprehensively evaluating changes in the masticatory muscles after orthognathic surgery.
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Affiliation(s)
- Ozge Muftuoglu
- Department of Orthodontics, Faculty of Dentistry, Ankara Medipol University, Ankara, Turkey.
| | - Ezgi Sunal Akturk
- Department of Orthodontics, Faculty of Dentistry, Bezmialem Vakif University, İstanbul, Turkey
| | - Hakan Eren
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Cansu Gorurgoz
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Bursa Uludağ University, Bursa, Turkey
| | - Hakan Alpay Karasu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ankara Medipol University, Ankara, Turkey
| | - Kaan Orhan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Bora Akat
- Department of Prosthodontics, Faculty of Dentistry, Ankara University, Ankara, Turkey
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Chen S, Yan C. Diagnostic value of ultrasound elastography combined with serological indicators in liver fibrosis in chronic hepatitis B. Biotechnol Genet Eng Rev 2023:1-11. [PMID: 36994831 DOI: 10.1080/02648725.2023.2197186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
To explore the value of ultrasound elastography combined with serological indicators in the diagnosis of liver fibrosis in chronic hepatitis B. A total of 156 patients with chronic hepatitis B from April 2020 to February 2022 were enrolled in this study as subjects. They were assigned to the liver fibrosis group (n=115) and the non-liver fibrosis group (n=41) according to whether the patients had liver fibrosis. They were divided into S1 stage (n=48), S2 stage (n=38), and S3 stage (n=29) according to histopathological staging criteria. Shear wave elastography (SWE) values, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), procollagen type III (PCIII), and laminin (LN) were compared among patients in each stage. Spearman's method was utilized to analyze the correlation of liver serum biochemical indicators and SWE value with liver fibrosis. The predictive performance of SWE value and serological indicators was analyzed using receiver operating characteristic curves. According to Spearman's method, the liver fibrosis stage was positively correlated with SWE value. Serological indicators combined with ultrasound elastography can accurately assess the degree of liver fibrosis in patients with chronic hepatitis B and provide a basis for clinical judgment.
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Affiliation(s)
- Shuxia Chen
- Department of Ultrasound in Medicine, Medical Service Community Of People's Hospital of Fenghua, Ningbo, Zhejiang, China
| | - Caoxin Yan
- Department of Ultrasound in Medicine, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, Zhejiang, China
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Qiu Z, Zheng R, Lin J, Li J, Zhai Y. Clinical Usefulness of Ultrasound Elastography in Colonic Diseases: A Narrative Review. Curr Med Imaging 2023:CMIR-EPUB-130535. [PMID: 36999184 DOI: 10.2174/1573405620666230330112422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 11/28/2022] [Accepted: 12/16/2022] [Indexed: 04/01/2023]
Abstract
Ultrasound elastography is an innovation of ultrasound technology that has developed since the 1990s. It has been successfully applied for many organs, such as the thyroid, breast, liver, prostate, and muscle systems, providing qualitative and quantitative information about tissue stiffness for clinical diagnoses. For colorectal tumors, ultrasound elastography can distinguish colon adenoma from colon adenocarcinoma and predict the chemotherapeutic effects of colon cancer by monitoring the stiffness changes of cancer tissue. In Crohn's disease, ultrasound elastography helps assess the stages of the course and guides further treatment strategies. Compared with colonoscopy, ultrasound elastography frees patients from the fears of uncomfortable procedures and enables operators to comprehensively observe the bowel wall and the surrounding structures. In this review, we introduced the principles and the pathological basis of ultrasound elastography and compared the diagnostic efficacies of colonoscopy with colonic ultrasound elastography. Meanwhile, we summarized the ultrasonography of colonic diseases and reviewed the clinical usefulness of ultrasound elastography in colonic diseases.
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Affiliation(s)
- Zhongxian Qiu
- Department of Ultrasound, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Ruoting Zheng
- Department of Ultrasound, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Jiawei Lin
- The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China, Department of Gastrointestinal surgery
| | - Jiafan Li
- Department of Ultrasound, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Yuxia Zhai
- Department of Ultrasound, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
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Ishikawa H, Muraki T, Yamamoto N, Itoi E, Izumi SI. Effect of shoulder immobilization position and activities of daily living on the stiffness of the repaired supraspinatus tendon. Clin Biomech (Bristol, Avon) 2023; 101:105856. [PMID: 36512943 DOI: 10.1016/j.clinbiomech.2022.105856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/29/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Although tension on the supraspinatus tendon may be increased by wearing an abduction brace in an improper position or activities of daily living with the operated arm in the brace, the amount of tension has not been objectively evaluated. METHODS Eighteen patients who underwent arthroscopic rotator cuff repair were enrolled. The stiffness of the repaired supraspinatus tendon was measured with ultrasound elastography to estimate the tension on the repaired tendon. Measurements were performed in 5 immobilization positions (0°, 30°, and 45° of arm elevation in the scapular plane; 30° of arm elevation in the scapular plane+60° (horizontal adduction) and -60° (horizontal abduction)) and 3 static positions simulating drinking, brushing teeth, and dressing. FINDINGS Stiffness at 30° of scapular plane elevation was lower than 0° of scapular plane elevation (P = 0.034), 30° of elevation in the scapular plane+60° (P < 0.001), and -60° (P < 0.001). There was no significant difference in the stiffness between 30° and 45° of scapular plane elevation (P = 1.000). The stiffness was the greatest at 30° of elevation in the scapular plane-60° among the 5 immobilization positions. The stiffnesses at drinking and brushing teeth were greater than 30° of scapular plane elevation (P < 0.001). INTERPRETATION Immobilization with the arm ≥30° of elevation in the scapular plane may be an optimal position for minimizing stiffness or tension on the repaired tendon. Drinking and brushing teeth may need to be performed using the non-operated arm to protect the repaired tendon.
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Affiliation(s)
- Hiroaki Ishikawa
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Takayuki Muraki
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nobuyuki Yamamoto
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan
| | - Eiji Itoi
- Department of Orthopaedic Surgery, Tohoku Rosai Hospital, Sendai, Japan
| | - Shin-Ichi Izumi
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Japan
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13
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Fleischer LT, Ballester L, Dutt M, Howarth K, Poznick L, Darge K, Furth SL, Hartung EA. Evaluation of galectin-3 and intestinal fatty acid binding protein as serum biomarkers in autosomal recessive polycystic kidney disease. J Nephrol 2023; 36:133-145. [PMID: 35980535 DOI: 10.1007/s40620-022-01416-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 07/27/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Autosomal recessive polycystic kidney disease (ARPKD) causes fibrocystic kidney disease, congenital hepatic fibrosis, and portal hypertension. Serum galectin-3 (Gal-3) and intestinal fatty acid binding protein (I-FABP) are potential biomarkers of kidney fibrosis and portal hypertension, respectively. We examined whether serum Gal-3 associates with kidney disease severity and serum I-FABP associates with liver disease severity in ARPKD. METHODS Cross-sectional study of 29 participants with ARPKD (0.2-21 years old) and presence of native kidneys (Gal-3 analyses, n = 18) and/or native livers (I-FABP analyses, n = 21). Serum Gal-3 and I-FABP were analyzed using enzyme linked immunosorbent assay. Kidney disease severity variables included estimated glomerular filtration rate (eGFR) and height-adjusted total kidney volume (htTKV). Liver disease severity was characterized using ultrasound elastography to measure liver fibrosis, and spleen length and platelet count as markers of portal hypertension. Simple and multivariable linear regression examined associations between Gal-3 and kidney disease severity (adjusted for liver disease severity) and between I-FABP and liver disease severity (adjusted for eGFR). RESULTS Serum Gal-3 was negatively associated with eGFR; 1 standard deviation (SD) lower eGFR was associated with 0.795 SD higher Gal-3 level (95% CI - 1.116, - 0.473; p < 0.001). This association remained significant when adjusted for liver disease severity. Serum Gal-3 was not associated with htTKV in adjusted analyses. Overall I-FABP levels were elevated, but there were no linear associations between I-FABP and liver disease severity in unadjusted or adjusted models. CONCLUSIONS Serum Gal-3 is associated with eGFR in ARPKD, suggesting its value as a possible novel biomarker of kidney disease severity. We found no associations between serum I-FABP and ARPKD liver disease severity despite overall elevated I-FABP levels.
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Affiliation(s)
| | - Lance Ballester
- Biostatistics and Data Management Core, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Mohini Dutt
- Division of Nephrology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Kathryn Howarth
- Division of Nephrology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Laura Poznick
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kassa Darge
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Susan L Furth
- Division of Nephrology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Erum A Hartung
- Division of Nephrology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA. .,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Zemzemi C, Phillips M, Vela DC, Hilvert NA, Racadio JM, Bader KB, Haworth KJ, Holland CK. Effect of Thrombin and Incubation Time on Porcine Whole Blood Clot Elasticity and Recombinant Tissue Plasminogen Activator Susceptibility. Ultrasound Med Biol 2022; 48:1567-1578. [PMID: 35644763 PMCID: PMC9247038 DOI: 10.1016/j.ultrasmedbio.2022.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/07/2022] [Accepted: 04/03/2022] [Indexed: 06/15/2023]
Abstract
Deep vein thrombosis is a major source of morbidity and mortality worldwide. Catheter-directed thrombolytics are the frontline approach for vessel recanalization, though fibrinolytic efficacy is limited for stiff, chronic thrombi. Although thrombin has been used in preclinical models to induce thrombosis, the effect on lytic susceptibility and clot stiffness is unknown. The goal of this study was to explore the effect of bovine thrombin concentration and incubation time on lytic susceptibility and stiffness of porcine whole blood clots in vitro. Porcine whole blood was allowed to coagulate at 37°C in glass pipets primed with 2.5 or 15 U/mL thrombin for 15 to 120 min. Lytic susceptibility to recombinant tissue plasminogen activator (rt-PA, alteplase) over a range of concentrations (3.15-107.00 µg/mL) was evaluated using percentage clot mass loss. The Young's moduli and degrees of retraction of the clots were estimated using ultrasound-based single-track-location shear wave elasticity and B-mode imaging, respectively. Percentage mass loss decreased and clot stiffness increased with the incubation period. Clots formed with 15 U/mL and incubated for 2 h exhibited properties similar to those of highly retracted clots: Young's modulus of 2.39 ± 0.36 kPa and percentage mass loss of 8.69 ± 2.72% when exposed to 3.15 µg/mL rt-PA. The histological differences between thrombin-induced porcine whole blood clots in vitro and thrombi in vivo are described.
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Affiliation(s)
- Chadi Zemzemi
- Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio, USA.
| | - Matthew Phillips
- Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Deborah C Vela
- Cardiovascular Pathology, Texas Heart Institute, Houston, Texas, USA
| | - Nicole A Hilvert
- Department of Radiology and Medical Imaging, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - John M Racadio
- Department of Radiology and Medical Imaging, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Kenneth B Bader
- Department of Radiology, University of Chicago, Chicago, Illinois, USA
| | - Kevin J Haworth
- Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio, USA; Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, USA
| | - Christy K Holland
- Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio, USA; Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, USA
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15
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Zhou K, Dodge JL, Yuan L, Terrault NA. Metabolic Risk Profiles for Hepatic Steatosis Differ by Race/Ethnicity: An Elastography-Based Study of US Adults. Dig Dis Sci 2022; 67:3340-3355. [PMID: 34173916 DOI: 10.1007/s10620-021-07124-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/16/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Most population-based studies of risk profiles for liver steatosis have relied upon serum markers (e.g., ALT or FIB-4) or ultrasound steatosis index to define cases. We sought to examine racial/ethnic differences in metabolic risk factors associated with liver steatosis and fibrosis at the population level using elastography-based measures. METHODS In total, 4509 adults completed vibration-controlled transient elastography (VCTE) with controlled attenuated parameter (CAP) examinations in the 2017-2018 National Health and Nutrition Examinations Survey. Race/ethnicity was self-identified; metabolic parameters included waist circumference, obesity, diabetes, hypertension, and hyperlipidemia. Primary outcome was steatosis defined by CAP score ≥ 280 decibels per meter and secondary outcome significant fibrosis by VCTE median stiffness ≥ 8 kilopascals. Race-specific logistic regression models were performed to assess the relationship between metabolic parameters and hepatic steatosis and fibrosis. RESULTS Prevalence of elastography-based hepatic steatosis was > 30% for all race/ethnicities. Steatosis was associated with increasing waist circumference for all race/ethnicities (OR ranging 1.7-2.3, p < 0.01). Steatosis was associated with diabetes for Whites (OR 2.4, 95% CI 1.2-4.7), Asians (OR 3.0, 1.4-6.3), and Hispanics (OR 2.2, 1.3-3.6), but not Blacks (OR 1.3, 0.8-2.2); hypertension for Whites (OR 1.7, 1.3-4.7) and Asians (OR 2.1, 1.1-3.8); and hyperlipidemia for Blacks only (OR 2.2, 1.3-3.7). Of metabolic risk factors, higher odds of fibrosis were demonstrated with higher waist circumference per 10 cm increase (OR 2.1, 1.8-2.4) and diabetes (OR 2.5, 1.6-3.7), but the effect of diabetes was present in all racial/ethnic groups except Blacks (p-interaction < 0.05). CONCLUSION Blacks have a distinct metabolic phenotype for steatosis, while Asians, Whites, and Hispanics are more similar. Racial/ethnic differences in risk profiles are important to consider in prevention, screening strategies, and interventions for fatty liver disease.
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Affiliation(s)
- Kali Zhou
- Division of Gastrointestinal and Liver Diseases, University of Southern California, 1450 San Pablo St. HC4, Room 3000, Los Angeles, CA, 90033, USA. .,Research Center for Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Jennifer L Dodge
- Division of Gastrointestinal and Liver Diseases, University of Southern California, 1450 San Pablo St. HC4, Room 3000, Los Angeles, CA, 90033, USA.,Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA.,Research Center for Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Liyun Yuan
- Division of Gastrointestinal and Liver Diseases, University of Southern California, 1450 San Pablo St. HC4, Room 3000, Los Angeles, CA, 90033, USA.,Research Center for Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Norah A Terrault
- Division of Gastrointestinal and Liver Diseases, University of Southern California, 1450 San Pablo St. HC4, Room 3000, Los Angeles, CA, 90033, USA.,Research Center for Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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16
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Mentzel HJ, Glutig K, Gräger S, Krüger PC, Waginger M. Ultrasound elastography in children - nice to have for scientific studies or arrived in clinical routine? Mol Cell Pediatr 2022; 9:11. [PMID: 35668217 PMCID: PMC9169959 DOI: 10.1186/s40348-022-00143-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 04/01/2022] [Indexed: 12/12/2022] Open
Abstract
Ultrasound elastography (USE) is a modality that in addition to fundamental B-mode, Doppler, and contrast-enhanced sonography is suitable to make qualitative and quantitative statements about the stiffness of tissues. Introduced more than 20 years ago in adults, USE becomes now a diagnostic tool also in children. The aim of this paper is to describe current available techniques for USE in children. The significance for routine use in children is shown, and further interesting applications are reported.
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Affiliation(s)
- Hans-Joachim Mentzel
- Section of Pediatric Radiology, Department of Radiology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - Katja Glutig
- Section of Pediatric Radiology, Department of Radiology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Stephanie Gräger
- Section of Pediatric Radiology, Department of Radiology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Paul-Christian Krüger
- Section of Pediatric Radiology, Department of Radiology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Matthias Waginger
- Section of Pediatric Radiology, Department of Radiology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany
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Huang M, Miller T, Fu SN, Ying MTC, Pang MYC. Structural and passive mechanical properties of the medial gastrocnemius muscle in ambulatory individuals with chronic stroke. Clin Biomech (Bristol, Avon) 2022; 96:105672. [PMID: 35617816 DOI: 10.1016/j.clinbiomech.2022.105672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 04/08/2022] [Accepted: 05/12/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study aimed to investigate the structural, morphological and passive mechanical properties of the medial gastrocnemius muscle among ambulating chronic stroke survivors using a computational model previously established in healthy individuals without stroke. METHODS Individuals with chronic stroke (n = 14, age = 63.4 ± 6.0 years) and healthy controls (n = 15, age = 59.6 ± 8.4 years) participated in the study. The mechanical properties of the medial gastrocnemius were measured during continuous passive ankle motion using ultrasound elastography and a corresponding muscle mechanical property-angle curve was estimated where slack angle and elasticity were determined. Muscle thickness, fascicle length, pennation angle, and echo intensity were also assessed using B-mode ultrasound. FINDINGS No significant differences in slack angle (paretic: -16.2° ± 6.13°, non-paretic: -16.93° ± 6.80°, p = 0.82), or slack elasticity (paretic: 4.36 ± 1.94 kPa, non-paretic: 4.54 ± 1.24 kPa, p = 0.64) were found between sides or groups. Lower muscle pennation angle (paretic: 13.6 ± 2.9°, non-paretic: 15.9 ± 2.0°, p = 0.019) and higher echo intensity (paretic: 80.5 ± 13.6, non-paretic: 63.4 ± 17.1, p = 0.003) were observed for paretic muscles. No significant between-sides differences were found for muscle thickness (paretic: 1.5 ± 0.3 cm, non-paretic: 1.6 ± 0.2 cm, p = 0.255) or fascicle length (paretic: 6.6 ± 1.9 cm, non-paretic: 7.1 ± 2.2 cm, p = 0.216). Significant between-groups difference was also observed for fascicle length [non-dominant side (control): 6.2 ± 0.8 cm, paretic side (stroke): 6.6 ± 1.9 cm, p = 0.017]. INTERPRETATION Although muscle mechanical properties increased exponentially over the slack ankle, measures between paretic and non-paretic sides were similar in ambulating participants with chronic stroke. Side-to-side differences in structural and morphological measures suggest the impact of stroke was relatively more pronounced for these muscle parameters than for passive mechanical properties.
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Affiliation(s)
- Meizhen Huang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
| | - Tiev Miller
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
| | - Siu Ngor Fu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
| | - Michael T C Ying
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong.
| | - Marco Y C Pang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
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Wang Y, Jacobson DS, Urban MW. A Non-invasive Method to Estimate the Stress-Strain Curve of Soft Tissue Using Ultrasound Elastography. Ultrasound Med Biol 2022; 48:786-807. [PMID: 35168849 PMCID: PMC8983594 DOI: 10.1016/j.ultrasmedbio.2021.12.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/16/2021] [Accepted: 12/24/2021] [Indexed: 05/03/2023]
Abstract
Ultrasound elastography performed under small strain conditions has been intensively studied. However, small deformations may be not sufficiently large to differentiate some abnormal tissues. By combining quasi-static and shear wave elastography, we developed a non-invasive method to estimate the localized stress- strain curve of materials. This method exerts progressive multistep uniaxial compression on the materials, and shear wave measurements were performed at every compression step. This method estimates the 2-D displacements between steps via a 2-D region growing motion tracking method and accumulates these displacements to obtain the large material displacements with respect to the initial configuration. At each step, the shear modulus and stress were calculated according to linear elastic theory. The proposed method was tested on custom-made tissue-mimicking phantoms. Mechanical compression testing was conducted on the samples made of the same material as the phantoms and taken as the reference. The stress-strain curves for the same material from the proposed method and from mechanical testing are in good agreement. The root mean square error (RMSE) and area percentage error (APE) of the stress-strain curve between ultrasound measurement and mechanical testing for soft materials ranged from 0.18 to 0.26 kPa and from 5.6% to 7.8%, respectively. The RMSE and APE for stiff materials ranged from 0.56 to 1.17 kPa and 8.0% to 17.9%. Therefore, our method was able to provide good estimates of the stress-strain curve for tissue-mimicking materials.
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Affiliation(s)
- Yuqi Wang
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
| | | | - Matthew W Urban
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
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19
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Roots J, Trajano GS, Fontanarosa D. Ultrasound elastography in the assessment of post-stroke muscle stiffness: a systematic review. Insights Imaging 2022; 13:67. [PMID: 35380302 PMCID: PMC8982789 DOI: 10.1186/s13244-022-01191-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/10/2022] [Indexed: 12/31/2022] Open
Abstract
Background Post-stroke muscle stiffness is a major challenge in the rehabilitation of stroke survivors, with no gold standard in clinical assessment. Muscle stiffness is typically evaluated by the Modified Ashworth Scale or the Tardieu Scale; however, these can have low reliability and sensitivity. Ultrasound elastography is an advanced imaging technology that can quantitatively measure the stiffness of a tissue and has been shown to have good construct validity when compared to clinically assessed muscle stiffness and functional motor recovery. Objective The purpose of this article is to systematically review the literature regarding the change in muscle stiffness as measured by ultrasound elastography in stroke survivors. Methods Scopus, PubMed, Embase, CINAHL, MEDLINE and Cochrane Library were searched for relevant studies that assessed the change in stiffness of post-stroke muscle stiffness measured by ultrasound elastography following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results In total, 29 articles were identified, using either strain elastography and shear wave elastography to measure the stiffness of muscles in stroke survivors, most frequently in the biceps and medial gastrocnemius muscles. The stiffness was typically higher in the paretic compared to the non-paretic or healthy control. Other variations that increased the stiffness include increasing the joint angle and introducing a passive stretch or muscle activation. The paretic muscle has also been assessed pre- and post-treatment demonstrating a decrease in stiffness. Conclusion Ultrasound elastography is a promising imaging technology for determining the muscle stiffness in stroke survivors with need for a standardized imaging protocol.
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Affiliation(s)
- Jacqueline Roots
- School of Clinical Sciences, Queensland University of Technology, Gardens Point Campus, 2 George St, Brisbane, QLD, 4000, Australia.,Centre for Biomedical Technologies (CBT), Queensland University of Technology, 2 George St, Brisbane, QLD, 4000, Australia
| | - Gabriel S Trajano
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Gardens Point Campus, 2 George St, Brisbane, QLD, 4000, Australia
| | - Davide Fontanarosa
- School of Clinical Sciences, Queensland University of Technology, Gardens Point Campus, 2 George St, Brisbane, QLD, 4000, Australia. .,Centre for Biomedical Technologies (CBT), Queensland University of Technology, 2 George St, Brisbane, QLD, 4000, Australia.
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20
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Blank J, Blomquist M, Arant L, Cone S, Roth J. Characterizing Musculoskeletal Tissue Mechanics Based on Shear Wave Propagation: A Systematic Review of Current Methods and Reported Measurements. Ann Biomed Eng 2022; 50:751-768. [PMID: 35359250 DOI: 10.1007/s10439-022-02935-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 02/11/2022] [Indexed: 12/17/2022]
Abstract
Developing methods for the non-invasive characterization of the mechanics of musculoskeletal tissues is an ongoing research focus in biomechanics. Often, these methods use the speed of shear wave propagation to characterize tissue mechanics (e.g., shear wave elastography and shear wave tensiometry). The primary purpose of this systematic review was to identify, compare, and contrast current methods for exciting and measuring shear wave propagation in musculoskeletal tissues. We conducted searches in the Web of Science, PubMed, and Scopus databases for studies published from January 1, 1900, to May 1, 2020. These searches targeted both shear wave excitation using acoustic pushes and mechanical taps, and shear wave speed measurement using ultrasound, magnetic resonance imaging, accelerometers, and laser Doppler vibrometers. Two reviewers independently screened and reviewed the articles, identifying 524 articles that met our search criteria. Regarding shear wave excitation, we found that acoustic pushes are useful for exciting shear waves through the thickness of the tissue of interest, and mechanical taps are useful for exciting shear waves in wearable applications. Regarding shear wave speed measurement, we found that ultrasound is used most broadly to measure shear waves due to its ability to study regional differences and target specific tissues of interest. The strengths of magnetic resonance imaging, accelerometers, and laser Doppler vibrometers make them advantageous to measure shear wave speeds for high-resolution shear wave imaging, wearable measurements, and non-contact ex vivo measurements, respectively. The advantages that each method offers for exciting and measuring shear waves indicate that a variety of systems can be assembled using currently available technologies to determine musculoskeletal tissue material behavior across a range of innovative applications.
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Affiliation(s)
- Jonathon Blank
- Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Matthew Blomquist
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Lesley Arant
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Stephanie Cone
- Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Joshua Roth
- Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, WI, USA. .,Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, 1111 Highland Ave WIMR 5037, Madison, WI, 53705, USA.
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Shi J, Chen L, Wang B, Zhang H, Xu L, Ye J, Liu Y, Shao Y, Sun X, Zou Y. The value of ultrasound elastography combined with multi-parameters in the diagnosis of BI-RADS4 breast lesions. Technol Health Care 2022; 30:1077-1089. [PMID: 35342064 DOI: 10.3233/thc-213272] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%) in the global cancer statistics 2020. OBJECTIVE To evaluate the diagnostic value of ultrasound elastography combined with multi-parameters in differentiating category 4 benign and malignant lesions in the breast imaging reporting and data system (BI-RADS). METHODS This study retrospectively analyzed 206 patients (213 breast lesions) who visited the Department of Breast Surgery and underwent a breast core needle biopsy in the Department of Ultrasound in Peking University First hospital from April to December 2019. The shear wave velocity (SWV) values were collected at the following locations by virtual touch tissue imaging quantification (VTIQ): breast lesion interior, breast lesion margin, surrounding glands, and surrounding fat. Simultaneously, the strain ratio (SR) of breast lesions to glands and the area ratio (AR) of breast lesions were collected under strain elastography and a two-dimensional ultrasound mode. RESULTS Univariate analysis found that the SWV value, measured by ultrasound elastography parameters, and the AR between the elasticity and the two-dimensional ultrasound breast lesions showed statistical differences when differentiating benign and malignant lesions (p< 0.05). Binary logistic regression analysis found that the SWV values of the lesion interior and the surrounding glands were statistically significant. The joint predictors were calculated and analyzed by Receiver Operating Characteristic (ROC), and it was found that the joint predictors and the SWV values of the lesion interior have great diagnostic value. The cut-off value, sensitivity and specificity of the joint predictor and the SWV value of the lesion interior were > 3.65, 88.35% and 76.36% and > 5.55 m/s, 79.61% and 82.73%, respectively. CONCLUSIONS Ultrasound elastography combined with multi-parameters has good diagnostic value in differentiating four BI-RADS4 breast lesions.
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Affiliation(s)
- Jian Shi
- Department of Ultrasound, Peking University, First Hospital, Beijing, China
| | - Luzeng Chen
- Department of Ultrasound, Peking University, First Hospital, Beijing, China
| | - Bin Wang
- Department of Ultrasound, Peking University, First Hospital, Beijing, China
| | - Hong Zhang
- Department of Pathology, Peking University, First Hospital, Beijing, China
| | - Ling Xu
- Breast Disease Center, Peking University, First Hospital, Beijing, China
| | - Jingming Ye
- Breast Disease Center, Peking University, First Hospital, Beijing, China
| | - Yinhua Liu
- Breast Disease Center, Peking University, First Hospital, Beijing, China
| | - Yuhong Shao
- Department of Ultrasound, Peking University, First Hospital, Beijing, China
| | - Xiuming Sun
- Department of Ultrasound, Peking University, First Hospital, Beijing, China
| | - Yinghua Zou
- Department of Interventional Radiology and Vascular Surgery, Peking University, First Hospital, Beijing, China
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Long H, Xu W, Zhong X, Chen Z, Su L, Duan Y, Shi Y, Xie X, Lin M. Feasibility of liver stiffness measured using two-dimensional shear wave elastography in assessing preoperative liver function for patients with hepatocellular carcinoma. Abdom Radiol (NY) 2022; 47:664-671. [PMID: 34914008 DOI: 10.1007/s00261-021-03374-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 11/28/2021] [Accepted: 11/29/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate the feasibility of liver stiffness (LS) measured using two-dimensional shear wave elastography (2D SWE) in assessing preoperative liver function for patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS A total of 143 patients who underwent surgical resection for HCC between August 2018 and December 2019 were enrolled prospectively. LS measurement, liver function tests including serum biochemical indicators, and indocyanine green (ICG) clearance test were performed preoperatively. Child-Pugh (CP) score, Albumin-bilirubin (ALBI) score and Model for End-Stage Liver Disease score were calculated. ICG retention rate at 15 min (ICG R15) and ICG elimination rate constant (ICG K) were determined automatically. Fibrosis stage was determined based on pathological findings. The association between LS and serum biochemical indicators, liver function scores, and the ICG results were analyzed. RESULTS Weak to moderate correlations were identified between LS and biochemical indicators of liver function (all p < 0.01). Weak correlation was identified between LS and CP score, and between LS and ALBI score (all p < 0.001). Moderate correlation was identified between LS and ICG R15 (Pearson r = 0.62, p < 0.001), and between LS and ICG K value (Pearson r = - 0.49, p < 0.001). The best cutoff of LS to discriminate a normal ICG R15 was 10.6 kPa, with area under the curve (AUC), sensitivity, specificity of 0.874, 0.900 and 0.724, respectively. CONCLUSIONS LS determined using 2D SWE could be a potential tool for the preoperative evaluation of liver function in patients with HCC.
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Affiliation(s)
- Haiyi Long
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China
| | - Wenxin Xu
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China
| | - Xian Zhong
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China
| | - Zebin Chen
- Center of Hepato-Pancreatico-Biliary Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China
| | - Liya Su
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China
| | - Yu Duan
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China
| | - Yifan Shi
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China
| | - Xiaoyan Xie
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China
| | - Manxia Lin
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China.
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23
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Cai D, Wu S. Efficacy of logistic regression model based on multiparametric ultrasound in assessment of cervical lymphadenopathy - a retrospective study. Dentomaxillofac Radiol 2022; 51:20210308. [PMID: 34609901 PMCID: PMC8802707 DOI: 10.1259/dmfr.20210308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES To investigate whether a multiparametric ultrasound (MPUS) diagnostic model improves differential diagnosis of benign and malignant cervical lymph nodes. METHODS MPUS evaluation was performed on 87 lesions in 86 patients, and related characteristics and parameters of the patients and lesions were studied and logistic regression models based on the MPUS characteristics of cervical lymph nodes were built. A receiver operating characteristic curve and area under the curve (AUC) were built for the evaluation of diagnostic performances. RESULTS Of the 87 lesions in 86 patients, there were 31 benign and 56 malignant lesions. Regression models for Duplex ultrasound and MPUS were established. The Duplex ultrasound regression model showed a sensitivity, specificity, positive predictive value and negative predictive value of 94.4, 61.3, 86.3 and 80.9%, respectively. The predictive accuracy was 82.4%, and the AUC was 0.861. The MPUS regression model showed a sensitivity, specificity, positive predictive value and negative predictive value of 98.1, 61.3, 81.5 and 95.0%, respectively. The predictive accuracy was 84.7%, and the AUC was 0.894. The differences in AUCs between the Duplex ultrasound model and MPUS model, ultrasound model and ultrasonic elastography (UE), and Duplex ultrasound and UE were not significant (all p > 0.05); the differences in AUCs between the MPUS model and Duplex ultrasound, Duplex ultrasound model and Duplex ultrasound, and MPUS model and UE were significant (all p < 0.05). CONCLUSIONS The Duplex ultrasound and MPUS models achieve significantly higher diagnostic performance for differentiating between benign and malignant cervical lymph nodes.
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Affiliation(s)
| | - Size Wu
- Department of Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou, China
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24
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Mora KE, Mlawer SJ, Bae AJ, Richards MS, Loiselle AE, Buckley MR. Ultrasound strain mapping of the mouse Achilles tendon during passive dorsiflexion. J Biomech 2022; 132:110920. [PMID: 34998182 PMCID: PMC10564406 DOI: 10.1016/j.jbiomech.2021.110920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 11/21/2022]
Abstract
Immediately prior to inserting into bone, many healthy tendons experience impingement from nearby bony structures. However, super-physiological levels of impingement are implicated in insertional tendinopathies. Unfortunately, the mechanisms underlying the connection between impingement and tendon pathology remain poorly understood, in part due to the shortage of well-characterized animal models of impingement at clinically relevant sites. As a first step towards developing a model of excessive tendon impingement, the objective of this study was to characterize the mechanical strain environment in the mouse Achilles tendon insertion under passive dorsiflexion and confirm that - like humans - mice experience impingement of the tendon insertion from the calcaneus (heel bone) in dorsiflexed ankle positions. Based on previous work in humans, we hypothesized that during dorsiflexion, the mouse Achilles tendon insertion would experience high levels of transverse compressive strain due to calcaneal impingement. A custom-built loading platform was used to apply passive dorsiflexion, while an ultrasound transducer positioned over the Achilles tendon captured radiofrequency images. A non-rigid image registration algorithm was then used to map the transverse compressive strain based on the acquired ultrasound image sequences. Our results demonstrate that during passive dorsiflexion, transverse compressive strains were produced throughout the Achilles tendon, with significantly larger strain magnitudes at the tendon insertion than at the midsubstance. Furthermore, there was increasing transverse compressive strain observed within the Achilles tendon as a function of increasing dorsiflexion angle. This study enhances our understanding of the unique mechanical loading environment of the Achilles tendon under physiologically relevant conditions.
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Affiliation(s)
- Keshia E Mora
- Department of Biomedical Engineering, University of Rochester, Rochester, NY 14620, USA; Center for Musculoskeletal Research, Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, NY 14620, USA.
| | - Samuel J Mlawer
- Department of Biomedical Engineering, University of Rochester, Rochester, NY 14620, USA; Center for Musculoskeletal Research, Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, NY 14620, USA
| | - Albert J Bae
- Department of Biomedical Engineering, University of Rochester, Rochester, NY 14620, USA; Center for Musculoskeletal Research, Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, NY 14620, USA
| | - Michael S Richards
- Department of Biomedical Engineering, Rochester Institute of Technology, Rochester, NY 14623, USA
| | - Alayna E Loiselle
- Department of Biomedical Engineering, University of Rochester, Rochester, NY 14620, USA; Center for Musculoskeletal Research, Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, NY 14620, USA
| | - Mark R Buckley
- Department of Biomedical Engineering, University of Rochester, Rochester, NY 14620, USA; Center for Musculoskeletal Research, Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, NY 14620, USA
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25
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Michikura M, Ogura M, Hori M, Matsuki K, Makino H, Hosoda K, Harada-Shiba M. Association between Achilles Tendon Softness and Atherosclerotic Cardiovascular Disease in Patients with Familial Hypercholesterolemia. J Atheroscler Thromb 2022; 29:1603-1612. [PMID: 35013021 DOI: 10.5551/jat.63151] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIMS Achilles tendon (AT) xanthomas are a specific physical finding of familial hypercholesterolemia (FH) and AT thickness has been used for its diagnosis and evaluation of its severity. Recently, we reported that the AT of FH patients was softer than that of non-FH patients and the combined use of a cut-off value for AT softness with that for AT thickness improved diagnostic accuracy. However, an association between AT softness and severity of atherosclerosis has not been reported. Accordingly, the present study aimed to investigate whether AT softness was associated with carotid atherosclerosis and presence of atherosclerotic cardiovascular disease (ASCVD) in FH. METHODS The AT of 176 genetically diagnosed FH patients and 98 non-FH patients was examined to measure AT thickness and the elasticity index (EI) as an indicator for assessing AT softness using ultrasonography. RESULTS Increased age was associated with AT softness, and overweight was negatively related to AT softness. There were significant inverse correlations between EI and maximum and mean intima-media thickness (IMT) within the common carotid artery only among FH patients. In multiple linear regression analysis, although the relationship between EI and mean IMT was attenuated, the association between EI and maximum IMT remained robust. In logistic regression analysis adjusted for age, sex and traditional cardiovascular risk factors (smoking history, presence of hypertension, presence of diabetes mellitus, overweight, LDL-cholesterol, HDL-cholesterol, and Log triglycerides), EI was associated with presence of ASCVD (Odds ratio per 1-SD increase, 0.37;95% CI, 0.15 - 0.86; P=0.0252). CONCLUSION The degree of lipid deposition in the AT of FH patients could be assessed by its thickness as well as its softness. AT softness is not only useful in diagnosing FH but is also associated with the severity of carotid atherosclerosis and presence of ASCVD. In addition, these findings suggest that AT softness would be helpful in risk assessment for FH patients.
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Affiliation(s)
- Masahito Michikura
- Department of Molecular Innovation in Lipidology, National Cerebral and Cardiovascular Center Research Institute.,Department of Endocrinology and Metabolism, National Cerebral and Cardiovascular Center Hospital
| | - Masatsune Ogura
- Department of Molecular Innovation in Lipidology, National Cerebral and Cardiovascular Center Research Institute.,Department of General Medical Science, Chiba University Graduate School of Medicine.,Department of Metabolism and Endocrinology, Eastern Chiba Medical Center
| | - Mika Hori
- Department of Molecular Innovation in Lipidology, National Cerebral and Cardiovascular Center Research Institute.,Department of Endocrinology, Research Institute of Environmental Medicine, Nagoya University
| | - Kota Matsuki
- Department of Molecular Innovation in Lipidology, National Cerebral and Cardiovascular Center Research Institute.,Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine
| | - Hisashi Makino
- Department of Endocrinology and Metabolism, National Cerebral and Cardiovascular Center Hospital
| | - Kiminori Hosoda
- Department of Endocrinology and Metabolism, National Cerebral and Cardiovascular Center Hospital
| | - Mariko Harada-Shiba
- Department of Molecular Innovation in Lipidology, National Cerebral and Cardiovascular Center Research Institute.,Department of Molecular Pathogenesis, National Cerebral and Cardiovascular Center Research Institute
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26
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Ding Z, Liu W, He N, Ma X, Fu L, Ye L. Value of ultrasound elastography combined with contrast-enhanced ultrasound and micro-flow imaging in differential diagnosis of benign and malignant breast lesions. Am J Transl Res 2021; 13:13941-13949. [PMID: 35035735 PMCID: PMC8748137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/19/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Breast cancer is one of the most common malignant tumors in women and shows a rising incidence at younger ages. Therefore, early diagnosis is of great significance for treatment and prognosis. This study aimed to compare the value of ultrasound elastography (UE) combined with contrast-enhanced ultrasound (CEUS) and micro-flow imaging (MFI) in differential diagnosis of benign and malignant lesions of the breast. METHODS The sonographic characteristics of UE and CEUS as well as the vascular characteristics of MFI of 109 breast lesions categorized as Breast Imaging Reporting and Data System (BI-RADS) category 4, confirmed by surgical or biopsy pathology were retrospectively analyzed. Receiver operating characteristic (ROC) curves were used to compare the diagnostic efficacy of the three examination modalities, either alone or in combination. RESULTS Of the 109 breast lesions, 78 lesions were pathologically diagnosed as malignant and 31 as benign. At diagnosis, the area under the ROC curve (AUC), sensitivity, specificity, and accuracy of UE were 0.8495, 65.38%, 83.87% and 83.34%, respectively. The AUC, sensitivity, specificity and accuracy of MFI were 86.29%, 70.51%, 87.10% and 85.56%, respectively. The AUC, sensitivity, specificity and accuracy of CEUS were 90.84%, 88.46%, 74.19% and 89.16%, respectively. The AUC, sensitivity, specificity and accuracy of the combined diagnosis of UE, MFI, and CEUS were 93.90%, 85.90%, 90.32%, and 92.07%, respectively. CONCLUSIONS The combination of UE, CEUS and MFI has the highest specificity and accuracy in the differential diagnosis of benign and malignant breast lesions compared to any one used singly.
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Affiliation(s)
- Zuopeng Ding
- Department of Ultrasound Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of ChinaHefei 230036, Anhui, China
| | - Weiyong Liu
- Department of Ultrasound Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of ChinaHefei 230036, Anhui, China
| | - Nianan He
- Department of Ultrasound Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of ChinaHefei 230036, Anhui, China
| | - Xiaopeng Ma
- Department of Breast Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of ChinaHefei 230036, Anhui, China
| | - Lili Fu
- Department of Ultrasound Medicine, Guoyang County People’s HospitalBozhou 233600, Anhui, China
| | - Lei Ye
- Department of Ultrasound Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of ChinaHefei 230036, Anhui, China
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27
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Ishikawa H, Muraki T, Morise S, Kurokawa D, Yamamoto N, Itoi E, Izumi SI. Changes in shoulder muscle activities and glenohumeral motion after rotator cuff repair: an assessment using ultrasound real-time tissue elastography. J Shoulder Elbow Surg 2021; 30:2577-2586. [PMID: 33895301 DOI: 10.1016/j.jse.2021.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 03/24/2021] [Accepted: 04/04/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Although rotator cuff repair is performed to restore the function of the rotator cuff muscles and glenohumeral (GH) joint motion, little has been known regarding the recovery process. The purpose of this study was (1) to investigate changes over time in activities of the supraspinatus and deltoid muscles assessed by ultrasound real-time tissue elastography (RTE) after rotator cuff repair and (2) to determine contributions of the activities of these muscles to the GH joint motion. METHODS Twenty patients after rotator cuff repair and 13 control participants were enrolled in this study. Elasticity of the supraspinatus and middle deltoid muscles were measured at rest and 30° of humerothoracic elevation in the scapular plane (scaption) by using RTE. The elasticity at 30° of scaption was normalized to that at rest in each muscle to quantify their muscle activities. In addition, the supraspinatus-to-middle deltoid (SSP/MD) ratio for the normalized elasticity was calculated. The GH elevation angle was measured with a digital inclinometer, which was calculated by subtracting the scapular upward rotation angle from 30° of scaption. For patients after rotator cuff repair, all measurements were performed at 6 weeks, 8 weeks, 3 months, and 6 months after surgery. Rotator cuff integrity was examined with magnetic resonance imaging at 6 months after surgery. RESULTS Fifteen of 20 patients who remained intact at 6 months after surgery completed this study. The supraspinatus activity at 6 weeks was significantly smaller than that at 3 months (P = .006) and 6 months (P = .010). There was no significant difference in the supraspinatus activity between the patients at 3 months and the control participants (P = .586). The middle deltoid activity at 6 weeks was significantly greater than that at 6 months (P = .003). There was positive correlation between GH elevation angle and the activity of the supraspinatus relative to the deltoid at 6 weeks (r = 0.75, P = .001) and 8 weeks (r = 0.53, P = .041). CONCLUSION The supraspinatus activity increased from 6 weeks to 3 months after surgery. The supraspinatus activity at 3 months after surgery was the same level as that in healthy individuals. On the other hand, the deltoid activity decreased from 6 weeks to 6 months after surgery. The increase in activity of the supraspinatus relative to the deltoid was likely to be related to the increase in GH elevation during postoperative at 8 weeks.
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Affiliation(s)
- Hiroaki Ishikawa
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Takayuki Muraki
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shuhei Morise
- Department of Rehabilitation, Sendai Medical Center, Sendai, Japan
| | - Daisuke Kurokawa
- Department of Orthopaedic Surgery, Japan Community Health Care Organization Sendai Hospital, Sendai, Japan
| | - Nobuyuki Yamamoto
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan
| | - Eiji Itoi
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan
| | - Shin-Ichi Izumi
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Japan
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28
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Bontzos G, Douglas VP, Douglas KAA, Kapsala Z, Drakonaki EE, Detorakis ET. Ultrasound Elastography in Ocular and Periocular Tissues: A Review. Curr Med Imaging 2021; 17:1041-1053. [PMID: 33319691 DOI: 10.2174/1573405616666201214123117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/31/2020] [Accepted: 10/15/2020] [Indexed: 11/22/2022]
Abstract
Ultrasound elastography has become available in everyday practice, allowing direct measurement of tissue elasticity with important and expanding clinical applications. Several studies that have evaluated pathological and non-pathological tissues have demonstrated that ultrasound elastography can actually improve the diagnostic accuracy of the underlying disease process by detecting differences in their elasticity. Ocular and periocular tissues can also be characterized by their elastic properties. In this context, a comprehensive review of literature on ultrasound elastography as well as its current applications in Ophthalmology is presented.
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Affiliation(s)
- Georgios Bontzos
- Department of Ophthalmology, University Hospital of Heraklion, Crete, Greece
| | | | | | - Zoi Kapsala
- Department of Ophthalmology, University Hospital of Heraklion, Crete, Greece
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29
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Sezgin O, Yaraş S, Özdoğan O. The course and prognostic value of increased pancreas stiffness detected by ultrasound elastography during acute pancreatitis. Pancreatology 2021; 21:1285-1290. [PMID: 34344610 DOI: 10.1016/j.pan.2021.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/03/2021] [Accepted: 07/21/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND In this study, we determined the pancreatic stiffness (PS) changes in the course of acute pancreatitis (AP) by ultrasound elastography and evaluated its relation with prognosis. MATERIAL/METHODS Pancreatic shear wave velocity measurements (SWM) were evaluated at the time of admission to the hospital, following clinical improvement, and one-month after for AP patients and compared to healthy volunteers. Its relationship with clinical severity indexes was evaluated. RESULTS The pancreatic SWM value in the healthy group was 7.72 ± 2.50 kPa, and in AP group was 10.97 ± 2.26 kPa (p = 0.000). There was no difference between mild and severe pancreatitis. The mean SWM was 8.96 ± 1.53 kPa after disease remission, and 8.83 ± 1.24 kPa after 1-month. CONCLUSIONS PS increases significantly during AP and decreases with clinical improvement, but this was still higher than controls, and it kept its elevation after 1-month. We think that larger, long-term studies are needed to determine the clinicopathological significance of this.
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Affiliation(s)
- Orhan Sezgin
- Mersin University Faculty of Medicine Gastroenterology Department, Mersin, Turkey
| | - Serkan Yaraş
- Mersin University Faculty of Medicine Gastroenterology Department, Mersin, Turkey.
| | - Osman Özdoğan
- Mersin University Faculty of Medicine Gastroenterology Department, Mersin, Turkey
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30
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Choi HH, Rodgers SK, Khurana A, Nelson LW, Kamaya A. Role of Ultrasound for Chronic Liver Disease and Hepatocellular Carcinoma Surveillance. Magn Reson Imaging Clin N Am 2021; 29:279-90. [PMID: 34243917 DOI: 10.1016/j.mric.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Ultrasound plays a vital role in the evaluation of patients with chronic liver disease and in hepatocellular carcinoma (HCC) surveillance in populations at risk for developing HCC. Semiannual ultrasound for HCC surveillance is universally recommended by all liver societies around the world. Advanced ultrasound techniques, such as elastography and contrast-enhanced ultrasound, offer additional benefits in imaging evaluation of chronic liver disease. Major benefits of ultrasound include its high safety profile and relatively low cost.
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Shao J, Shi G, Qi Z, Zheng J, Chen S. Advancements in the Application of Ultrasound Elastography in the Cervix. Ultrasound Med Biol 2021; 47:2048-2063. [PMID: 34049726 DOI: 10.1016/j.ultrasmedbio.2021.04.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 04/01/2021] [Accepted: 04/10/2021] [Indexed: 06/12/2023]
Abstract
Ultrasound elastography is a modern imaging technique that has developed rapidly in recent years. It enables objective measurement of tissue stiffness, a physical property intuitive to the human sense of touch. This novel technology has become a hotspot and plays a major role in scientific research and academic practice. Presently, ultrasound elastography has been used in the identification of benign and malignant tumors in superficial organs, such as breast and thyroid, providing clinically accurate diagnosis and treatment. The method has also been widely used for the liver, kidney, prostate, lymph nodes, blood vessels, skin and muscle system. In the application of cervical lesions, ultrasound elastography can distinguish normal cervix from abnormal cervix and differentiate benign from malignant lesions. It can significantly improve the diagnostic specificity for cervical cancer and is also useful for assessing infiltration depth and stage of cervical cancer, as well as predicting chemoradiotherapy treatment response. For cervical evaluation during pregnancy, ultrasound elastography is useful for assessing cervical softening and predicting premature delivery and outcome of induced labor. This article reviews the principles of ultrasound elastography as well as the current status and limitations in its application for cervical lesions and the cervix during pregnancy.
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Affiliation(s)
- Juntao Shao
- Department of Ultrasound, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, China.
| | - Guilian Shi
- School of Biomedical Engineering, Hubei University of Science and Technology, Xianning, Hubei Province, China
| | - Zhengqin Qi
- Department of Ultrasound, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, China
| | - Jingjing Zheng
- Department of Ultrasound, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, China
| | - Shigao Chen
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
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Manuchehri MS, Setarehdan SK. A robust time delay estimation method for ultrasonic echo signals and elastography. Comput Biol Med 2021; 136:104653. [PMID: 34304091 DOI: 10.1016/j.compbiomed.2021.104653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 12/18/2022]
Abstract
Modern medicine cannot ignore the significance of elastography in diagnosis and treatment plans. Despite improvements in accuracy and spatial resolution of elastograms, robustness against noise remains a neglected attribute. A method that can perform in a satisfactory manner under noisy conditions may prove useful for various elastography methods. Here, we propose a method based on eigenvalue decomposition (EVD). In this method, the estimated time delay is defined as the index of the maximum element in the eigenvector that corresponds to the minimum eigenvalue in the covariance matrix of the received signal. Moreover, the implementation of the least-squares (LS) solution and the lower-upper (LU) decomposition contributes to improving the speed of computation and the accuracy of the estimation under low signal-to-noise ratio (SNR) conditions. To assess the performance of the proposed algorithm, it is evaluated along with generalized cross-correlation (GCC) and EVD. The simulation results clearly confirm that the jitter variance achieved in the proposed algorithm outperforms GCC and EVD in the proximity of the Cramer-Rau lower band. Moreover, our algorithm provides satisfactory performance in terms of variance and bias against sub-sample delay at low SNRS. According to the experimental results, the calculated values of the elastographic signal-to-noise ratio (SNRe) and the elastographic contrast-to-noise ratio (CNRe) of the proposed algorithm were 16.7 and 20.09, respectively, clearly better than the values of the other two methods. Furthermore, the proposed algorithm offers less execution time (about 30% of GCC), with a computational complexity equal to GCC and better than EVD.
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Saito Y, Matsumoto N, Aizawa Y, Fukamachi D, Kitano D, Toyama K, Fujito H, Sezai A, Okumura Y. Prognostic Value of Liver Stiffness Measured by Two-Dimensional Elastography in Acute Decompensated Heart Failure with Preserved Ejection Fraction. Int Heart J 2021; 62:821-828. [PMID: 34276020 DOI: 10.1536/ihj.21-025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Liver stiffness (LS) assessed by ultrasound elastography reflects right-sided filling pressure and offers additional prognostic information in patients with acute decompensated heart failure (ADHF). However, the prognostic value of LS in heart failure (HF) with preserved ejection fraction (HFpEF) remains unclear. This study aimed to investigate the prognostic value of LS measured by two-dimensional shear wave elastography (2D-SWE) in patients with HFpEF.We prospectively enrolled 80 patients hospitalized for decompensated HFpEF between September 2019 and June 2020. Patients were categorized into three groups based on the tertile values of LS at discharge.The third tertile LS group had an older age; more advanced New York Heart Association functional class; higher total bilirubin, γ-glutamyl transferase (GGT), N-terminal pro-B type natriuretic peptide (NT pro-BNP), and Fibrosis-4 index; a larger right ventricle diastolic diameter, higher tricuspid regurgitation pressure gradient, and a larger maximal inferior vena cava diameter. During a median [interquartile range] follow-up period of 212 (82-275) days, 25 (31.2%) patients suffered composite end points (all-cause mortality and rehospitalization for worsening HF). The third tertile LS group had a significantly higher rate of composite end points (log-rank P = 0.002). A higher LS and the third tertile LS were significantly associated with the composite end points, even after adjusting for a conventional validated HF risk score and other previously reported prognostic risk factors.Increased LS measured by 2D-SWE reflects the severity of liver impairment by liver congestion and fibrosis, underlying right HF, and provides additional information for the prediction of poor outcomes in HFpEF.
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Affiliation(s)
- Yuki Saito
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Naoki Matsumoto
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine
| | - Yoshihiro Aizawa
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Daisuke Fukamachi
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Daisuke Kitano
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Kazuto Toyama
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Hidesato Fujito
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Akira Sezai
- Department of Cardiovascular Surgery, Nihon University School of Medicine
| | - Yasuo Okumura
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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Zúñiga LDO, López CAG, González ER. Ultrasound Elastography in the Assessment of the Stiffness of Spastic Muscles: A Systematic Review. Ultrasound Med Biol 2021; 47:1448-1464. [PMID: 33707090 DOI: 10.1016/j.ultrasmedbio.2021.01.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 01/22/2021] [Accepted: 01/29/2021] [Indexed: 06/12/2023]
Abstract
The incidence of muscle spasticity is high in patients with diseases of the central nervous system. This condition leads to significant limitations in movement and impaired functional capacities. Muscle spasticity manifests as changes in the mechanical properties of the muscles. This muscle disorder is generally assessed using qualitative methods, whose validity, reliability and sensitivity are questionable. In recent years, ultrasound elastography (USE) has been used as a non-invasive technique for characterizing the stress response and mechanical properties of individual muscles in the evaluation of spasticity. This article presents a systematic review of the USE techniques, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) declaration guidelines, used for the evaluation of muscle stiffness caused by spasticity. The articles selected in this study were evaluated using the Quality Appraisal of Diagnostic Reliability (QAREL) tool. Mainly, studies on the assessment of spasticity involving the evaluation of muscle stiffness with USE techniques (i.e., shear-wave elastography [SWE] or compression elastography [CE]) were selected. Then, common topics related to the assessment of spastic muscles and the statistical results of these studies were classified. Of 21 articles, nine used only CE, 10 used only SWE and two used both techniques. In the studies, statistically significant differences were observed in the measurements of muscle stiffness between the paretic and non-paretic sides as well as between patients and healthy patients. The clinical measurements obtained, devices used and assessment and probe positions for both techniques were discussed. The most frequently studied muscles were the biceps (n = 7) and gastrocnemius (n = 11). On applying the QAREL tool, we found that only two studies showed compliance at 80%-90%, seven studies at 50%-70% and the remaining 12 at 10%-40%. The results showed that USE techniques have limitations in spasticity assessment, such as subjectivity because of the lack of standardized protocols. A deficit of studies on intra-operator and inter-operator measurements indicates that this technique is not yet mature for spasticity diagnosis, although it is a promising diagnostic tool for designing treatment plans and monitoring the effectiveness of therapeutic modalities.
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Affiliation(s)
- Laura Daniela Ordierez Zúñiga
- University of Cauca, Electronics and Telecommunications Engineering Faculty, Electronics Deparment, Automation research group, Popayán, Colombia.
| | - Carlos Alberto Gaviria López
- University of Cauca, Electronics and Telecommunications Engineering Faculty, Electronics Deparment, Automation research group, Popayán, Colombia
| | - Elizabeth Roldán González
- Fundación Universitaria María Cano, Physiotherapy program, research group importance of movement of human development, Fisioter, Colombia
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Li W, Shen M, Zhang Y, Cong Y, Zu H, Chen H, Wang Y. A Model for Predicting Malignant Sub-pleural Solid Masses Using Grayscale Ultrasound and Ultrasound Elastography. Ultrasound Med Biol 2021; 47:1212-1218. [PMID: 33573845 DOI: 10.1016/j.ultrasmedbio.2021.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/13/2021] [Accepted: 01/13/2021] [Indexed: 06/12/2023]
Abstract
This article aimed to establish a prediction model of grayscale sonography and ultrasound elastography for malignant sub-pleural solid masses and evaluate its diagnostic value. The study included 153 patients, including 89 patients with malignant tumors and 64 patients with benign diseases. Statistical differences between the malignant and benign groups were found in the factors of age, air bronchogram, borderline, shape and elasticity score (p < 0.05). Age, elasticity score and borderline were effective factors for predicting malignant sub-pleural solid masses, offering an area under the receiver operating characteristic curve (AUROC) value of 0.72 (95% confidence interval [CI] 0.64-0.80), 0.73 (95% CI 0.65-0.79) and 0.70 (95% CI 0.62-0.77), respectively. The AUROC value of the prediction model for malignant sub-pleural solid masses was 0.88 (95% CI 0.81-0.92), which indicates that the prediction model was able to improve the diagnostic accuracy and that it may prove a useful auxiliary diagnostic tool for malignant sub-pleural solid masses, especially in primary health care institutions in developing countries.
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Affiliation(s)
- Wanbin Li
- Department of Ultrasonography, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China; Department of Intervention Radiology, Shanghai Fengxian District Central Hospital, Shanghai, China
| | - Mengjun Shen
- Department of Ultrasonography, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yi Zhang
- Department of Ultrasonography, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yang Cong
- Department of Ultrasonography, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Huiming Zu
- Department of Ultrasonography, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hongwei Chen
- Department of Ultrasonography, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yin Wang
- Department of Ultrasonography, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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Quarato CMI, Venuti M, Dimitri L, Lacedonia D, Simeone A, Mirijello A, Cosmo SD, Maiello E, Taurchini M, Scioscia G, Barbaro MPF, Copetti M, Sperandeo M. Transthoracic ultrasound shear wave elastography for the study of subpleural lung lesions. Ultrasonography 2021; 41:93-105. [PMID: 34218607 PMCID: PMC8696150 DOI: 10.14366/usg.21021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/15/2021] [Indexed: 11/03/2022] Open
Abstract
PURPOSE The aim of this study was to assess whether new-generation shear wave elastography (SWE) is suitable for the characterization of lung subpleural lesions. METHODS In total, 190 consecutive patients with subpleural lung lesions received ultrasonography and SWE. Patients with suspected malignancy underwent ultrasound-guided transthoracic needle biopsy. Final diagnoses were made on the basis of patients' clinical course, microbiological studies, and histological results. SWE was also performed in 25 healthy volunteers. RESULTS We found no statistically significant differences in stiffness between lung carcinomas, lung metastases, and pneumonia (P=0.296) or between different histological types of lung cancer (P=0.393). Necrosis was associated with reduced stiffness in pneumonia. Excluding necrotic lesions, pneumonia showed higher stiffness than lung carcinomas (2.95±0.68 m/s vs. 2.60±0.54 m/s, P=0.006). Chronic pneumonia showed increased stiffness (3.03±0.63 m/s), probably due to the presence of fibrotic tissue on histology. Pleural effusion was associated with a statistically significant reduction in stiffness, both in lung carcinomas (P=0.004) and lung metastases (P=0.002). The presence of air in healthy lung tissue may lead to incorrect speed estimates due to shear wave reflection (very high values, 14.64±2.19 m/s). CONCLUSION Transthoracic SWE could not distinguish lung malignancy from pneumonia, or between different histological types of lung carcinomas. In particular, SWE seems unable to resolve the clinical dilemma of chronic subpleural consolidations.
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Affiliation(s)
- Carla Maria Irene Quarato
- Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Riuniti di Foggia, University of Foggia, Foggia, Italy
| | - Mariapia Venuti
- Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Riuniti di Foggia, University of Foggia, Foggia, Italy
| | - Lucia Dimitri
- Unit of Pathology, Department of Internal Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Donato Lacedonia
- Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Riuniti di Foggia, University of Foggia, Foggia, Italy
| | - Anna Simeone
- Department of Radiology, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Antonio Mirijello
- Department of Internal Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Salvatore De Cosmo
- Department of Internal Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Evaristo Maiello
- Unit of Oncology, Department of Internal Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Marco Taurchini
- Unit of Thoracic Surgery, Department of Internal Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Giulia Scioscia
- Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Riuniti di Foggia, University of Foggia, Foggia, Italy
| | - Maria Pia Foschino Barbaro
- Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Riuniti di Foggia, University of Foggia, Foggia, Italy
| | - Massimiliano Copetti
- Unit of Biostatistics, Department of Internal Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Marco Sperandeo
- Unit of Interventional and Diagnostic Ultrasound, Department of Internal Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
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Idobe-Fujii Y, Omoso R, Fujii S, Fujiwara H, Nakamura Y, Nomi T, Sasaki Y, Sasaki H, Isomoto H, Murawaki Y. Normal values of combinational elastography in adult liver: the influence of age. J Med Ultrason (2001) 2021; 48:207-213. [PMID: 33651239 DOI: 10.1007/s10396-021-01082-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 02/12/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE We aimed to clarify the normal values obtained by simultaneous use of shear wave imaging and strain imaging (combinational elastography) in liver and reveal how aging influences them. METHODS In our checkup center, 257 examinees were diagnosed with normal liver based on questionnaires about liver disease and their drinking history, liver function test results, and ultrasound B-mode study findings. We estimated the values of combinational elastography and considered the correlation between the values and age. A multivariate analysis was performed concerning several features and the liver fibrosis (LF) index. We divided examinees into a younger group (< 65 years old) and an older group (≥ 65 years old), and assessed the effect of age on the LF index. RESULTS The mean shear wave velocity (Vs) of shear wave measurement (SWM) was 1.10 ± 0.17 m/s (range 0.84-1.93), and the mean LF index of real-time tissue elastography (RTE) was 1.371 ± 0.458 (range 0.258-3.173). There was no significant correlation between Vs and age. However, the LF index increased significantly with age. The multivariate analysis showed that age (P < 0.001) and BMI (P < 0.05) significantly affected the LF index. Indeed, the LF index in the older group was significantly higher than that in the younger group (P < 0.001). CONCLUSION In adult liver, the normal Vs of SWM was 1.10 ± 0.17 m/s, and the normal LF index of RTE was 1.371 ± 0.458. The LF index increased significantly with age in contrast to Vs; therefore, the influence of age should be considered when using combinational elastography.
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Affiliation(s)
- Yoko Idobe-Fujii
- Checkup Center, Saiseikai Sakaiminato General Hospital, 44 Yonegawa-cho, Sakaiminato, Tottori, 684-8555, Japan.
| | - Ryoko Omoso
- Clinical Laboratory, Saiseikai Sakaiminato General Hospital, Tottori, Japan
| | - Shinya Fujii
- Division of Radiology, Department of Multidisciplinary Internal Medicine, Tottori University Faculty of Medicine, Tottori, Japan
| | - Hiromitsu Fujiwara
- Clinical Laboratory, Saiseikai Sakaiminato General Hospital, Tottori, Japan
| | - Yuki Nakamura
- Department of Gastroenterology, Saiseikai Sakaiminato General Hospital, Tottori, Japan
| | - Takahiro Nomi
- Department of Gastroenterology, Saiseikai Sakaiminato General Hospital, Tottori, Japan
| | - Yuichiro Sasaki
- Department of Gastroenterology, Saiseikai Sakaiminato General Hospital, Tottori, Japan
| | - Hiroyuki Sasaki
- Checkup Center, Saiseikai Sakaiminato General Hospital, 44 Yonegawa-cho, Sakaiminato, Tottori, 684-8555, Japan
| | - Hajime Isomoto
- Division of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, Tottori University Faculty of Medicine, Tottori, Japan
| | - Yoshikazu Murawaki
- Department of Gastroenterology, Saiseikai Sakaiminato General Hospital, Tottori, Japan
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Muršić M, Sjekavica I, Šimunović M, Ježek D. THE ROLE OF ULTRASOUND ELASTOGRAPHY IN THE DIAGNOSIS OF PATHOLOGIC CONDITIONS OF TESTICLES AND SCROTUM. Acta Clin Croat 2021; 60:41-49. [PMID: 34588720 PMCID: PMC8305351 DOI: 10.20471/acc.2021.60.01.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 12/06/2020] [Indexed: 11/24/2022] Open
Abstract
Several years ago, elastography emerged as a potentially very useful ultrasound technique that is currently used in diagnostic workup of the breast, liver and some other organ systems, whereas for other ones it is still mainly in the phase of research. The aim of the study was to compare elasticity index (EI) of testicles using strain elastography in healthy subjects and those with pathologic changes of testicles/scrotum. A total of 117 patients were included in the study. Measurements were performed on a Logiq E9 ultrasound system using strain elastography. In healthy subjects, the mean EI value was 1.34±0.35 for right testis and 1.49±0.47 for left testis. Increased mean EI values were found in the following six conditions: patients with varicocele, infertile patients, solitary testis after orchidectomy of the other testicle because of tumor, patients with testicular tumors, patients after orchidopexy of undescended testicle, and patients with congenitally smaller testicle. There is a paucity of literature data on the use of elastography in testes, as well as on normal elastography values in testicular tissue. Strain elastography was demonstrated to be a valuable method to acquire additional information in patients with pathologic changes in testicles/scrotum. These data provide reference values for further research in a larger sample of subjects.
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Affiliation(s)
| | - Ivica Sjekavica
- 1Department of Diagnostic and Interventional Radiology, Zagreb University Hospital Centre, Zagreb, Croatia; 2University of Zagreb, School of Medicine, Zagreb, Croatia; 3Department of Transfusion Medicine and Transplantation Biology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Marko Šimunović
- 1Department of Diagnostic and Interventional Radiology, Zagreb University Hospital Centre, Zagreb, Croatia; 2University of Zagreb, School of Medicine, Zagreb, Croatia; 3Department of Transfusion Medicine and Transplantation Biology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Davor Ježek
- 1Department of Diagnostic and Interventional Radiology, Zagreb University Hospital Centre, Zagreb, Croatia; 2University of Zagreb, School of Medicine, Zagreb, Croatia; 3Department of Transfusion Medicine and Transplantation Biology, Zagreb University Hospital Centre, Zagreb, Croatia
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Hartung EA, Calle-Toro JS, Lopera CM, Wen J, Carson RH, Dutt M, Howarth K, Furth SL, Darge K, Serai SD. Magnetic resonance elastography to quantify liver disease severity in autosomal recessive polycystic kidney disease. Abdom Radiol (NY) 2021; 46:570-80. [PMID: 32757071 DOI: 10.1007/s00261-020-02694-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/30/2020] [Accepted: 07/25/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To evaluate whether liver and spleen magnetic resonance elastography (MRE) can measure the severity of congenital hepatic fibrosis (CHF) and portal hypertension (pHTN) in individuals with autosomal recessive polycystic kidney disease (ARPKD), and to examine correlations between liver MRE and ultrasound (US) elastography. METHODS Cross-sectional study of nine individuals with ARPKD and 14 healthy controls. MRE was performed to measure mean liver and spleen stiffness (kPa); US elastography was performed to measure point shear wave speed (SWS) in both liver lobes. We compared: (1) MRE liver and spleen stiffness between controls vs. ARPKD; and (2) MRE liver stiffness between participants with ARPKD without vs. with pHTN, and examined correlations between MRE liver stiffness, spleen length, platelet counts, and US elastography SWS. Receiver operating characteristic (ROC) analysis was performed to examine diagnostic accuracy of liver MRE. RESULTS Participants with ARPKD (median age 16.8 [IQR 13.3, 18.9] years) had higher median MRE liver stiffness than controls (median age 14.7 [IQR 9.7, 16.7 years) (2.55 vs. 1.92 kPa, p = 0.008), but MRE spleen stiffness did not differ. ARPKD participants with pHTN had higher median MRE liver stiffness than those without (3.60 kPa vs 2.49 kPa, p = 0.05). Liver MRE and US elastography measurements were strongly correlated. To distinguish ARPKD vs. control groups, liver MRE had 78% sensitivity and 93% specificity at a proposed cut-off of 2.48 kPa [ROC area 0.83 (95% CI 0.63-1.00)]. CONCLUSION Liver MRE may be a useful quantitative method to measure the severity of CHF and pHTN in individuals with ARPKD.
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Lin Y, Liu Y, Jiang B, Li W, Li H, Wang H. Application of Hepatic Transit Time and Shear Wave Velocity in Assessing Portal Pressure in Patients with Cirrhotic Portal Hypertension. Ultrasound Med Biol 2021; 47:272-278. [PMID: 33153804 DOI: 10.1016/j.ultrasmedbio.2020.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/30/2020] [Accepted: 10/01/2020] [Indexed: 06/11/2023]
Abstract
The aim of the study described here was to explore the value of hepatic transit time (HTT) and shear wave velocity (SWV) in diagnosing cirrhotic portal hypertension. Fifty-seven patients had undergone esophagogastric varicose vein embolization (group OBS) and 50 healthy controls (group CON) were retrospectively compared with respect to HTT (arterial-hepatic vein [HA-HVTT], portal vein-hepatic vein [PV-HVTT], liver parenchyma-hepatic vein [PA-HVTT]) and SWV to analyze their efficacy in diagnosing cirrhotic portal hypertension. The correlations between SWV/HTT and free portal pressure (FPP) in group OBS were also analyzed. Compared with group CON, group OBS had a shorter HTT and faster SWV. The area under the curve (AUC) of PV-HVTT (0.93) was higher than those of HA-HVTT (0.75) and PA-HVTT (0.64), the AUCs of PV-HVTT (0.93, threshold 7.9 s) and SWV (0.91, threshold 2.0 cm/s) did not statistically differ (z = 0.35, p = 0.73). HTT and FPP in group OBS had a negative correlation. In conclusion, HTT and SWV can be used to diagnose cirrhotic portal hypertension without difference in diagnostic efficacy, and HTT is more meaningful for assessing the changes in portal pressure.
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Affiliation(s)
- Yuanqiang Lin
- Department of Ultrasound, China-Japan Union Hospital, Jilin University, Changchun, Jilin, China
| | - Yan Liu
- Department of Ultrasound, China-Japan Union Hospital, Jilin University, Changchun, Jilin, China
| | - Bo Jiang
- Department of General Surgery, Nanhu District, China-Japan Union Hospital, Jilin University, Changchun, Jilin, China
| | - Wenhui Li
- Department of Ultrasound, China-Japan Union Hospital, Jilin University, Changchun, Jilin, China
| | - Hequn Li
- Department of Ultrasound, China-Japan Union Hospital, Jilin University, Changchun, Jilin, China
| | - Hui Wang
- Department of Ultrasound, China-Japan Union Hospital, Jilin University, Changchun, Jilin, China.
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Wang Y, Wu X, Li J, Chen J, Tan H, Sun L, Lu M. Diagnostic performance of combination of ultrasound elastography and BRAF gene detection in malignant thyroid nodule: a retrospective study. Int J Clin Exp Pathol 2020; 13:2962-2972. [PMID: 33425097 PMCID: PMC7791383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/30/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES The aims of our study were to explore the preoperative diagnostic value of ultrasound elastography combined with BRAF gene detection in malignant thyroid nodule, and find whether shear wave elastography (SWE) combined with BRAF gene detection can improve the diagnostic sensitivity and specificity. METHODS From 1480 patients with thyroid nodule examined between January 2015 and December 2017, a retrospective analysis was performed on 161 patients who underwent thyroidectomy. Diagnosis was confirmed by postoperative pathology, including 139 malignant thyroid nodules and 22 benign thyroid nodules. All the patients underwent SWE, BRAF gene detection, and the combination for their preoperative evaluation. The sensitivities, specificities, and accuracies of SWE, BRAF gene detection, and the combination for detection of malignant thyroid nodules were calculated and then compared using Fisher's exact probability test, based on the original preoperative reports and postoperative pathology. A receiver-operating characteristic curve analysis was performed to compare the diagnostic performance of SWE, BRAF gene detection, and combination for detecting malignant thyroid nodules. RESULTS Based on the original preoperative reports and postoperative pathology, SWE, BRAF gene detection, and the combination showed sensitivities of 88.67%, 78.41%, 92.8%, and specificities of 72.77%, 77.27%, 95.45%. A correct diagnosis was obtained in 85.82%, 78.26%, 93.16% and missed diagnosis rates were 12.23%, 21.58%, and 7.19%. The sensitivities, specificities, and correct diagnosis rate in the combination group were significantly higher than any single detection method (P<0.05). The missed diagnosis rate in the combination group was significantly lower than any single detection method (P<0.05). The receptor operating characteristics curve analysis showed a significantly higher diagnostic performance for the combination than for SWE and BRAF gene detection (P<0.05). The interobserver agreement for detecting malignant thyroid nodule was better for the combination than for SWE or BRAF gene detection alone. CONCLUSION For the detection of a malignant thyroid nodule, SWE combined with BRAF gene detection was more sensitive and showed a higher diagnostic performance than SWE or BRAF gene detection alone.
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Affiliation(s)
- Yuguo Wang
- Department of Ultrasound, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese MedicineNanjing 210028, China
| | - Xinping Wu
- Department of Ultrasound, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese MedicineNanjing 210028, China
| | - Jie Li
- Department of Ultrasound, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese MedicineNanjing 210028, China
| | - Jing Chen
- Department of Ultrasound, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese MedicineNanjing 210028, China
| | - Huafeng Tan
- Department of General Surgery, Nanjing Lishui District Hospital of Traditional Chinese MedicineNanjing 211200, China
| | - Liang Sun
- Department of Ultrasound, Nanjing Lishui District Hospital of Traditional Chinese MedicineNanjing 211200, China
| | - Min Lu
- Department of Digestive, Nanjing Lishui District Hospital of Traditional Chinese MedicineNanjing 211200, China
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Liu X, Wang Y, Zhang P, Wang Q, Feng Q, Chen W. Radial Motion Estimation of Myocardium in Rats with Myocardial Infarction: A Hybrid Method of FNCCGLAM and Polar Transformation. Ultrasound Med Biol 2020; 46:3413-3425. [PMID: 32921512 DOI: 10.1016/j.ultrasmedbio.2020.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 06/28/2020] [Accepted: 08/09/2020] [Indexed: 06/11/2023]
Abstract
Ultrasound elastography is a novel approach of evaluating regional myocardial systolic function and detecting infarcted area. This study aims to evaluate the radial motion of myocardial infarction (MI) area in left ventricular parasternal short axis (PSAX) view using a hybrid method of fast normalized cross-correlation and global analytic minimization (FNCCGLAM) and polar transformation. Fifteen rats were randomly selected for sham group, MI group and ischemia-reperfusion (IR) group (N = 5 for each group). The ultrasound radiofrequency data of the PSAX view of rat heart were acquired. After polar transformation of the data, the infarcted myocardium with the change of mechanical property was tracked over one myocardial systolic phase by the proposed method in comparison with fast normalized cross-correlation (FNCC) and dynamic programming analytic minimization (DPAM). To obtain a clear visualization of the myocardium, the inverse polar transformation was performed. The results indicated that the use of FNCCGLAM refined the myocardial displacements to obtain high-quality myocardial elastographic map with a higher contrast-to-noise ratio and dynamically tracked the infarcted myocardial segment with a higher success rate in comparison with FNCC and DPAM. It was found that the radial systolic motion of the infarcted anterior segment in the MI group reduced significantly (p < 0.05) in comparison with the sham group, while the systolic function of that myocardial segment in the IR group recovered at some extent. The results in this study suggest that FNCCGLAM is superior to FNCC and DPAM with the improved accuracy and robustness of motion estimation and has potentials as displacement estimator in ultrasound elastography.
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Affiliation(s)
- Xiaomin Liu
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
| | - Yinong Wang
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
| | - Peizhen Zhang
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
| | - Qing Wang
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China; Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou 510515, China.
| | - Qianjin Feng
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China; Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou 510515, China
| | - Wufan Chen
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China; Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou 510515, China
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Ma Y, Kwok S, Sun J, Pan X, Pavlatos E, Clayson K, Hazen N, Liu J. IOP-induced regional displacements in the optic nerve head and correlation with peripapillary sclera thickness. Exp Eye Res 2020; 200:108202. [PMID: 32861767 PMCID: PMC7655654 DOI: 10.1016/j.exer.2020.108202] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 08/13/2020] [Accepted: 08/25/2020] [Indexed: 12/30/2022]
Abstract
Mechanical insult induced by intraocular pressure (IOP) is likely a driving force in the disease process of glaucoma. This study aimed to evaluate regional displacements in human optic nerve head (ONH) and peripapillary tissue (PPT) in response to acute IOP elevations, and their correlations with morphological characteristics of the posterior eye. Cross-sectional (2D) images of the ONH and PPT in 14 globes of 14 human donors were acquired with high-frequency ultrasound during whole globe inflation from 5 to 30 mm Hg. High-frequency ultrasound has a spatial resolution of tens of micrometers and is capable of imaging through the ONH and PPT thickness. Tissue displacements were calculated using a correlation-based speckle tracking algorithm for a dense matrix of kernels covering the 2D imaging plane. The ONH was manually segmented in the ultrasound B-mode images acquired at 5 mmHg based on echogenicity. The lamina cribrosa (LC) boundaries were visible in eight of the fourteen eyes and the LC region was segmented using a semi-automated superpixel-based method. The ONH had larger radial displacement than the PPT in all tested eyes and the difference increased with increasing IOP. A significant negative correlation was found between ONH-PPT displacement difference and PPT thickness (p < 0.05), while no significant correlations were found between ONH-PPT displacement difference and other morphological parameters including PPT radius of curvature, scleral canal size, LC thickness and anterior LC surface depth. Within the ONH, the radial displacement decreased in the region anterior to and across LC but not in the region posterior to LC. Finite element models using simplified geometry and material properties confirmed the role of LC in reducing the overall ONH radial displacements, but did not predict the displacement gradient change observed experimentally. These results suggested that a thinner PPT may be associated with a larger relative posterior motion of the ONH with respect to the surrounding PPT and the LC may play a major role in preventing excessive posterior displacement of ONH during acute IOP elevations.
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Affiliation(s)
- Yanhui Ma
- Department of Biomedical Engineering, Ohio State University, Columbus, OH, USA
| | - Sunny Kwok
- Department of Biomedical Engineering, Ohio State University, Columbus, OH, USA
| | - Jiajun Sun
- Department of Biomedical Engineering, Ohio State University, Columbus, OH, USA
| | - Xueliang Pan
- Department of Biomedical Informatics, Ohio State University, Columbus, OH, USA
| | - Elias Pavlatos
- Department of Biomedical Engineering, Ohio State University, Columbus, OH, USA
| | - Keyton Clayson
- Department of Biomedical Engineering, Ohio State University, Columbus, OH, USA; Biophysics Interdisciplinary Group, Ohio State University, Columbus, OH, USA
| | - Nicholas Hazen
- Department of Biomedical Engineering, Ohio State University, Columbus, OH, USA; Biophysics Interdisciplinary Group, Ohio State University, Columbus, OH, USA
| | - Jun Liu
- Department of Biomedical Engineering, Ohio State University, Columbus, OH, USA; Biophysics Interdisciplinary Group, Ohio State University, Columbus, OH, USA; Department of Ophthalmology and Visual Science, Ohio State University, Columbus, OH, USA.
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Fang J, Zhao W, Li Q, Zhang B, Pu C, Wang H. Correlation Analysis of Conventional Ultrasound Characteristics and Strain Elastography with Ki-67 Status in Breast Cancer. Ultrasound Med Biol 2020; 46:2972-2978. [PMID: 32768322 DOI: 10.1016/j.ultrasmedbio.2020.06.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 06/12/2020] [Accepted: 06/30/2020] [Indexed: 06/11/2023]
Abstract
Our objectives were to measure the relationships between conventional ultrasound features, strain elastography in breast cancer and Ki-67 index and to identify parameters that predict Ki-67 index. We included 181 lesions of 178 patients who underwent surgery for breast cancer at Xianyang Central Hospital. In multivariate logistic regression analysis, strain elastography and axillary-node metastasis showed significant Ki-67 index values; the overall theoretical prediction percentage correct was 75.7%. Strain elastography showed that the median Ki-67 index in the hard group was higher than that in the soft group, and the Ki-67 index increased with increasing elasticity score. This finding may guide ultrasound-guided breast tumor biopsy for selection of puncture regions. The combined use of the Ki-67 index for strain-elastography prediction and puncture-biopsy pathology reports may increase the accuracy of clinical treatment.
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Affiliation(s)
- Jianqiang Fang
- Department of Interventional Ultrasound, Xianyang Central Hospital, Xianyang, Shaanxi, China
| | - Weian Zhao
- Department of Interventional Ultrasound, Xianyang Central Hospital, Xianyang, Shaanxi, China
| | - Qing Li
- Department of Interventional Ultrasound, Xianyang Central Hospital, Xianyang, Shaanxi, China
| | - Binyu Zhang
- Department of Interventional Ultrasound, Xianyang Central Hospital, Xianyang, Shaanxi, China
| | - Cui Pu
- Department of Interventional Ultrasound, Xianyang Central Hospital, Xianyang, Shaanxi, China
| | - Hao Wang
- Department of Orthopedics, Xianyang Central Hospital, Xianyang, Shaanxi, China.
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Zhou H, Yan H, Yan W, Wang X, Li Q. In vivo ultraosound elastographic evaluation of the age-related change of human lens nuclear stiffness. BMC Ophthalmol 2020; 20:135. [PMID: 32252697 DOI: 10.1186/s12886-020-01404-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 03/25/2020] [Indexed: 11/26/2022] Open
Abstract
Background To evaluate the age-related changes in the stiffness of the human lens nucleus in vivo. Methods A total of 78 volunteers with best-corrected visual acuity of 20/20with a mean ± standard deviation intraocular pressure (IOP) of 16 ± 2.5 mmHg were divided into 3 groups of 26. The mean ages of Groups A, B and C were 81 ± 5.5, 44 ± 3.2 and 21 ± 2.5 years, with mean axial lengths of 23.8 ± 0.5 mm, 23.8 ± 0.4 mm and 23.9 ± 0.3 mm, respectively. Using an elastographer, the ultrasound echolucency and elastic strain rate of the lens nucleus of one eye, selected randomly, of each subject were measured three times. The strain rate of the lens cortex could not be assessed. The qualitative differences in the strain rates across the groups were assessed, and differences in the strain rate ratios of the lens nuclei across groups were analysed by one-way ANOVA. Results The strain rates of the lens nuclei of Group A were much lower than those in Groups B and C, as assessed qualitatively; the elastograph images of the lens nuclei of the older group showed a blue colour.The strain rate ratios of the lens nuclei of Groups A, B and C were 0.02 ± 0.08, 0.69 ± 0.12 and 1.95 ± 0.85, respectively. The differences in the lens nucleus strain rate ratios across the groups were statistically significant, with p-values < 0.05. Conclusions Ultrasound elastography demonstrated in vivo that an older age is associated with a statistically significantly lower lens nucleus strain rate ratio and therefore a markedly higher lens nuclear stiffness.
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Mirzaei M, Asif A, Fortin M, Rivaz H. 3D normalized cross-correlation for estimation of the displacement field in ultrasound elastography. Ultrasonics 2020; 102:106053. [PMID: 31790861 DOI: 10.1016/j.ultras.2019.106053] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 07/30/2019] [Accepted: 10/14/2019] [Indexed: 06/10/2023]
Abstract
This paper introduces a novel technique to estimate tissue displacement in quasi-static elastography. A major challenge in elastography is estimation of displacement (also referred to time-delay estimation) between pre-compressed and post-compressed ultrasound data. Maximizing normalized cross correlation (NCC) of ultrasound radio-frequency (RF) data of the pre- and post-compressed images is a popular technique for strain estimation due to its simplicity and computational efficiency. Several papers have been published to increase the accuracy and quality of displacement estimation based on NCC. All of these methods use 2D spatial windows in RF data to estimate NCC, wherein displacement is assumed to be constant within each window. In this work, we extend this assumption along the third dimension. Two approaches are proposed to get third dimension. In the first approach, we use temporal domain to exploit neighboring samples in both spatial and temporal directions. Considering temporal information is important since traditional and ultrafast ultrasound machines are, respectively, capable of imaging at more than 30 frame per second (fps) and 1000 fps. Another approach is to use time-delayed pre-beam formed data (channel data) instead of RF data. In this method information of all channels that are recorded as pre-beam formed data of each RF line will be considered as 3rd dimension. We call these methods as spatial temporal normalized cross correlation (STNCC) and channel data normalized cross correlation (CNCC) and show that they substantially outperforms NCC using simulation, phantom and in-vivo experiments. Given substantial improvements of results in addition to the relative simplicity of implementing STNCC and CNCC, the proposed approaches can potentially have a large impact in both academic and commercial work on ultrasound elastography.
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Affiliation(s)
- Morteza Mirzaei
- Department of Electrical and Computer Engineering, Concordia University, Montreal, Quebec, Canada.
| | - Amir Asif
- Department of Electrical and Computer Engineering, Concordia University, Montreal, Quebec, Canada
| | - Maryse Fortin
- PERFORM Centre, Concordia University, Montreal, Quebec, Canada
| | - Hassan Rivaz
- Department of Electrical and Computer Engineering, Concordia University, Montreal, Quebec, Canada; PERFORM Centre, Concordia University, Montreal, Quebec, Canada
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Miller DL, Dong Z, Dou C, Patterson B, Raghavendran K. Pulmonary Capillary Hemorrhage Induced by Super Sonic Shear Wave Elastography in Rats. Ultrasound Med Biol 2019; 45:2993-3004. [PMID: 31412979 PMCID: PMC6768750 DOI: 10.1016/j.ultrasmedbio.2019.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/20/2019] [Accepted: 07/06/2019] [Indexed: 05/05/2023]
Abstract
The occurrence of the pulmonary capillary hemorrhage (PCH) bioeffect of diagnostic ultrasound in rats was investigated for a SuperSonic Imagine shear wave elastography system (Aixplorer, Supersonic Imagine, Aix-en-Provence, France). The elastography imaging repeated at 1 Hz and consisted of widely spaced B-mode image pulses, supersonic push (SSP) pulses and shear wave imaging (SWI) pulses. Groups of rats anesthetized with ketamine and xylazine, or with ketamine only, were imaged on their right side in a warm water bath for one frame, 30 s and 300 s. The image focus and region of interest were adjusted to give exposure only with the background B-mode imaging, or primarily with the SSP and SWI pulses. A sham group had only low power aiming scans. The lungs were removed 5 min after exposure and evaluated for PCH area and volume. The B mode was notably ineffective and produced significant PCH only at the maximum 0 dB output. The SSP pulses together with the SWI pulses produced significant PCH for 300 s, 30 s and even single image exposures. Peak rarefactional pressure amplitude PCH thresholds for 300 s exposure were the same with or without the B-mode pulses at 1.5 MPa (in situ mechanical index, MIIS = 0.67). A 30 s duration resulted in a slightly increased threshold of 1.7 MPa (MIIS = 0.76). The omission of xylazine from the anesthetic, which reduces the sensitivity of rat lung to PCH occurrence, resulted in an increased threshold of 2.1 MPa (MIIS = 0.94). The unique SSP pulses were much more effective than the B mode, but thresholds were comparable to previous results with other diagnostic ultrasound modes on other systems.
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Affiliation(s)
- Douglas L Miller
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.
| | - Zhihong Dong
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Chunyan Dou
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Brandon Patterson
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
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Huang D, Lin T, Wang S, Cheng L, Xie L, Lu Y, Chen M, Zhu L, Shi J. The liver fibrosis index is superior to the APRI and FIB-4 for predicting liver fibrosis in chronic hepatitis B patients in China. BMC Infect Dis 2019; 19:878. [PMID: 31640590 PMCID: PMC6805580 DOI: 10.1186/s12879-019-4459-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 09/10/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The purpose of this study was to prospectively investigate the value of real-time ultrasound elastography (RTE) for the diagnosis of liver fibrosis (LF) in patients with chronic hepatitis B (CHB), to correlate the elastography findings with the histologic stage of LF and to compare RTE findings with those from noninvasive tests of LF calculated using laboratory blood parameters. METHODS Liver biopsies, laboratory blood testing, and RTE were performed in 91 patients with CHB. The LF index (LFI) was calculated using a multiple linear regression equation involving 11 parameters, which represented the degree of LF. The higher the LFI is, the greater the degree of LF. RESULTS The mean aspartate aminotransferase-to-platelet ratio index (APRI) and the mean fibrosis index based on four factors (FIB-4) were significantly different for the 5 stages of LF, respectively. The APRI (r = 0.43, P = 0.006), FIB-4 (r = 0.51, P = 0.012) and LFI (r = 0.562, P = 0.004) were correlated with the stages of LF. For discriminating stage F0 from F1, only the LFI had significant power (P = 0.026) for predicting stage F1. For discriminating stage F4 from F3, only the LFI had statistically significant power (P = 0.024) in predicting stage F4. The areas under the receiver operating characteristic curves (AUCs) of the LFI for diagnosing significant, advanced LF and liver cirrhosis were significantly higher than those of the APRI and FIB-4, and the LFI had better sensitivity and specificity. CONCLUSIONS The LFI calculated by RTE is reliable for the assessment of LF in patients with CHB and has better discrimination power than the APRI and FIB-4.
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Affiliation(s)
- Dedong Huang
- Department of Infectious Diseases, the 903rd Hospital of PLA, Hangzhou, China
| | - Taofa Lin
- Department of Infectious Diseases, the 900th Hospital of PLA, No.156 North Road West 2nd Ring Road, Fuzhou, 350013, China
| | - Shaoyang Wang
- Department of Infectious Diseases, the 900th Hospital of PLA, No.156 North Road West 2nd Ring Road, Fuzhou, 350013, China. .,Clinical educational Institute of the 900th Hospital of PLA affiliated Fujian Medical University, No.156 North Road West 2nd Ring Road, Fuzhou, 350013, China.
| | - Lieyun Cheng
- Department of ultrasound, the 900th Hospital of PLA, Fuzhou, China
| | - Liping Xie
- Department of Infectious Diseases, the 900th Hospital of PLA, No.156 North Road West 2nd Ring Road, Fuzhou, 350013, China
| | - Youguang Lu
- Department of Infectious Diseases, the 900th Hospital of PLA, No.156 North Road West 2nd Ring Road, Fuzhou, 350013, China
| | - Muxing Chen
- Department of Infectious Diseases, the 900th Hospital of PLA, No.156 North Road West 2nd Ring Road, Fuzhou, 350013, China
| | - Lingling Zhu
- Department of Infectious Diseases, the 900th Hospital of PLA, No.156 North Road West 2nd Ring Road, Fuzhou, 350013, China
| | - Jie Shi
- Department of Infectious Diseases, the 903rd Hospital of PLA, Hangzhou, China
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