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Haueise A, Le Sant G, Eisele-Metzger A, Dieterich AV. Is musculoskeletal pain associated with increased muscle stiffness? Evidence map and critical appraisal of muscle measurements using shear wave elastography. Clin Physiol Funct Imaging 2024; 44:187-204. [PMID: 38155545 DOI: 10.1111/cpf.12870] [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: 06/06/2023] [Revised: 11/13/2023] [Accepted: 12/20/2023] [Indexed: 12/30/2023]
Abstract
INTRODUCTION AND AIMS Approximately 21% of the world's population suffers from musculoskeletal conditions, often associated with sensations of stiff muscles. Targeted therapy requires knowing whether typically involved muscles are objectively stiffer compared to asymptomatic individuals. Muscle stiffness is quantified using ultrasound shear wave elastography (SWE). Publications on SWE-based comparisons of muscle stiffness between individuals with and without musculoskeletal pain are increasing rapidly. This work reviewed and mapped the existing evidence regarding objectively measured muscle stiffness in musculoskeletal pain conditions and surveyed current methods of applying SWE to measure muscle stiffness. METHODS A systematic search was conducted in PubMed and CINAHL using the keywords "muscle stiffness", "shear wave elastography", "pain", "asymptomatic controls" and synonyms. The search was supplemented by a hand search using Google Scholar. Included articles were critically appraised with the AXIS tool, supplemented by items related to SWE methods. Results were visually mapped and narratively described. RESULTS Thirty of 137 identified articles were included. High-quality evidence was missing. The results comprise studies reporting lower stiffness in symptomatic participants, no differences between groups and higher stiffness in symptomatic individuals. Results differed between pain conditions and muscles, and also between studies that examined the same muscle(s) and pathology. The methods of the application of SWE were inconsistent and the reporting was often incomplete. CONCLUSIONS Existing evidence regarding the objective stiffness of muscles in musculoskeletal pain conditions is conflicting. Methodological differences may explain most of the inconsistencies between findings. Methodological standards for SWE measurements of muscles are urgently required.
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Affiliation(s)
- Andreas Haueise
- Faculty of Health, Security, Society, Furtwangen University, Furtwangen, Germany
| | - Guillaume Le Sant
- CHU Nantes, Movement-Interactions-Performance, MIP, Nantes Université, Nantes, France
- School of Physiotherapy, IFM3R, St-Sebastien/Loire, France
| | - Angelika Eisele-Metzger
- Institute for Evidence in Medicine, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany
| | - Angela V Dieterich
- Faculty of Health, Security, Society, Furtwangen University, Furtwangen, Germany
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Tano N, Koda R, Tanigawa S, Kamiyama N, Yamakoshi Y, Tabaru M. Continuous Shear Wave Elastography for Liver Using Frame-to-Frame Equalization of Complex Amplitude. Ultrason Imaging 2024; 46:197-206. [PMID: 38651542 DOI: 10.1177/01617346241247127] [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] [Indexed: 04/25/2024]
Abstract
This study addresses a crucial necessity in the field of noninvasive liver fibrosis diagnosis by introducing the concept of continuous shear wave elastography (C-SWE), utilizing an external vibration source and color Doppler imaging. However, an application of C-SWE to assess liver elasticity, a deep region within the human body, arises an issue of signal instability in the obtained data. To tackle this challenge, this work proposes a method involving the acquisition of multiple frames of datasets, which are subsequently compressed. Furthermore, the proposed frame-to-frame equalization method compensates discrepancies in the initial phase that might exist among multiple-frame datasets, thereby significantly enhancing signal stability. The experimental validation of this approach encompasses both phantom tests and in vivo experiments. In the phantom tests, the proposed technique is validated through a comparison with the established shear wave elastography (SWE) technique. The results demonstrate a remarkable agreement, with an error in shear wave velocity of less than 4.2%. Additionally, the efficacy of the proposed method is confirmed through in vivo tests. As a result, the stabilization of observed shear waves using the frame-to-frame equalization technique exhibits promising potential for accurately assessing human liver elasticity. These findings collectively underscore the viability of C-SWE as a potential diagnostic instrument for liver fibrosis.
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Affiliation(s)
- Naoki Tano
- Institute of Innovative Research, Tokyo Institute of Technology, Yokohama, Japan
| | - Ren Koda
- Graduate School of Science and Technology, Gunma University, Kiryu, Japan
| | | | | | - Yoshiki Yamakoshi
- Graduate School of Science and Technology, Gunma University, Kiryu, Japan
| | - Marie Tabaru
- Institute of Innovative Research, Tokyo Institute of Technology, Yokohama, Japan
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Zaniker EJ, Zhang M, Hughes L, La Follette L, Atazhanova T, Trofimchuk A, Babayev E, Duncan FE. Shear wave elastography to assess stiffness of the human ovary and other reproductive tissues across the reproductive lifespan in health and disease†. Biol Reprod 2024:ioae050. [PMID: 38609185 DOI: 10.1093/biolre/ioae050] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/15/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
The ovary is one of the first organs to show overt signs of aging in the human body, and ovarian aging is associated with a loss of gamete quality and quantity. The age-dependent decline in ovarian function contributes to infertility and an altered endocrine milieu, which has ramifications for overall health. The aging ovarian microenvironment becomes fibro-inflammatory and stiff with age, and this has implications for ovarian physiology and pathology, including follicle growth, gamete quality, ovulation dynamics, and ovarian cancer. Thus, developing a non-invasive tool to measure and monitor the stiffness of the human ovary would represent a major advance for female reproductive health and longevity. Shear wave elastography is a quantitative ultrasound imaging method for evaluation of soft tissue stiffness. Shear wave elastography has been used clinically in assessment of liver fibrosis and characterization of tendinopathies and various neoplasms in thyroid, breast, prostate, and lymph nodes as a non-invasive diagnostic and prognostic tool. In this study, we review the underlying principles of shear wave elastography and its current clinical uses outside the reproductive tract as well as its successful application of shear wave elastography to reproductive tissues, including the uterus and cervix. We also describe an emerging use of this technology in evaluation of human ovarian stiffness via transvaginal ultrasound. Establishing ovarian stiffness as a clinical biomarker of ovarian aging may have implications for predicting the ovarian reserve and outcomes of Assisted Reproductive Technologies as well as for the assessment of the efficacy of emerging therapeutics to extend reproductive longevity. This parameter may also have broad relevance in other conditions where ovarian stiffness and fibrosis may be implicated, such as polycystic ovarian syndrome, late off target effects of chemotherapy and radiation, premature ovarian insufficiency, conditions of differences of sexual development, and ovarian cancer. Summary sentence: Shear Wave Elastography is a non-invasive technique to study human tissue stiffness, and here we review its clinical applications and implications for reproductive health and disease.
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Affiliation(s)
- Emily J Zaniker
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Man Zhang
- Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Lydia Hughes
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Tomiris Atazhanova
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Alexis Trofimchuk
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Elnur Babayev
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Francesca E Duncan
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Center for Reproductive Longevity and Equality, Buck Institute for Research on Aging, Novato, CA, USA
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Xu R, Ren L, Zhang X, Qian Z, Wu J, Liu J, Li Y, Ren L. Non-invasive in vivo study of morphology and mechanical properties of the median nerve. Front Bioeng Biotechnol 2024; 12:1329960. [PMID: 38665817 PMCID: PMC11043530 DOI: 10.3389/fbioe.2024.1329960] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
The current literature studied the median nerve (MN) at specific locations during joint motions. As only a few particular parts of the nerve are depicted, the relevant information available is limited. This experiment investigated the morphological and biomechanical properties of the MN. The effects of the shoulder and wrist motions on MN were explored as well. Eight young healthy female individuals were tested with two-dimensional ultrasound and shear wave elastography (SWE). The morphological and biomechanical properties were examined in limb position 1, with the wrist at the neutral position, the elbow extended at 180°, and the shoulder abducted at 60°. In addition, the experiment assessed the differences among the wrist, forearm, elbow, and upper arm with Friedman's test and Bonferroni post hoc analysis. Two groups of limb positions were designed to explore the effects of shoulder movements (shoulder abducted at 90° and 120°) and wrist movements (wrist extended at 45° and flexed at 45°) on the thickness and Young's modulus. Differences among the distributions of five limb positions were tested as well. The ICC3, 1 values for thickness and Young's modulus were 0.976 and 0.996, respectively. There were differences among the MN thicknesses of four arm locations in limb position 1, while Young's modulus was higher at the elbow and wrist than at the forearm and upper arm. Compared to limb position 1, only limb position 4 had an effect on MN thickness at the wrist. Both shoulder and wrist motions affected MN Young's modulus, and the stiffness variations at typical locations all showed a downward trend proximally in all. The distributions of MN thickness and Young's modulus showed fold line patterns but differed at the wrist and the pronator teres. The MN in the wrist is more susceptible to limb positions, and Young's modulus is sensitive to nerve changes and is more promising for the early diagnosis of neuropathy.
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Affiliation(s)
- Ruixia Xu
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, China
| | - Lei Ren
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, China
| | - Xiao Zhang
- School of Medical Informatics and Engineering, Xuzhou Medical University, Xuzhou, China
| | - Zhihui Qian
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, China
| | - Jianan Wu
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, China
| | - Jing Liu
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, China
| | - Ying Li
- Editorial Department of Journal of Bionic Engineering, Jilin University, Changchun, China
| | - Luquan Ren
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, China
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Tsurukami H, Itoigawa Y, Uehara H, Hatae F, Kubota A, Mizuno M, Maezawa K, Takazawa Y, Ishijima M. Stiffness Changes in Shoulder Muscles between Pitchers and Position Players after Throwing Overhead Using Shear Wave Elastography and Throwing Motion Analysis. J Clin Med 2024; 13:2056. [PMID: 38610821 PMCID: PMC11012453 DOI: 10.3390/jcm13072056] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/16/2024] [Accepted: 03/30/2024] [Indexed: 04/14/2024] Open
Abstract
Objectives: The objective is to compare stiffness changes around the shoulder muscles between pitchers and position players after throwing overhead using shear wave elastography (SWE) in relation to throwing motion analysis and muscle strength. Methods: A total of 32 male college baseball players (12 pitchers and 20 position players) were observed throwing 20 times, and SWE was performed to evaluate 13 shoulder muscle items-tendons (supraspinatus, infraspinatus, subscapularis, and teres minor), muscles (supraspinatus, infraspinatus [transverse and oblique part], teres minor, lower trapezius, latissimus dorsi, and pectoralis minor), and capsules (posterior and posteroinferior). Motion analysis was used to assess elbow torque, forearm angle, forearm rotation speed, and maximum external rotation angle of the shoulder. Muscle strength was measured using a dynamometer for abduction, internal/external rotation of the shoulder at an abduction of 0°, internal/external rotation of the shoulder at an abduction of 90°, and internal/external rotation of shoulder at a flexion of 90°. Results: In the pitcher group, SWE values for the teres minor muscle and latissimus dorsi muscle increased significantly after throwing. In the position player group, SWE values for the teres minor muscle significantly increased, and SWE values of the pectoralis minor muscle decreased after throwing. In the pitcher group, positive correlations were found between the teres minor muscle and forearm rotation speed and between the latissimus dorsi muscle and forearm angle. No significant difference was found in muscle strength after throwing in any of the groups. Conclusions: Stiffness changes occurred after throwing and were related to the motion analysis, but the regions in which stiffness occurred varied between pitchers and position players.
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Affiliation(s)
- Hironori Tsurukami
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, Urayasu 279-0021, Japan; (H.T.); (F.H.); (K.M.)
- Department of Orthopaedic Surgery, Faculty of Medicine, Juntendo University, Hongo, Tokyo 113-0034, Japan; (H.U.); (M.I.)
| | - Yoshiaki Itoigawa
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, Urayasu 279-0021, Japan; (H.T.); (F.H.); (K.M.)
- Department of Orthopaedic Surgery, Faculty of Medicine, Juntendo University, Hongo, Tokyo 113-0034, Japan; (H.U.); (M.I.)
| | - Hirohisa Uehara
- Department of Orthopaedic Surgery, Faculty of Medicine, Juntendo University, Hongo, Tokyo 113-0034, Japan; (H.U.); (M.I.)
| | - Fumitoshi Hatae
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, Urayasu 279-0021, Japan; (H.T.); (F.H.); (K.M.)
- Department of Orthopaedic Surgery, Faculty of Medicine, Juntendo University, Hongo, Tokyo 113-0034, Japan; (H.U.); (M.I.)
| | - Atsushi Kubota
- Graduate School of Health and Sports Science, Juntendo University, Inzai 270-1695, Japan; (A.K.); (M.M.); (Y.T.)
- Department of Sports Medicine, Faculty of Medicine, Juntendo University, Hongo, Tokyo 113-0034, Japan
| | - Motoki Mizuno
- Graduate School of Health and Sports Science, Juntendo University, Inzai 270-1695, Japan; (A.K.); (M.M.); (Y.T.)
| | - Katsuhiko Maezawa
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, Urayasu 279-0021, Japan; (H.T.); (F.H.); (K.M.)
| | - Yuuji Takazawa
- Graduate School of Health and Sports Science, Juntendo University, Inzai 270-1695, Japan; (A.K.); (M.M.); (Y.T.)
- Department of Sports Medicine, Faculty of Medicine, Juntendo University, Hongo, Tokyo 113-0034, Japan
| | - Muneaki Ishijima
- Department of Orthopaedic Surgery, Faculty of Medicine, Juntendo University, Hongo, Tokyo 113-0034, Japan; (H.U.); (M.I.)
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Alapati R, Bon Nieves A, Wagoner S, Lawrence A, Jones J, Bur AM. Quantitative measurements of radiation-induced fibrosis for head and neck cancer: A narrative review. Laryngoscope Investig Otolaryngol 2024; 9:e1249. [PMID: 38651078 PMCID: PMC11034491 DOI: 10.1002/lio2.1249] [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: 11/30/2023] [Revised: 02/23/2024] [Accepted: 03/30/2024] [Indexed: 04/25/2024] Open
Abstract
Objectives To provide a comprehensive summary of the different modalities available to measure soft tissue fibrosis after radiotherapy in head and neck cancer patients. Data Sources PubMed, Scopus, and Web of Sciences. Review Methods A search was conducted using a list of medical subject headings and terms related to head and neck oncology, radiation fibrosis, and quantitative measurements, including bioimpedance, MRI, and ultrasound. Original research related to quantitative measurement of neck fibrosis post-radiotherapy was included without time constraints, while reviews, case reports, non-English texts, and inaccessible studies were excluded. Discrepancies during the review were resolved by discussing with the senior author until consensus was reached. Results A total of 284 articles were identified and underwent title and abstract screening. Seventeen articles had met our criteria for full-text review based on relevance, of which nine had met our inclusion criteria. Young's modulus (YM) and viscoelasticity measures have demonstrated efficacy in quantifying neck fibrosis, with fibrotic tissues displaying significantly higher YM values and altered viscoelastic properties such as increased stiffness rate-sensitivity and prolonged stress-relaxation post-radiation. Intravoxel incoherent motion offers detailed insights into tissue changes by assessing the diffusion of water molecules and blood perfusion, thereby differentiating fibrosed from healthy tissues. Shear wave elastography has proven to be an effective technique for quantifying radiation-induced fibrosis in the head and neck region by measuring shear wave velocity. Conclusion There are various modalities to measure radiation-induced fibrosis, each with its unique strengths and limitations. Providers should be aware of these implications and decide on methodologies based on their specific clinical workflow. Level of Evidence Step 5.
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Affiliation(s)
- Rahul Alapati
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Antonio Bon Nieves
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Sarah Wagoner
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Amelia Lawrence
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Jill Jones
- Department of RadiologyUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Andrés M. Bur
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
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Su S, Ye J, Ke H, Zhong H, Lyu G, Xu Z. Multimodal ultrasound imaging: a method to improve the accuracy of sentinel lymph node diagnosis in breast cancer. Front Oncol 2024; 14:1366876. [PMID: 38590661 PMCID: PMC10999636 DOI: 10.3389/fonc.2024.1366876] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 03/08/2024] [Indexed: 04/10/2024] Open
Abstract
Aim This study assessed the utility of multimodal ultrasound in enhancing the accuracy of breast cancer sentinel lymph node (SLN) assessment and compared it with single-modality ultrasound. Methods Preoperative examinations, including two-dimensional ultrasound (2D US), intradermal contrast-enhanced ultrasound (CEUS), intravenous CEUS, shear-wave elastography (SWE), and surface localization, were conducted on 86 SLNs from breast cancer patients. The diagnostic performance of single and multimodal approaches for detecting metastatic SLNs was compared to postoperative pathological results. Results Among the 86 SLNs, 29 were pathologically diagnosed as metastatic, and 57 as non-metastatic. Single-modality ultrasounds had AUC values of 0.826 (intradermal CEUS), 0.705 (intravenous CEUS), 0.678 (2D US), and 0.677 (SWE), respectively. Intradermal CEUS significantly outperformed the other methods (p<0.05), while the remaining three methods had no statistically significant differences (p>0.05). Multimodal ultrasound, combining intradermal CEUS, intravenous CEUS, 2D US, and SWE, achieved an AUC of 0.893, with 86.21% sensitivity and 84.21% specificity. The DeLong test confirmed that multimodal ultrasound was significantly better than the four single-modal ultrasound methods (p<0.05). Decision curve analysis and clinical impact curves demonstrated the superior performance of multimodal ultrasound in identifying high-risk SLN patients. Conclusion Multimodal ultrasound improves breast cancer SLN identification and diagnostic accuracy.
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Affiliation(s)
- Shanshan Su
- Department of Ultrasound in Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Jiayi Ye
- Department of Radiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Helin Ke
- Department of Ultrasound in Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Huohu Zhong
- Department of Ultrasound in Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Guorong Lyu
- Department of Ultrasound in Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Zhirong Xu
- Department of Ultrasound in Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
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Martikkala L, Pemmari A, Himanen SL, Mäkelä K. Median Nerve Shear Wave Elastography is Associated With the Neurophysiological Severity of Carpal Tunnel Syndrome. J Ultrasound Med 2024. [PMID: 38516753 DOI: 10.1002/jum.16450] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/08/2024] [Accepted: 03/08/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVES This study examines the associations between the median nerve (MN) shear wave elastography (SWE), the MN cross-sectional area (CSA), patient's symptoms, and the neurophysiological severity of carpal tunnel syndrome (CTS). The most appropriate site to perform SWE was also tested. METHODS This prospective study comprised 86 wrists of 47 consecutive patients who volunteered for MN ultrasound after an electrodiagnostic study. The neurophysiological severity of CTS was assessed according to the results of a nerve conduction study (NCS). The MN CSA was measured at the carpal tunnel inlet (wCSA) and the forearm (fCSA). SWE was performed on the MN in a longitudinal orientation at the wrist crease (wSWE), at the forearm (fSWE), and within the carpal tunnel (tSWE). RESULTS The wCSA and wSWE correlated positively with the neurophysiological severity of CTS (r = .619, P < .001; r = .582, P < .001, respectively). The optimal cut-off values to discriminate the groups with normal NCS and with findings indicating CTS were 10.5 mm2 for the wCSA and 4.12 m/s for the wSWE. With these cut-off values, wCSA had a sensitivity of 80% and specificity of 87% and wSWE a sensitivity of 88% and specificity of 76%. Neither tSWE nor fSWE correlated with the neurophysiological severity of CTS or differed between NCS negative and positive groups (P = .429, P = .736, respectively). CONCLUSION Shear wave velocity in the MN at the carpal tunnel inlet increases in CTS and correlates to the neurophysiological CTS severity equivalently to CSA measured at the same site.
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Affiliation(s)
- Lauri Martikkala
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Antti Pemmari
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Clinical Neurophysiology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
| | - Sari-Leena Himanen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Clinical Neurophysiology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
| | - Katri Mäkelä
- Department of Clinical Neurophysiology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
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Ten B, Asfuroğlu ZM, Eskandari MM, Temel G, Esen K, Yüksek HH, Balcı Y. The place of B-mode ultrasonography, shear-wave elastography, and superb microvascular imaging in the diagnosis of De Quervain tenosynovitis. J Clin Ultrasound 2024. [PMID: 38446065 DOI: 10.1002/jcu.23661] [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] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/20/2024] [Accepted: 02/26/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE Superb microvascular imaging (SMI) and Shear wave elastography (SWE) are newly developed ultrasonographic diagnostic tools used to support the diagnosis of De Quervain tenosynovitis (DQT). The aim of this study was to examine the capacity to differentiate between the wrist with DQT and the healthy wrist, as well as the potential for predicting the disease's severity using B-mode ultrasonography, SWE, and SMI. METHODS A total of 19 cases with unilateral clinical DQT were included in the prospective study. The wrists of these cases without DQT clinic constituted the control group. RESULTS The SWE parameters of m/s and kPa cutoff values were ≤5.225 and ≤ 77.65, respectively, in the wrists with DQT compared to the wrists not diagnosed with DQT (p < 0.001). Regarding SMI findings no microvascularity was determined in the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendon sheaths of the wrists without DQT, and a significant increase was observed in the degree of microvascularity as the clinical severity of DQT increased. CONCLUSION SWE results can differentiate between the presence and absence of DQT. SMI grading of the APL and EPB tendon sheaths may be helpful to the clinician in deciding the clinical severity of DQT.
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Affiliation(s)
- Barış Ten
- Department of Radiology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Zeynel Mert Asfuroğlu
- Department of Orthopedics and Traumatology, Mersin University Faculty of Medicine, Mersin, Turkey
| | | | - Gülhan Temel
- Department of Department of Biostatistics, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Kaan Esen
- Department of Radiology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Hasan Hüsnü Yüksek
- Department of Radiology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Yüksel Balcı
- Department of Radiology, Mersin University Faculty of Medicine, Mersin, Turkey
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Çelik AO, Günay B, Çoker GB, Ustabaşıoğlu FE, Ateş S, Tunçbilek N. Evaluation of placenta in patients with gestational diabetes using shear wave elastography and superb microvascular imaging. Acta Radiol 2024; 65:318-323. [PMID: 38111238 DOI: 10.1177/02841851231217201] [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] [Indexed: 12/20/2023]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a common disease, and the placenta shows various functional and morphological changes in these patients. Superb microvascular imaging (SMI) and shear wave elastography (SWE) are innovative ultrasound (US) methods that provide detailed information about tissue vascularization and elasticity. PURPOSE To evaluate placental changes in patients with GDM with SMI and SWE methods. MATERIAL AND METHODS For this case-control study, 20 healthy and 20 women with GDM were included. Women at >21 weeks of pregnancy were evaluated with SMI and SWE by two independent radiologists. Mean SMI values and mean SWE values from three different region of interest-based measurements were compared between the two groups. RESULTS We identified that the mean SMI and SWE value of the GDM group was found to be significantly higher than that of the control group (P = 0.002, P = 0.001 respectively). Using a receiver operating characteristic curve, the cutoff value of the SMI ratio, which maximizes the prediction of the presence of GDM, was 0.1234279750 (95% confidence interval [CI] = 0.625-0.920), the SWE cut-off value was 15.5 kPa (95% CI = 0.794-0.989). CONCLUSION We have demonstrated that evaluation with SMI and SWE might allow quantitative assessment of the morphological changes of placentas in women with GDM. We believe that the use of innovative methods such as SMI and SWE in addition to conventional US examinations in daily practice and studies will provide significant clinical benefits to patient management.
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Affiliation(s)
- Ahmet Onur Çelik
- Department of Radiology, Çanakkale Mehmet Akif Ersoy State Hospital, Çanakkale, Turkey
| | - Burak Günay
- Department of Radiology, Trakya University Faculty of Medicine, Turkey
| | - Gonca Büşra Çoker
- Department of Gynecology and Obstetrics, Trakya University Faculty of Medicine, Turkey
| | | | - Sinan Ateş
- Department of Gynecology and Obstetrics, Trakya University Faculty of Medicine, Turkey
| | - Nermin Tunçbilek
- Department of Radiology, Trakya University Faculty of Medicine, Turkey
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11
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Guo XH, Wang H, Chen SJ, Xie YJ, Liu RR. Multidimensional Ultrasound Evaluation of Diastasis Recti Abdominis During Different Gestational Periods. J Ultrasound Med 2024; 43:525-533. [PMID: 38050787 DOI: 10.1002/jum.16384] [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] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/13/2023] [Accepted: 11/20/2023] [Indexed: 12/06/2023]
Abstract
OBJECTIVE The purpose of this study is to explore the application value of two-dimensional ultrasound and shear wave elastography (SWE) in the multidimensional evaluation of diastasis recti abdominis (DRA) during different gestational periods. METHODS A cohort of 202 gravidas that were examined in our hospital between June 2021 and September 2022 were selected for the purpose of the study, which included 26 cases with <14 weeks of pregnancy, 36 cases in the 14th-27th week of pregnancy, 36 cases in the 28th-34th week of pregnancy, 32 cases in the 35th-38th week of pregnancy, 45 cases at 42 days postpartum, and 27 cases at 3 months postpartum. The inter-rectus distance (IRD) and the thickness in each gestational period were measured, and Young's modulus of the rectus abdominis at different gestational periods was measured using SWE by two sonographers. The differences in IRD, thickness, and elasticity characteristics during different periods, and the correlation between rectus abdominis elasticity and IRD, thickness, body mass index (BMI), neonatal weight, and delivery mode were analyzed and compared. The consistency of SWE parameters obtained by different sonographers was also compared. RESULTS There were significant differences in IRD, thickness, and Young's modulus during different gestational periods (P = .000, P < .001, P < .001). Early postpartum IRD and Young's modulus did not restore to the level of early pregnancy (P < .001, P < .001), while the thickness of rectus abdominis was not significantly different from that of early pregnancy (P = .211). The Young's modulus of rectus abdominis was negatively correlated with the IRD (r = .515), positively correlated with the thickness of rectus abdominis (r = .408), and weakly negatively correlated with maternal BMI (r = -.296). There was no significant correlation with neonatal weight or delivery mode (P = .147, .648). The Bland-Altman plot showed that the two sonographers had good consistency in evaluating the elasticity of rectus abdominis by SWE. CONCLUSION The multidimensional evaluation of DRA by ultrasound is feasible and IRD and Young's modulus can be used to evaluate the postpartum recovery of DRA. The combination of the two can objectively reflect the severity of DRA morphology and function.
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Affiliation(s)
- Xiao-Han Guo
- Department of Ultrasonic, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, China
| | - Hua Wang
- Department of Ultrasonic, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, China
| | - Sheng-Jiang Chen
- Department of Ultrasonic, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China
| | - Yu-Juan Xie
- Department of Ultrasonic, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China
| | - Rui-Rui Liu
- Department of Ultrasonic, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China
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12
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Bosio G, Destrempes F, Yazdani L, Roy Cardinal MH, Cloutier G. Resonance, Velocity, Dispersion, and Attenuation of Ultrasound-Induced Shear Wave Propagation in Blood Clot In Vitro Models. J Ultrasound Med 2024; 43:535-551. [PMID: 38108551 DOI: 10.1002/jum.16387] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 11/24/2023] [Accepted: 11/25/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE Improve the characterization of mechanical properties of blood clots. Parameters derived from shear wave (SW) velocity and SW amplitude spectra were determined for gel phantoms and in vitro blood clots. METHODS Homogeneous phantoms and phantoms with gel or blood clot inclusions of different diameters and mechanical properties were analyzed. SW amplitude spectra were used to observe resonant peaks. Parameters derived from those resonant peaks were related to mimicked blood clot properties. Three regions of interest were tested to analyze where resonances occurred the most. For blood experiments, 20 samples from different pigs were analyzed over time during a 110-minute coagulation period using the Young modulus, SW frequency dispersion, and SW attenuation. RESULTS The mechanical resonance was manifested by an increase in the number of SW spectral peaks as the inclusion diameter was reduced (P < .001). In blood clot inclusions, the Young modulus increased over time during coagulation (P < .001). Descriptive spectral parameters (frequency peak, bandwidth, and distance between resonant peaks) were linearly correlated with clot elasticity values (P < .001) with R2 = .77 for the frequency peak, .60 for the bandwidth, and .48 for the distance between peaks. The SW dispersion and SW attenuation reflecting the viscous behavior of blood clots decreased over time (P < .001), mainly in the early stage of coagulation (first minutes). CONCLUSION The confined soft inclusion configuration favored SW mechanical resonances potentially challenging the computation of spectral-based parameters, such as the SW attenuation. The impact of resonances can be reduced by properly selecting the region of interest for data analysis.
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Affiliation(s)
- Guillaume Bosio
- Institute of Biomedical Engineering, University of Montreal, Montreal, Quebec, Canada
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - François Destrempes
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Ladan Yazdani
- Institute of Biomedical Engineering, University of Montreal, Montreal, Quebec, Canada
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Marie-Hélène Roy Cardinal
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Guy Cloutier
- Institute of Biomedical Engineering, University of Montreal, Montreal, Quebec, Canada
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
- Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Montreal, Quebec, Canada
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13
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Day JM, Merriman H. Common Wrist-Extensor Tendon and Pectoralis Muscle Stiffness in Healthy Recreational Tennis Players. J Sport Rehabil 2024; 33:174-180. [PMID: 38377986 DOI: 10.1123/jsr.2023-0202] [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: 06/26/2023] [Revised: 12/21/2023] [Accepted: 01/06/2024] [Indexed: 02/22/2024]
Abstract
CONTEXT Imbalances in upper-extremity soft tissue stiffness may play a role in the development of shoulder and elbow musculoskeletal injuries in tennis players. Ultrasound shear wave elastography provides quantifiable and specific data regarding muscle stiffness. The purpose of this study was to compare tendon and muscle stiffness in healthy tennis players to nontennis players. DESIGN Cross-sectional study. METHODS The shear wave modulus, measured in kilopascals, was obtained for the dominant pectoralis major, pectoralis minor, and common wrist-extensor tendon using 2-dimensional shear wave elastography ultrasound imaging (GE Logiq S8, L9 linear transducer). Independent t test was run to compare age, body mass index, and the activity index score between both groups. Within-day intrarater reliability was assessed using a within-examiner intraclass correlation coefficients (ICC [3, 1]) with 95% confidence intervals. A multivariate general linear model was run to compare the mean differences between the tennis and nontennis players for each of the soft tissues. RESULTS Twenty-six individuals (13 tennis players and 13 nontennis players) were recruited. Within-day ICCs were very good (ICC > .78 for the pectoralis musculature) and excellent (ICC > .94 for the common wrist extensor). Common extensor tendon stiffness was significantly higher in tennis players compared to nontennis players (mean difference = 114.8 [61.8], confidence interval, -22.8 to 252.5 kPa for the dominant arm [P = .039]). Mean pectoralis major and minor stiffness differences were not significant (P > .214). CONCLUSIONS Common wrist-extensor stiffness in healthy recreational tennis players is higher than those who do not play tennis. Therefore, clinicians may need to facilitate a greater soft tissue stiffness response with resistance training when rehabilitating recreational tennis players as compared to those not playing tennis. Additional normative data on a larger sample of recreational tennis players should be collected.
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Affiliation(s)
- Joseph M Day
- Department of Physical Therapy, University of Dayton, Dayton, OH, USA
| | - Harold Merriman
- Department of Physical Therapy, University of Dayton, Dayton, OH, USA
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14
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Caenen A, Bézy S, Pernot M, Nightingale KR, Vos HJ, Voigt JU, Segers P, D'hooge J. Ultrasound Shear Wave Elastography in Cardiology. JACC Cardiovasc Imaging 2024; 17:314-329. [PMID: 38448131 DOI: 10.1016/j.jcmg.2023.12.007] [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: 12/23/2022] [Revised: 11/14/2023] [Accepted: 12/07/2023] [Indexed: 03/08/2024]
Abstract
The advent of high-frame rate imaging in ultrasound allowed the development of shear wave elastography as a noninvasive alternative for myocardial stiffness assessment. It measures mechanical waves propagating along the cardiac wall with speeds that are related to stiffness. The use of cardiac shear wave elastography in clinical studies is increasing, but a proper understanding of the different factors that affect wave propagation is required to correctly interpret results because of the heart's thin-walled geometry and intricate material properties. The aims of this review are to give an overview of the general concepts in cardiac shear wave elastography and to discuss in depth the effects of age, hemodynamic loading, cardiac morphology, fiber architecture, contractility, viscoelasticity, and system-dependent factors on the measurements, with a focus on clinical application. It also describes how these factors should be considered during acquisition, analysis, and reporting to ensure an accurate, robust, and reproducible measurement of the shear wave.
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Affiliation(s)
- Annette Caenen
- Institute for Biomedical Engineering and Technology, Ghent University, Ghent, Belgium; Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium; Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Stéphanie Bézy
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Mathieu Pernot
- Physics for Medicine, INSERM, CNRS, ESPCI, PSL University, Paris, France
| | | | - Hendrik J Vos
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Jens-Uwe Voigt
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium; Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium.
| | - Patrick Segers
- Institute for Biomedical Engineering and Technology, Ghent University, Ghent, Belgium
| | - Jan D'hooge
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
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Rako ZA, Yogeswaran A, Yildiz S, Weidemann P, Zedler D, da Rocha BB, Kryvenko V, Schäfer S, Ghofrani HA, Seeger W, Kremer NC, Tello K. Liver stiffness is associated with right heart dysfunction, cardiohepatic syndrome, and prognosis in pulmonary hypertension. J Heart Lung Transplant 2024:S1053-2498(24)00056-1. [PMID: 38373557 DOI: 10.1016/j.healun.2024.02.013] [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: 12/12/2023] [Revised: 02/11/2024] [Accepted: 02/13/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Pulmonary hypertension (PH) can lead to congestive hepatopathy, known as cardiohepatic syndrome (CHS). Hepatic congestion is associated with increased liver stiffness, which can be quantified using shear wave elastography. We aimed to investigate whether hepatic shear wave elastography detects patients at risk in the early stages of PH. METHODS Sixty-three prospectively enrolled patients undergoing right heart catheterization (52 diagnosed with PH and 11 with invasive exclusion of PH) and 52 healthy volunteers underwent assessments including echocardiography and hepatic shear wave elastography. CHS was defined as increased levels of ≥2 of the following: gamma-glutamyl transferase, alkaline phosphatase, and bilirubin. Liver stiffness was defined as normal (≤5.0 kPa) or high (>5.0 kPa). RESULTS Compared with normal liver stiffness, high liver stiffness was associated with impaired right ventricular (RV) and right atrial (RA) function (median [interquartile range] RV ejection fraction: 54 [49; 57]% vs 45 [34; 51]%, p < 0.001; RA reservoir strain: 49 [41; 54]% vs 33 [22; 41]%, p < 0.001), more severe tricuspid insufficiency (p < 0.001), and higher prevalence of hepatovenous backflow (2% vs 29%, p < 0.001) and CHS (2% vs 10%, p = 0.038). In the patient subgroup with precapillary PH (n = 48), CHS and high liver stiffness were associated with increased European Society of Cardiology/European Respiratory Society 2022 risk scores (p = 0.003). CONCLUSIONS Shear wave liver elastography yields important information regarding right heart function and may complement risk assessment in patients with (suspected) PH.
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Affiliation(s)
- Zvonimir A Rako
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Athiththan Yogeswaran
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Selin Yildiz
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Peter Weidemann
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Daniel Zedler
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Bruno Brito da Rocha
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Vitalii Kryvenko
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Simon Schäfer
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Hossein Ardeschir Ghofrani
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, Germany; Department of Pneumology, Kerckhoff Heart, Rheuma and Thoracic Center, Bad Nauheim, Germany; Department of Medicine, Imperial College London, London, UK
| | - Werner Seeger
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Nils C Kremer
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Khodr Tello
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, Germany.
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16
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Wang S, Xu X, Cao S, Cheng J, Wang Y, Dong Y. Sonographic methods to predict type 2 diabetes patients with sarcopenia: B mode ultrasound and shear wave elastography. Clin Hemorheol Microcirc 2024:CH231822. [PMID: 38393892 DOI: 10.3233/ch-231822] [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: 02/25/2024]
Abstract
BACKGROUND Type 2 diabetes accelerates the loss of muscle mass and strength. Sarcopenia is also one of the chronic complications of diabetes. OBJECTIVE To investigate the clinical value of B mode ultrasound (BMUS) and shear wave elastography (SWE) for predicting type 2 diabetic sarcopenia. METHODS We recorded Skeletal Muscle Mass Index (ASMI), grip strength, muscle thickness (MT), pinna angle (PA), fascicle length (FL), and the difference of Young's modulus in the relaxed states and tense states (ΔSWE). The correlations between clinical indicators and ultrasound characteristics were compared. A diagnostic model of sarcopenia was developed to assess the independent correlates and evaluate the diagnostic efficacy of sarcopenia. RESULTS ASMI was significantly and positively correlated with MT and ΔSWE (r = 0.826, 0.765, P < 0.01), and grip strength was significantly and positively correlated with MT and ΔSWE (r = 0.797, 0.818, P < 0.01). MT was the most significant predictor of sarcopenia (OR = 4.576, P < 0.001), and the cut-off value of MT was 11.4 mm (AUC: 0.952). CONCLUSION BMUS and SWE can quantitatively assess muscle mass and strength, and are effective methods to predict the occurrence of sarcopenia in elderly patients with type 2 diabetes.
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Affiliation(s)
- Shengqiao Wang
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinliang Xu
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Siqi Cao
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Juan Cheng
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Wang
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Dong
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Wekerle M, Murillo K, vonBoscamp M, Hauber V, Ebert MP, Antoni C, Hirth M. Point- shear wave elastography generated by acoustic radiation force impulse in chronic pancreatitis. United European Gastroenterol J 2024. [PMID: 38363191 DOI: 10.1002/ueg2.12543] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/19/2023] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Transcutaneous point-shear wave elastography (p-SWE) performed using an acoustic radiation force impulse can be used to quantify pancreatic stiffness in chronic pancreatitis (CP). We aimed to evaluate its usefulness to diagnose and monitor CP. METHODS 175 participants were included in this prospective study including patients with CP (n = 65), liver cirrhosis (LC; n = 60), alcohol abuse (n = 10) and healthy controls (n = 40). Point-shear wave elastography of the pancreas was performed and quantified as median shear wave velocity (SWV). In the same way, p-SWE of the spleen served as a marker of portal hypertension. The M-ANNHEIM Severity score was used as global marker for disease activity in CP. RESULTS Compared to healthy controls, pancreatic SWV was significantly elevated in CP (1.38 vs. 0.96 m/s; p < 0.0001, MWU-test). Pancreatic SWV was increased in alcoholic CP but not in hereditary CP. Receiver operating characteristic analysis revealed 1.2 m/s as the optimal cut-off to identify non-heredity-CP subjects (90% specificity; 81% sensitivity; 92% positive predictive value). Pancreatic SWV correlated significantly with the M-ANNHEIM Severity score, severity of CP-typical complications (both p < 0.05, linear regression analysis), morphological changes of the pancreas and need for hospital treatment (both p < 0.05, MWU-test) but not with exocrine or endocrine insufficiency. Pancreatic SWV >1.7 m/s was identified to predict M-ANNHEIM Severity score ≥11 points. Pancreatic SWV was also elevated in LC (1.42 m/s; p < 0.001), correlating with increased splenic SWV. CONCLUSION Transcutaneous pancreatic p-SWE represents a bedside, cost-effective and non-invasive tool which adds valuable information to the process of diagnosing and monitoring CP. By portal hypertension, an increased pancreatic SWV must be expected.
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Affiliation(s)
- Maximilian Wekerle
- Department of Medicine II, Medical Faculty at Mannheim, University of Heidelberg, Mannheim, Germany
| | - Katharina Murillo
- Department of Medicine II, Medical Faculty at Mannheim, University of Heidelberg, Mannheim, Germany
| | - Manuel vonBoscamp
- Department of Medicine II, Medical Faculty at Mannheim, University of Heidelberg, Mannheim, Germany
| | - Veronika Hauber
- Department of Medicine II, Medical Faculty at Mannheim, University of Heidelberg, Mannheim, Germany
| | - Matthias P Ebert
- Department of Medicine II, Medical Faculty at Mannheim, University of Heidelberg, Mannheim, Germany
| | - Christoph Antoni
- Department of Medicine II, Medical Faculty at Mannheim, University of Heidelberg, Mannheim, Germany
| | - Michael Hirth
- Department of Medicine II, Medical Faculty at Mannheim, University of Heidelberg, Mannheim, Germany
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18
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Koruyucu AN, Aşantoğrol F. Determination of masseter and temporal muscle thickness by ultrasound and muscle hardness by shear wave elastography in healthy adults as reference values. Dentomaxillofac Radiol 2024; 53:137-152. [PMID: 38211311 DOI: 10.1093/dmfr/twad013] [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: 07/31/2023] [Revised: 10/16/2023] [Accepted: 12/17/2023] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVES The purpose of this study is to prospectively investigate the reference values of masseter and temporal muscle thicknesses by ultrasonography and muscle hardness values by shear wave elastography in healthy adults. METHODS The sample of the study consisted of a total of 160 healthy individuals aged between 18 and 59, including 80 women and 80 men. By examining the right and left sides of each participant, thickness and hardness values were obtained for 320 masseter muscles and 320 temporal muscles in total. RESULTS The mean masseter muscle thickness was found to be 1.09 cm at rest and 1.40 cm in contraction. The mean temporal muscle thickness was found to be 0.88 cm at rest and 0.98 cm in contraction. The thickness values of the masseter and temporal muscles were significantly greater in the male participants than in the female participants (P < .001). While there were significant differences between the right and left masseter muscle thickness values at rest and in contraction, the values of the temporal muscles did not show a significant difference between the sides. While the resting hardness (rSWE) of the masseter muscle was transversally 6.91 kPa and longitudinally 8.49 kPa, these values in contraction (cSWE) were found, respectively, 31.40 and 35.65 kPa. The median temporal muscle hardness values were 8.84 kPa at rest and 20.43 kPa in contraction. Masseter and temporal muscle hardness values at rest and in contraction were significantly higher among the male participants compared to the female participants (P < .001). CONCLUSION In this study, reference values for the thickness and hardness of the masseter and temporal muscles are reported. Knowing these values will make it easier to assess pain in the masseter and temporal muscles and determine the diagnosis and prognosis of masticatory muscle pathologies by allowing the morphological and functional assessments of these muscles, and it will identify ranges for reference parameters.
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Affiliation(s)
- Ayşe Nur Koruyucu
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Gaziantep University, 27310 Gaziantep, Turkey
| | - Firdevs Aşantoğrol
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Gaziantep University, 27310 Gaziantep, Turkey
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Chen Z, Wang Y, Ying MTC, Su Z, Han X, Gunda ST. Association of renal elasticity evaluated by real-time shear wave elastography with renal fibrosis in patients with chronic kidney disease. Br J Radiol 2024; 97:392-398. [PMID: 38308024 DOI: 10.1093/bjr/tqad030] [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: 09/01/2023] [Revised: 10/25/2023] [Accepted: 11/14/2023] [Indexed: 02/04/2024] Open
Abstract
OBJECTIVE Renal fibrosis is a final common pathological hallmark in the progression of chronic kidney disease (CKD). Non-invasive evaluation of renal fibrosis by mapping renal stiffness obtained by shear wave elastography (SWE) may facilitate the clinical therapeutic regimen for CKD patients. METHODS A cohort of 162 patients diagnosed with CKD, who underwent renal biopsy, was prospectively and consecutively recruited between April 2019 and December 2021. The assessment of renal cortex stiffness was performed using SWE imaging. The patients were classified into different groups based on pathological renal fibrosis (mild group: n = 74; moderate-to-severe group: n = 88). Binary logistic regression model and generalized additive model were conducted to investigate the association of renal elasticity with renal fibrosis. RESULTS Compared with the mildly impaired group, the moderate-to-severe group showed a significant decline in renal elasticity (P < .001). In the fully adjusted model, each 10 kPa drop in renal elasticity was associated with a 3.5-fold increment in the risk of moderate-to-severe renal fibrosis (fully adjusted odds ratio, 4.54; 95% CI, 2.41-8.57). Particularly, participants in the lowest elasticity group (≤29.92 kPa) had a 20-fold increased chance of moderate-to-severe renal fibrosis than those in the group with highest elasticity (≥37.93 kPa). An inverse linear association was observed between renal elasticity increment and moderate-to-severe renal fibrosis risk. CONCLUSION There is a negative linear association between increased renal elasticity and moderate-to-severe renal fibrosis risk among CKD patients. Patients with diminished renal stiffness have a higher risk of moderate-to-severe renal fibrosis. ADVANCES IN KNOWLEDGE CKD patients with reduced renal stiffness have a higher likelihood of moderate-to-severe renal fibrosis.
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Affiliation(s)
- Ziman Chen
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon 999077, Hong Kong
| | - Yingli Wang
- Ultrasound Department, EDAN Instruments, Inc, Shenzhen 518000, China
| | - Michael Tin Cheung Ying
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon 999077, Hong Kong
| | - Zhongzhen Su
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China
| | - Xinyang Han
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon 999077, Hong Kong
| | - Simon Takadiyi Gunda
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon 999077, Hong Kong
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20
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Kapoor A, Singh A, Kapur A, Mahajan G, Sharma S. Use of shear wave imaging with intestinal ultrasonography in patients with chronic diarrhea. J Clin Ultrasound 2024; 52:163-175. [PMID: 37997499 DOI: 10.1002/jcu.23594] [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: 08/26/2023] [Revised: 10/05/2023] [Accepted: 10/10/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE A retrospective study was designed to determine the role of shear wave elastography (SWE) and intestinal ultrasonography to differentiate between inflammatory and fibrotic bowel strictures by determining Young's modulus (E) and shear wave dispersion (SWD) and to compare its role with contrast-enhanced computed tomography (CECT) in patients with chronic diarrhea and pain abdomen. METHODS Seventy-six patients who had increased small bowel thickness (SBWT) >3 mm, and large bowel wall thickness (LBWT) >4 mm on intestinal ultrasonography (IUS) were evaluated in a two-step manner. The first step involved classifying patients with increased SBWT >3 mm and LBWT >4 mm by use of SWE and dispersion into three groups that is group I (fibrotic), group II (inflammatory) thickening, and group III (mixed-fibrosis and inflammatory) wall thickening. In the second step, etiological classification was done using six gray scale features of IUS that is length and degree of bowel thickening, presence of bowel stratification, Limberg grade of vascularity, status of mesenteric fat, juxta bowel status-nodes, fluid, and fistula formation to reach to a definitive diagnosis. These findings were compared with findings on CECT. Twenty-three patients had diagnosis confirmed by biopsy while 18 underwent surgery with histologic confirmation of operative findings. The sensitivity, specificity and AUROC for both modalities were compared. RESULTS Group I that is fibrotic group had 33 patients with fibrotic strictures of which fibrotic Crohn's disease (CD)and tuberculosis of the bowel were the dominant types followed by neoplastic and infective causes. In Group II that is inflammatory there were 32 patients with predominantly infective ileo-colitis, and ulcerative colitis patients while 11 patients were present in group III that is (mixed fibrotic and inflammatory) type of bowel wall thickening and were patients of inflammatory CD, infective ileo-colitis. The presence of length of bowel involvement, Limberg grade, mesenteric fat proliferation, and SBWT>9 mm were the statistically significant parameters on IUS which helped to reach to final diagnosis. The sensitivity and specificity of combined SWE with SWD and IUS were 100% and 99% while that of CECT was 78% and 96% respectively with AUROC of 100% and 64%. CONCLUSION SWI combined with IUS in a two-step manner is an accurate way to evaluate patients with chronic diarrhea who have increased SBWT and is not only able to differentiate inflammatory from fibrotic bowel wall thickening but also helps to form an etiological diagnosis.
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Affiliation(s)
- Atul Kapoor
- Department of Radiology, Advanced Diagnostics and Institute of Imaging, Amritsar, Punjab, India
| | - Anil Singh
- Department of Gastroenterology, North central Institute of Gastroenterology, Pathankot, Punjab, India
| | - Aprajita Kapur
- Department of Radiology, Advanced Diagnostics and Institute of Imaging, Amritsar, Punjab, India
| | - Goldaa Mahajan
- Department of Radiology, Advanced Diagnostics and Institute of Imaging, Amritsar, Punjab, India
| | - Shalinder Sharma
- Department of Radiology, Advanced Diagnostics and Institute of Imaging, Amritsar, Punjab, India
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Yurtsever I, Yıldız S, Amirjanov S, Yozgat CY, Balsak S, Peker AA, Atasoy B, Erol AB, Toluk O, Aydoğdu İ. Diagnostic role of gray-scale and shear-wave elastography in pediatric patients with undescended testes: a prospective controlled study. J Ultrason 2024; 24:1-7. [PMID: 38343787 PMCID: PMC10850941 DOI: 10.15557/jou.2024.0004] [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: 06/25/2023] [Accepted: 09/11/2023] [Indexed: 04/26/2024] Open
Abstract
Aim Ultrasound elastography is a simple non-invasive method for measuring tissue elasticity in relation to tissue fibrosis. The aim of this study was to compare echogenicity, volume and shear wave velocities of undescended vs normally descended testes. Material and methods Sixty-six boys with undescended testes were included in this study. The median age range was 35.5 (10-118) months old. The cases included in this prospective study consisted of 66 patients with non-operated undescended testes, with 51 of them being affected unilaterally and 15 affected bilaterally, as diagnosed by physical examination. The control group consisted of 31 healthy boys without any particular health problems. This prospective study was performed by gray-scale ultrasonography and shear wave elastography in boys with undescended testes and healthy testes. The testicular volumes were established by ultrasound measurement, the echogenicity and shear wave elastography values were measured in boys with unilateral and bilateral undescended testes, and the results were compared with healthy boys' testes and their contralateral testes. The stiffness values were recorded for speed (m/s) and elasticity (kPa), and the stiffness values of undescended testes were compared with the healthy control group. Results Echogenicity values were lower in the bilateral undescended testes group than in the healthy group, and the healthy group's echogenicity was normal (p <0.001). The ROC curve was used to identify a cut-off shear wave elastography value for predicting decreased testicular echogenicity by using average shear wave elastography values. The area under the curve for the undescended testes was 0.78 (95% CI: 0.70-0.85, sensitivity 83.7%, specificity 68.7%, p <0.001), with an average shear wave elastography value of 2.32 (m/s) for above the cut-off point indicates. This was found to be significantly associated with reduced echogenicity on gray-scale ultrasonography, suggesting that it may be correlated with fibrosis developing in patients with undescended testes. Conclusion The study provides interesting findings in that it proposes an alternative non-invasive method for the assessment of testicular tissue in undescended testes. We used shear wave elastography to compare the stiffness of normal testes in both heathy patients and in the contralateral healthy testes of boys with undescended testes, with the values obtained for the undescended testes reflecting the level of fibrosis of the parenchyma. Another outcome of this study was observed in patients with unilateral undescended testes, where the normally descended testes showed increased shear wave elastography values, which could be an early indication of parenchymal change.
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Affiliation(s)
- Ismail Yurtsever
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Seyma Yıldız
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Samil Amirjanov
- Pediatric Surgery, Bezmialem Vakif University, Istanbul, Turkey
| | - Can Yılmaz Yozgat
- Faculty of Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Serdar Balsak
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Bahar Atasoy
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Ahmet Berk Erol
- Faculty of Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Ozlem Toluk
- Biostatistics, Bezmialem Vakif University, Istanbul, Turkey
| | - İbrahim Aydoğdu
- Pediatric Surgery, Bezmialem Vakif University, Istanbul, Turkey
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22
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Hazzan R, Abu Ahmad N, Habib AS, Saleh I, Ziv N. Suboptimal reliability of FIB-4 and NAFLD-fibrosis scores for staging of liver fibrosis in general population. JGH Open 2024; 8:e13034. [PMID: 38380260 PMCID: PMC10877654 DOI: 10.1002/jgh3.13034] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/02/2024] [Accepted: 01/16/2024] [Indexed: 02/22/2024]
Abstract
Background and Aim The burden and incidence of liver cirrhosis are increasing worldwide. Early detection of liver fibrosis would help in early interventions and preventing the progression of fibrosis and cirrhosis. The accepted noninvasive markers for liver fibrosis staging, namely fibrosis-4 (FIB-4) and nonalcoholic fatty liver disease fibrosis score (NFS), have shown inconsistent performance for detecting the fibrosis stage. We aimed to evaluate the efficacy of FIB-4 score and NFS for the detection of liver fibrosis in the general population. Methods From a general population referred from a single, community-based family-physician clinic, we included study participants between the ages of 45 and 65 years, with no knowledge of liver disease and no record of alcohol consumption. Liver fibrosis was evaluated by the FIB-4 score and NFS using shear wave elastography (SWE) or transient elastography (TE) measurements as a reference. Results A total of 76 participants (aged 61.5 ± 0.37 years, 33% females) were included in the study cohort. We observed a nonsignificant correlation between liver stiffness measurement (LSM) and FIB-4 and NFS (r = 0.1, P = 0.37; r = 0.16, P = 0.15, respectively). Our results showed that only 5.2% with FIB-4 >3.25 and 9.7% with NFS >0.675 had LSM >12 kPa. The compatibility of fibrosis staging was 55% between FIB-4 score and LSM and only 18% between NFS and LSM. Conclusion We found that FIB-4 and NFS are unreliable tools for liver fibrosis estimation in the general population. There is a need for more reliable noninvasive methods for the early detection of liver fibrosis.
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Affiliation(s)
| | | | | | | | - Neeman Ziv
- Diagnostic Imaging InstituteEmek Medical CenterAfulaIsrael
- The Faculty of MedicineTechnion Institute of TechnologyHaifaIsrael
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23
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Paramalingam S, Needham M, Bulsara M, Mastaglia FL, Keen HI. The longitudinal study of muscle changes with ultrasound: differential changes in idiopathic inflammatory myopathy subgroups. Rheumatology (Oxford) 2024; 63:490-497. [PMID: 37225404 DOI: 10.1093/rheumatology/kead239] [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: 02/23/2023] [Revised: 04/21/2023] [Accepted: 05/13/2023] [Indexed: 05/26/2023] Open
Abstract
OBJECTIVES We investigated shear wave elastography (SWE), B mode US and power Doppler (PDUS) as imaging biomarkers for longitudinal follow-up in idiopathic inflammatory myopathy (IIM), with a particular focus on immune-mediated necrotizing myopathy (IMNM) and DM. METHODS Participants had serial SWE, PDUS on the deltoid (D) and vastus lateralis (VL) muscles on four occasions at intervals of 3-6 months. Clinical assessments included manual muscle testing, and patient- and physician-reported outcome scales. RESULTS Thirty-three participants were included: IMNM = 17, DM = 12, overlap myositis = 3, PM = 1. Twenty were in a prevalent clinic group, and 13 were recently treated cases in an incident group. Differential changes in SWS and US domains occurred with time in both the prevalent and incident groups. In the VL-prevalent subgroup, echogenicity increased over time (P = 0.040), while in the incident cases there was a trend for reduction to normal over time (P = 0.097) with treatment. Muscle bulk reduced in the D-prevalent subgroup over time (P = 0.096), suggesting atrophy. SWS also reduced in the VL-incident subgroup over time (P = 0.096), suggesting a trend towards improvement in muscle stiffness with treatment. CONCLUSION SWE and US appear promising as imaging biomarkers for patient follow-up in IIM and indicate changes over time, especially with echogenicity, muscle bulk and SWS in the VL. Due to the limitations of the participant numbers, additional studies with a larger cohort are needed to help evaluate these US domains further and outline specific characteristics within the IIM subgroups.
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Affiliation(s)
- Shereen Paramalingam
- University of Notre Dame Australia, Fremantle, Western Australia, Australia
- Department of Rheumatology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Merrilee Needham
- University of Notre Dame Australia, Fremantle, Western Australia, Australia
- Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Western Australia, Australia
- Department of Neurology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Max Bulsara
- Institute for Health Research, Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, University of Western Australia, Australia
| | - Helen I Keen
- Department of Rheumatology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
- School of Medicine, University of Western Australia, Australia
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Yang C, Tsai H, Chou Y, Yang Y. NR1H4 mutation and rapid progressive intrahepatic cholestasis in infancy: A case report and literature review. Clin Case Rep 2024; 12:e8531. [PMID: 38405357 PMCID: PMC10890968 DOI: 10.1002/ccr3.8531] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 02/27/2024] Open
Abstract
Farnesoid X receptor (FXR) is a nuclear bile acid receptor encoded by the NR1H4 gene, a vital regulator of bile acid homeostasis. Pathogenic mutations of NR1H4 manifest as low gamma-glutamyl transferase (GGT) cholestasis with rapid progression to liver failure, which is referred to as progressive familial intrahepatic cholestasis 5 (PFIC-5). Herein, we present a case with rapid progressive cholestasis, liver failure in early infancy with the NR1H4 termination mutation.
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Affiliation(s)
- Chiao‐Yu Yang
- Department of PediatricsNational Cheng Kung University HospitalTainanTaiwan
- Department of Pediatrics, An Nan HospitalChina Medical UniversityTainanTaiwan
| | - Hung‐Wen Tsai
- Department of PathologyNational Cheng Kung University HospitalTainanTaiwan
- Institute of Clinical MedicineCollege of Medicine, National Cheng Kung UniversityTainanTaiwan
| | - Yen‐Yin Chou
- Department of PediatricsNational Cheng Kung University HospitalTainanTaiwan
| | - Yao‐Jong Yang
- Department of PediatricsNational Cheng Kung University HospitalTainanTaiwan
- Institute of Clinical MedicineCollege of Medicine, National Cheng Kung UniversityTainanTaiwan
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25
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Hossain MM, Konofagou EE. Feasibility of Phase Velocity Imaging Using Multi Frequency Oscillation- Shear Wave Elastography. IEEE Trans Biomed Eng 2024; 71:607-620. [PMID: 37647191 PMCID: PMC10873514 DOI: 10.1109/tbme.2023.3309996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
OBJECTIVE To assess viscoelasticity, a pathologically relevant biomarker, shear wave elastography (SWE) generally uses phase velocity (PV) dispersion relationship generated via pulsed acoustic radiation force (ARF) excitation pulse. In this study, a multi-frequency oscillation (MFO)- excitation pulse with higher weight to higher frequencies is proposed to generate PV images via the generation of motion with energy concentrated at the target frequencies in contrast to the broadband frequency motion generated in pulsed SWE (PSWE). METHODS The feasibility of MFO-SWE to generate PV images at 100 to 1000 Hz in steps of 100 Hz was investigated by imaging 6 and 70 kPa inclusions with 6.5 and 10.4 mm diameter and ex vivo bovine liver with and without the presence of an aberration layer and chicken muscle ex vivo, and 4T1 mouse breast tumor, in vivo with comparisons to PSWE. RESULTS MFO-SWE-derived CNR was statistically higher than PSWE for 6 kPa (both with and without aberration) and 70 kPa (with aberration) inclusions and derived SNR of the liver was statistically higher than PSWE at higher frequency (600-1000 Hz). Quantitatively, at 600-1000 Hz, MFO-SWE improved CNR of inclusions (without and with) aberration on an average by (8.2 and 156)% and of the tumor by 122%, respectively, and improved SNR of the liver (without and with) aberration by (20.2 and 51.5)% and of chicken muscle by 72%, respectively compared to the PSWE. CONCLUSIONS AND SIGNIFICANCE These results indicate the advantages of MFO-SWE to improve PV estimation at higher frequencies which could improve viscoelasticity quantification and feature delineation.
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26
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Sakamoto F, Matsumoto S, Otani T, Takagi Y, Yamamoto T. The usefulness of shear wave elastography in evaluating erectile dysfunction severity before and after prostaglandin E1 test. Nagoya J Med Sci 2024; 86:104-109. [PMID: 38505715 PMCID: PMC10945220 DOI: 10.18999/nagjms.86.1.104] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/23/2023] [Indexed: 03/21/2024]
Abstract
Prostaglandin E1 intracavernous injection test is an established method for diagnosing erectile dysfunction. However, the evaluation is non-objective and often influenced by the evaluator's subjectivity. Herein, we measured and objectively evaluated shear wave elastography results of the corpus cavernosum before and after injection in 16 patients who underwent prostaglandin E1 testing. The response score of prostaglandin E1 tests were "1" in 2 cases, "2" in 2 cases, and "3" in 12 cases. The average transmission velocity before the injection and at the time of maximum erection after the injection were 2.21 m/s and 1.57 m/s, respectively. Transmission velocity decreased during erection in 14 of 16 cases (87.5%). The overall rate of change in transmission velocity due to injection was -26.7% and was significantly different between the poor (responses 1 and 2: -16.1%) and good erection (response 3: -30.2%) groups. To the best of our knowledge, this is the first attempt to evaluate erectile phenomenon using percutaneous ultrasonic elastography in Japan. Rate of change in shear wave transmission velocity due to prostaglandin E1 injection in the corpus cavernosum penis was associated with the degree of erection. Therefore, the rate of change in shear wave transmission velocity in the corpus cavernosum penis could be used as an objective index of erectile phenomenon. Percutaneous ultrasonic elastography is a non-invasive and useful test method for diagnosing erectile dysfunction, determining the therapeutic effect, and predicting prognosis.
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Affiliation(s)
| | - Seiji Matsumoto
- Headquarters for Research Promotion, Asahikawa Medical University, Asahikawa, Japan
- Clinical Research Support Center, Asahikawa Medical University Hospital, Asahikawa, Japan
| | - Toshikazu Otani
- Department of Urology, Chubu Rousai Hospital, Nagoya, Japan
- Department of Urology, Rokuwa Hospital, Inazawa, Japan
| | | | - Tokunori Yamamoto
- Clinical Research Support Center, Asahikawa Medical University Hospital, Asahikawa, Japan
- Promotion Office for Open Innovation, Institutes of Innovation for Future Society, Nagoya University, Nagoya, Japan
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27
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Hoffman HT, Koch M, Witt RL, Ryan WR, Zenk J, Katz P, Rahmati R, Rassekh C, Donato F, McCulloch TM, Joshi AS, Chang JL, Gillespie MB, Pichardo PFA, Orloff LA, Marcelino A, Wenzel P, Cohen D, Fundakowski CE, Cognetti DM, Walvekar RR, Bertelli A, Quon H, Anderson C, Policeni B, Siegel G. Proposal for standardized ultrasound analysis of the salivary glands: Part 1 submandibular gland. Laryngoscope Investig Otolaryngol 2024; 9:e1224. [PMID: 38362174 PMCID: PMC10866606 DOI: 10.1002/lio2.1224] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 01/05/2024] [Accepted: 01/25/2024] [Indexed: 02/17/2024] Open
Abstract
Objectives The Salivary Gland Committee of the American Academy of Otolaryngology-Head and Neck Surgery seeks to standardize terminology and technique for ultrasonograpy used in the evaluation and treatment of salivary gland disorders. Methods Development of expert opinion obtained through interaction with international practitioners representing multiple specialties. This committee work includes a comprehensive literature review with presentation of case examples to propose a standardized protocol for the language used in ultrasound salivary gland assessment. Results A multiple segment proposal is initiated with this focus on the submandibular gland. We provide a concise rationale for recommended descriptive language highlighted by a more extensive supplement that includes an extensive literature review with additional case examples. Conclusion Recommendations are provided to improve consistency both in performing and reporting submandibular gland ultrasound.
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Affiliation(s)
| | | | - Robert Lee Witt
- Christiana Care/Thomas Jefferson UniversityPhiladelphiaPennsylvaniaUSA
| | - William R. Ryan
- University of California San FranciscoSan FranciscoCaliforniaUSA
| | | | - Philippe Katz
- Institut d'Explorations Fonctionnelles des Glandes SalivairesParisFrance
| | | | - Christopher Rassekh
- University of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvaniaUSA
| | | | | | - Arjun S. Joshi
- The George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | | | - M. Boyd Gillespie
- University of Tennessee Health Science Center College of MedicineMemphisTennesseeUSA
| | | | | | | | - Piper Wenzel
- University of Iowa Hospitals and ClinicsIowa CityIowaUSA
| | - David Cohen
- Kaiser Permanente Los Angeles Medical CenterLos AngelesCaliforniaUSA
| | | | | | | | - Antonio Bertelli
- Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo BrazilSao PauloBrazil
| | - Harry Quon
- Johns Hopkins Medical Institutions CampusBaltimoreMarylandUSA
| | | | - Bruno Policeni
- University of Iowa Hospitals and ClinicsIowa CityIowaUSA
| | - Gordy Siegel
- Northwestern University Feinberg School of MedicineChicagoIllinoisUSA
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28
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Zhao S, Wu X, Zhang Y, Zhang C. Role of Shear Wave Elastography in the Diagnosis of Peyronie Disease. J Ultrasound Med 2024; 43:397-403. [PMID: 37948532 DOI: 10.1002/jum.16372] [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: 08/12/2023] [Accepted: 10/20/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES The present study aims to explore the role of shear wave elastography (SWE) in the diagnosis of Peyronie disease (PD). METHODS A total of 59 PD patients and 59 age-matched healthy adult men were included in this study. The B-mode ultrasound (US) and SWE were performed for all subjects, and the Young modulus (YM) values of the corresponding regions of the penis in the PD and control groups were recorded and compared. RESULTS The mean age of the included PD patients and age-matched controls was 53.81 years (SD 9.52, range 32-73). On B-mode US evaluation, 41 (69.5%) of 59 included PD patients were found to have penile plaques, and the remaining 18 (30.5%) patients had no evidence of penile plaque. After evaluation using SWE, the YM values in the penile plaque region of these 41 patients with penile dysplasia were found to be significantly higher (60.29 kPa ± 19.95) than those outside the plaque (in the same patient) (21.05 kPa ± 4.58) and in the same penile region of the control group (20.59 kPa ± 4.65) (P < .001). In the remaining 18 PD patients, the results showed that the YM value of the abnormal penile region in the PD patients (56.67 kPa ± 13.52) was significantly higher than the YM value outside the abnormal penile region in the same patients (22.79 kPa ± 4.31) and in the same penile region in the control group (19.87 kPa ± 3.48) (P < .001; P < .001). CONCLUSIONS In conclusion, this study showed that SWE as a non-invasive technique is useful in identifying and differentiating penile plaques in PD patients and is a simple, rapid and complementary method to B-mode US.
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Affiliation(s)
- Sheng Zhao
- The Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xu Wu
- The Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yuyang Zhang
- The Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Chaoxue Zhang
- The Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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29
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Cebula A, Cebula M, Czajkowska M, Gruszczyńska K, Kopyta I. Influence of the physical pressure of an ultrasound probe on shear-wave elastography measurements of the gastrocnemius muscle in a paediatric population: a non-interventional cohort study. Pol J Radiol 2024; 89:e24-e29. [PMID: 38371890 PMCID: PMC10867979 DOI: 10.5114/pjr.2024.134437] [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: 06/06/2023] [Accepted: 12/15/2023] [Indexed: 02/20/2024] Open
Abstract
Purpose The aim of our study is to evaluate the impact of ultrasound probe mechanical pressure on the stiffness of the gastrocnemius muscle in a healthy paediatric population. As far as we know, there has been no previous qualitative in vivo study on the impact of probe pressure on muscle shear-wave elastography results with objective evaluation of compression in the paediatric population. Material and methods In this cohort study, a group of 22 children (mean age 8.99 years, SD 2.74, 11 males) underwent elastography of the gastrocnemius muscle of the dominant leg. A custom-made, 3-dimensional printed probe cover was used to measure the mechanical pressure of the probe on tissues. Results The obtained results were related to the age, sex, BMI, and calf circumference of the subjects. We observed a significant difference in the stiffness parameter at a pressure of 1 N, with a further increase if force was increased (p < 0.001). A significant, very weak positive correlation of age and stiffness was observed (p < 0.001, r2 = 0.022). There was no significant correlation of stiffness, BMI, and calf circumference. Conclusions The use of compression during muscle elastography in children causes a significant bias in results, regardless of age, sex, BMI, or calf size.
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Affiliation(s)
- Agnieszka Cebula
- Department of Paediatric Neurology, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Poland
| | - Maciej Cebula
- Individual Specialist Medical Practice Maciej Cebula, Katowice, Poland
| | - Marta Czajkowska
- Doctoral School, Medical University of Silesia in Katowice, Poland
| | - Katarzyna Gruszczyńska
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Medical University of Silesia in Katowice, Poland
| | - Ilona Kopyta
- Department of Paediatric Neurology, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Poland
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30
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Tonna R, Chatzistergos PE, Wyatt O, Chockalingam N. Reliability and Validity of Shore Hardness in Plantar Soft Tissue Biomechanics. Sensors (Basel) 2024; 24:539. [PMID: 38257632 PMCID: PMC10818800 DOI: 10.3390/s24020539] [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: 12/18/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024]
Abstract
Shore hardness (SH) is a cost-effective and easy-to-use method to assess soft tissue biomechanics. Its use for the plantar soft tissue could enhance the clinical management of conditions such as diabetic foot complications, but its validity and reliability remain unclear. Twenty healthy adults were recruited for this study. Validity and reliability were assessed across six different plantar sites. The validity was assessed against shear wave (SW) elastography (the gold standard). SH was measured by two examiners to assess inter-rater reliability. Testing was repeated following a test/retest study design to assess intra-rater reliability. SH was significantly correlated with SW speed measured in the skin or in the microchamber layer of the first metatarsal head (MetHead), third MetHead and rearfoot. Intraclass correlation coefficients and Bland-Altman plots of limits of agreement indicated satisfactory levels of reliability for these sites. No significant correlation between SH and SW elastography was found for the hallux, 5th MetHead or midfoot. Reliability for these sites was also compromised. SH is a valid and reliable measurement for plantar soft tissue biomechanics in the first MetHead, the third MetHead and the rearfoot. Our results do not support the use of SH for the hallux, 5th MetHead or midfoot.
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Affiliation(s)
- Redent Tonna
- Department of Engineering, School of Digital, Technologies and Arts, Staffordshire University, Stoke-on-Trent ST4 2DE, UK;
| | - Panagiotis E. Chatzistergos
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent ST4 2DE, UK; (O.W.); (N.C.)
| | - Otis Wyatt
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent ST4 2DE, UK; (O.W.); (N.C.)
| | - Nachiappan Chockalingam
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent ST4 2DE, UK; (O.W.); (N.C.)
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Yi AJ, Yang WW, Cui XW, Dietrich CF, Wang B. The value of quantitative and a new qualitative color pattern shear wave elastography for the differentiation of ACR TI-RADS 4 or 5 category thyroid nodules measuring ≤10 mm. Front Endocrinol (Lausanne) 2024; 14:1275256. [PMID: 38260152 PMCID: PMC10800972 DOI: 10.3389/fendo.2023.1275256] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
Objective This study aims to evaluate the diagnostic performance of quantitative shear wave elastography (SWE) and a new qualitative color pattern SWE for the differentiation of benign and malignant American College of Radiology Thyroid Imaging, Reporting, and Data System (ACR TI-RADS) 4 or 5 category thyroid nodules measuring ≤10 mm. Materials and methods From May 2020 to July 2022, a total of 237 patients with 270 thyroid nodules were enrolled, and conventional ultrasound and SWE examinations were performed for each patient. Each ACR TI-RADS 4 or 5 category thyroid nodule measuring ≤10 mm was evaluated by quantitative SWE and a new qualitative color pattern SWE. The diagnostic performance of quantitative SWE parameters, the new qualitative color pattern SWE, and the combination of SWE with ACR TI-RADS, respectively, for the differentiation of benign and malignant ACR TI-RADS 4 or 5 category thyroid nodules measuring ≤10 mm was evaluated and compared. Results Among 270 thyroid nodules in 237 patients, 72 (26.67%) thyroid nodules were benign and 198 (73.33%) thyroid nodules were malignant. The qualitative color pattern SWE showed better diagnostic performance than the quantitative SWE parameters. When combining the qualitative color pattern SWE with ACR TI-RADS scores, with the optimal cutoff value of the total points ≥8, the thyroid nodules were considered malignant. The sensitivity, specificity, accuracy, and AUC were 89.90%, 56.94%, 81.11%, and 0.820 (95% CI: 0.768-0.864), respectively. Compared with using qualitative color pattern SWE alone, the combination of qualitative color pattern SWE and ACR TI-RADS had better diagnostic performance, which was significantly different (p < 0.05). Conclusion The combination of qualitative SWE color patterns and ACR TI-RADS had high sensitivity and accuracy, which might be a convenient and useful method to differentiate benign and malignant ACR TI-RADS 4 or 5 category thyroid nodules measuring ≤10 mm. It would be helpful for the management of thyroid nodules and improving prognosis.
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Affiliation(s)
- Ai-jiao Yi
- Department of medical ultrasound, Yueyang Central Hospital, Yueyang, China
| | - Wei-Wei Yang
- Department of medical ultrasound, Yueyang Central Hospital, Yueyang, China
| | - Xin-Wu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Christoph F. Dietrich
- Department Allgemeine Innere Medizin, Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
| | - Bin Wang
- Department of medical ultrasound, Yueyang Central Hospital, Yueyang, China
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Pimenta R, Antunes H, Bruno P, Veloso AP. Hamstrings mechanical properties profiling in football players of different competitive levels and positions after a repeated sprint protocol. Front Physiol 2024; 14:1315564. [PMID: 38239882 PMCID: PMC10794661 DOI: 10.3389/fphys.2023.1315564] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/12/2023] [Indexed: 01/22/2024] Open
Abstract
Purpose: This study compares the average speed, knee flexor peak torque and shear modulus of the hamstrings after a repeated sprint task, in football players of different competitive levels and playing positions. Methods: Fifty-four football field players without hamstring strain injury history participated, 15 being categorized as professional (2nd league) and 39 as semi-professional (17 in 3rd and 22 in 4th league). Muscle shear modulus was assessed using ultrasound-based shear wave elastography at rest and at 20% of maximal voluntary isometric effort before and immediately after the repeated sprint protocol. Results: No significant differences were seen in average sprint speed between competitive levels (p = 0.07; η2p = 0.28) and positions (p = 0.052; η2p = 0.29). Moreover, the sprint fatigue index showed no significant differences between competitive levels (p = 0.14; η2p = 0.08) and playing positions (p = 0.89; η2p = 0.05). No significant differences were observed in hamstring shear modulus changes between competitive levels (p = 0.94; η2p = 0.03) and positions (p = 0.92; η2p = 0.03). Peak torque changes also showed non-significant association with competitive levels (p = 0.46; η2p = 0.03) and positions (p = 0.60; η2p = 0.02). Conclusion: The results of this study suggest that the average sprint speed performance parameter and mechanical parameters are not able to distinguish football players of different competitive levels and positions.
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Affiliation(s)
- Ricardo Pimenta
- CIPER, Centro Interdisciplinar de Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
- Research Center of the Polytechnic Institute of Maia (N2i), Maia Polytechnic Institute (IPMAIA), Maia, Portugal
- Futebol Clube Famalicão—Futebol SAD, Department of Rehabilitation and Performance, Famalicão, Portugal
| | - Hugo Antunes
- CIPER, Centro Interdisciplinar de Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - Paula Bruno
- CIPER, Centro Interdisciplinar de Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - A. P. Veloso
- CIPER, Centro Interdisciplinar de Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
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Varol U, Valera-Calero JA, Sánchez-Jiménez E, Fernández-de-las-Peñas C, Ortega-Santiago R, Kobylarz MD, Navarro-Santana MJ. Levator Scapulae Stiffness Measurement Reliability in Individuals with and without Chronic Neck Pain by Experienced and Novel Examiners. Sensors (Basel) 2024; 24:277. [PMID: 38203140 PMCID: PMC10781297 DOI: 10.3390/s24010277] [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: 11/07/2023] [Revised: 12/19/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024]
Abstract
The levator scapulae muscle is a key structure in the etiopathology of neck and shoulder musculoskeletal pain. Although previous studies used shear-wave elastography (SWE) for characterizing this muscle elasticity, limited evidence assessed the inter-examiner reliability of this procedure. This study aimed to analyze the inter-examiner reliability for calculating Young's modulus and shear wave speed in a cohort of participants with and without chronic neck pain. A diagnostic accuracy study was conducted, acquiring a set of SWE images at the C5 level in participants with and without neck pain (n = 34 and 33, respectively) by two examiners (one experienced and one novel). After blinding the participants' identity, examiner involved, and side, the stiffness indicators were calculated by an independent rater in a randomized order. Intra-class correlation coefficients (ICC), standard error of measurement, minimal detectable changes, and coefficient of variation were calculated. Both cohorts had comparable sociodemographic characteristics (p > 0.05). No significant levator scapulae elasticity differences were found between genders, sides, or cohorts (all, p > 0.05). Inter-examiner reliability for calculating Young's modulus and shear wave speed was moderate-to-good for assessing asymptomatic individuals (ICC = 0.714 and 0.779, respectively), while poor-to-moderate in patients with neck pain (ICC = 0.461 and 0.546, respectively). The results obtained in this study support the use of this procedure for assessing asymptomatic individuals. However, reliability estimates were unacceptable to support its use for assessing elasticity in patients with chronic neck pain. Future studies might consider that the shear wave speed is more sensitive to detect real changes in comparison with Young's modulus.
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Affiliation(s)
- Umut Varol
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 29222 Alcorcón, Spain; (U.V.); (M.D.K.)
| | - Juan Antonio Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.V.-C.); (M.J.N.-S.)
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | | | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Ricardo Ortega-Santiago
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Mateusz D. Kobylarz
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 29222 Alcorcón, Spain; (U.V.); (M.D.K.)
- Akademia Terapii Manualnej i Igłoterapii Suchej (ATMIS), 34-400 Nowy Targ, Poland
| | - Marcos José Navarro-Santana
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.V.-C.); (M.J.N.-S.)
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
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Iida N, Kuroiwa T, Amadio P. Analysis of the thenar muscles with ultrasound shear wave elastography: Reliability and preliminary findings. Muscle Nerve 2024; 69:72-77. [PMID: 37964671 DOI: 10.1002/mus.28004] [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: 04/13/2023] [Revised: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 11/16/2023]
Abstract
INTRODUCTION/AIMS Ultrasound shear wave elastography (SWE) of the thenar muscles has the potential to provide a simple and noninvasive assessment of the severity of carpal tunnel syndrome (CTS), but its reliability is unknown. The purpose of this study was to assess the intra- and inter-rater reliability of SWE measurements of the elastic modulus of individual thenar muscles, to assess their suitability for clinical application. METHODS Fourteen healthy volunteers, seven male and seven female, participated in this study. The elastic modulus of the thenar muscles was measured with SWE, with two independent examiners to assess inter-rater reliability. The first examiner also performed a second measurement after an interval of least 1 day to assess intra-rater reliability. Reliability was evaluated using an intraclass correlation coefficient (ICC) and 95% confidence interval (CI). RESULTS For the abductor pollicis brevis (APB) and opponens pollicis (OPP), the CI of ICC in intra-rater reliability was 0.47-0.85 and 0.56-0.88, respectively. The CI of ICC in inter-rater reliability was 0.27-0.78 for the APB and 0.22-0.76 for the OPP. The ICCs of intra- and/or inter-rater reliability of other thenar muscles were less than 0.5. DISCUSSION In this study, SWE evaluations of thenar muscles were quite variable in terms of their reliability. A larger study will be needed to determine the source of this variability, improve reliability, and assess the value of SWE in the evaluation of the severity of CTS.
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Affiliation(s)
- Naoya Iida
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Tomoyuki Kuroiwa
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Peter Amadio
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
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Samanta A, Srivastava A, Yadav R, Kapoor A, Ghosh A, Mishra P, Sen Sarma M, Poddar U. Budd-Chiari syndrome in children: Radiological intervention and role of shear wave elastography in monitoring response. J Pediatr Gastroenterol Nutr 2024; 78:17-26. [PMID: 38291698 DOI: 10.1002/jpn3.12067] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/26/2023] [Accepted: 09/06/2023] [Indexed: 02/01/2024]
Abstract
OBJECTIVES Radiological intervention (RI) is the preferred treatment in children with Budd-Chiari syndrome (BCS). We studied the comparative long-term outcome of BCS children, with and without RI and utility of liver and splenic stiffness measurement (LSM, SSM) by 2-dimensional shear wave elastography (2D-SWE) in assessing response. METHODS Sixty children (40 boys, median age 10.5 [6.5-15.25] years) with BCS (29 newly diagnosed, 31 follow-up) were evaluated. LSM and SSM by 2D-SWE and vascular patency were monitored pre- and postprocedure (≥ 6 months postprocedure) in those undergoing RI. Medical therapy without anticoagulation and monitoring was done in subjects without RI. The RI and no-RI groups were compared. RESULTS Ascites (54,90%), hepatomegaly (56,93%) and prominent abdominal-veins (42,70%), were the commonest features. The majority (46,78%) had isolated hepatic vein block. 44 (73%) cases underwent RI, while 16 (27%) were managed conservatively. Both groups were similar at baseline. Post-RI subjects showed significant improvement in clinical findings, liver functions and portal hypertension. LSM [33 (32-34.5) to 19.2 (18-20.67) kPa] and SSM [54.5 (52.3-57.6) to 28.9 (27.6-30.25) kPa] showed a significant decline from baseline value over a follow-up of 12 (6-13) months. Gradual reduction occurred in the LSM and SSM over 1-5 years, with near-normal LSM [10.2 (9.2-11.5) kPa] and SSM [22.3 (20.5-24.3) kPa] values in patients (n-16) with > 5 years follow-up. Patients without RI showed worsening in LSM and SSM. Hepatopulmonary syndrome and hepatocellular carcinoma developed in 4 (8%) and 1 (1.7%) cases respectively. CONCLUSION RI leads to clinical recovery and reduction with near normalization of LSM and SSM over long-term follow-up in children with BCS. 2D-SWE is a promising tool to monitor outcomes.
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Affiliation(s)
- Arghya Samanta
- Department of Pediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Anshu Srivastava
- Department of Pediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Rajnikant Yadav
- Department of Radiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Aditya Kapoor
- Department of Cardiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Anindya Ghosh
- Department of Cardiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Prabhakar Mishra
- Department of Biostatistics and Health Informatics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Moinak Sen Sarma
- Department of Pediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Ujjal Poddar
- Department of Pediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
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Xie C, Man Q, Wan X, Ding Y, Li M. The clinical value of combining shear wave elastography, VOCAL technique, and T2* MRI of early gestation placenta to predict pre-eclampsia. J Clin Ultrasound 2024; 52:13-19. [PMID: 37883126 DOI: 10.1002/jcu.23575] [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] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE To investigate the clinical value of combining shear wave elastography (SWE) with the Volumetric Organ Computer-Aided AnaLysis (VOCAL) technique and T2* magnetic resonance imaging (MRI) to predict pre-eclampsia (PE). METHODS From December 2022 to March 2023, we recruited 31 pregnant women diagnosed with PE at our hospital as the observation group and 85 normal pregnant women as the control group. Differences in placental elasticity, vascularization index (VI), flow index (FI), vascularization flow index (VFI), and T2* MRI perfusion fraction (f) were compared between the two groups. Received operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value of placental elasticity, VI, FI, VFI, f, and their combination for predicting PE. RESULTS Placental elasticity was higher in the observation group than in the control group, while VI, FI, VFI, and f were lower in the observation group (all p < 0.05). The area under the curve (AUC) for placental elasticity, VI, FI, VFI, f, and their combination for predicting PE were 0.85, 0.77, 0.78, 0.84, 0.65, and 0.94, respectively. The sensitivity was 71%, 55%, 94%, 65%, 55%, and 81%. The specificity was 92%, 91%, 60%, 92%, 79%, and 98%. The combined prediction model had a higher AUC than the individual predictors (p < 0.05). CONCLUSION SWE combined with VOCAL technique and T2* MRI has high value for predicting PE and can provide reference information for clinical diagnosis.
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Affiliation(s)
- Chuanbo Xie
- Ultrasound Medicine Department, Zigong Hospital of Woman and Children Healthcare, Zigong, Sichuan, China
| | - Qin Man
- Prenatal Diagnosis Center, Zigong Hospital of Woman and Children Healthcare, Zigong, Sichuan, China
| | - Xiaomei Wan
- Ultrasound Medicine Department, Zigong Hospital of Woman and Children Healthcare, Zigong, Sichuan, China
| | - Yanyun Ding
- Ultrasound Medicine Department, Zigong Hospital of Woman and Children Healthcare, Zigong, Sichuan, China
| | - Min Li
- Imaging Department, Zigong Hospital of Woman and Children Healthcare, Zigong, Sichuan, China
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Huang YL, Tian XF, Qiu YJ, Lou WH, Jung EM, Dong Y, Wang HZ, Wang WP. Preoperative ultrasound radiomics for predicting clinically relevant postoperative pancreatic fistula after pancreatectomy. Clin Hemorheol Microcirc 2024; 86:313-326. [PMID: 37927251 DOI: 10.3233/ch-231955] [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] [Indexed: 11/07/2023]
Abstract
OBJECTIVES To evaluate the efficacy of the radiomics model based on preoperative B-mode ultrasound (BMUS) and shear wave elastography (SWE) for predicting the occurrence of clinically relevant-postoperative pancreatic fistula (CR-POPF). METHODS Patients who were scheduled to undergo pancreatectomy were prospectively enrolled and received ultrasound assessment within one week before surgery. The risk factors of POPF (grades B and grades C) were analyzed. Preoperative BMUS images, SWE values of pancreatic lesions and surrounding parenchyma were used to build preoperative prediction radiomics models. Radiomic signatures were extracted and constructed using a minimal Redundancy Maximal Relevance (mRMR) algorithm and an L1 penalized logistic regression. A combined model was built using multivariate regression which incorporated radiomics signatures and clinical data. RESULTS From January 2020 to November 2021, a total of 147 patients (85 distal pancreatectomies and 62 pancreaticoduodenectomies) were enrolled. During the three-week follow-up after pancreatectomy, the incidence rates of grade B/C POPF were 28.6% (42/147). Radiomic signatures constructed from BMUS of pancreas parenchymal regions (panRS) achieved an area under the receiver operating characteristic curve (AUC) of 0.75, accuracy of 68.7%, sensitivity of 85.7 %, and specificity of 61.9 % in preoperative noninvasive prediction of CR-POPF. The AUC of the radiomics model increased to 0.81 when panRS was used for the prediction of CR-POPF after pancreaticoduodenectomy. CONCLUSIONS Radiomics model based on ultrasound images was potentially useful for predicting CR-POPF. Patients with high-risk factors should be closely monitored when postoperation.
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Affiliation(s)
- Yun-Lin Huang
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao-Fan Tian
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi-Jie Qiu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wen-Hui Lou
- Department of Pancreas Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ernst-Michael Jung
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
| | - Yi Dong
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Han-Zhang Wang
- Precision Health Institute, GE Healthcare China, Shanghai, China
| | - Wen-Ping Wang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
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Nosakova L, Uhrik P, Pindura M, Vojtko M, Hoferica J, Cmarkova K, Miklusica J, Banovcin P. Pancreatic stiffness and anthropometric parameters in healthy volunteers. BRATISL MED J 2024; 125:172-175. [PMID: 38385543 DOI: 10.4149/bll_2024_27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
PURPOSE The aim of this study was to define the values of percutaneous ultrasound shear-wave and strain elastography of the pancreas in healthy volunteers. METHODS This is a single-center prospective study conducted on volunteers who underwent examination of percutaneous point shear‑wave elastography and strain elastography. Both the shear-wave speed (Vs) and strain histogram were measured 3 times and median values were evaluated. Relevant recorded clinical data were age, sex, and height. RESULTS From May 2020 to October 2021 a total of 90 patients (21 male, 69 female) were included in the study. Their average age was 26 years (from 22 to 65). The average SWM in kPa was 6.07 (2.58-17.29). The average value of SE was 134.44 (78.51-184.35). Most of the patients had BMI in the range of normal weight with an average value of 22.75 (17.5-28). The average depth of the localization of the pancreas was 4.5 cm. The effect of BMI on the strain histogram was significant (p < 0.05). We found a significant relationship between the strain histogram and the depth of localization of the pancreas (p < 0.01). CONCLUSION We described normal values for pancreatic stiffness using ultrasound elastography by 2D-SWE and strain elastography. Our results indicate changes in values depending on BMI and depth of the pancreas. (Tab. 1, Fig. 5, Ref. 19).
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Uehara H, Itoigawa Y, Wada T, Morikawa D, Koga A, Maruyama Y, Ishijima M. Shear wave elastography correlates to degeneration and stiffness of the long head of the biceps tendon in patients undergoing tenodesis with arthroscopic shoulder surgery. J Shoulder Elbow Surg 2024; 33:e31-e41. [PMID: 37327988 DOI: 10.1016/j.jse.2023.05.014] [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: 11/22/2022] [Revised: 04/11/2023] [Accepted: 05/06/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Tendinopathy of the long head of the biceps (LHB) tendon causes degeneration and changes its stiffness. However, a reliable means of diagnosis has not been established. Shear wave elastography (SWE) provides quantitative tissue elasticity measurements. In this study, the relationship of preoperative SWE values with biomechanically measured stiffness and degeneration of the LHB tendon tissue was investigated. METHODS LHB tendons were obtained from 18 patients who underwent arthroscopic tenodesis. SWE values were measured preoperatively at 2 sites, proximal to and within the bicipital groove of the LHB tendon. The LHB tendons were detached immediately proximal to the fixed sites and at their superior labrum insertion. Tissue degeneration was histologically quantified using the modified Bonar score. Tendon stiffness was determined using a tensile testing machine. RESULTS The SWE values of the LHB tendon were 502.1 ± 113.6 kPa proximal to the groove and 439.4 ± 123.3 kPa within the groove. The stiffness was 39.3 ± 19.2 N/mm. The SWE values displayed a moderate positive correlation with the stiffness proximal to the groove (r = 0.80) and within it (r = 0.72). The SWE value of the LHB tendon within the groove showed a moderate negative correlation with the modified Bonar score (r = -0.74). CONCLUSIONS These findings suggest that preoperative SWE values of the LHB tendon correlate moderately positively with stiffness and moderately negatively with tissue degeneration. Therefore, SWE may predict LHB tendon tissue degeneration and changes in stiffness caused by tendinopathy.
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Affiliation(s)
- Hirohisa Uehara
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, Chiba, Japan; Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yoshiaki Itoigawa
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, Chiba, Japan; Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Tomoki Wada
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Daichi Morikawa
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Akihisa Koga
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Yuichiro Maruyama
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Muneaki Ishijima
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Togawa R, Pfob A, Büsch C, Fastner S, Gomez C, Goncalo M, Hennigs A, Killinger K, Nees J, Riedel F, Schäfgen B, Stieber A, Tozaki M, Heil J, Barr R, Golatta M. Intra- and Interobserver Reliability of Shear Wave Elastography in Breast Cancer Diagnosis. J Ultrasound Med 2024; 43:109-114. [PMID: 37772458 DOI: 10.1002/jum.16344] [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: 08/01/2023] [Revised: 09/11/2023] [Accepted: 09/17/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVES Shear wave elastography (SWE) is increasingly used in breast cancer diagnostics. However, large, prospective, multicenter data evaluating the reliability of SWE is missing. We evaluated the intra- and interobserver reliability of SWE in patients with breast lesions categorized as BIRADS 3 or 4. METHODS We used data of 1288 women at 12 institutions in 7 countries with breast lesions categorized as BIRADS 3 to 4 who underwent conventional B-mode ultrasound and SWE. 1243 (96.5%) women had three repetitive conventional B-mode ultrasounds as well as SWE measurements performed by a board-certified senior physician. 375 of 1288 (29.1%) women received an additional ultrasound examination with B-mode and SWE by a second physician. Intraclass correlation coefficients (ICC) were calculated to examine intra- and interobserver reliability. RESULTS ICC for intraobserver reliability showed an excellent correlation with ICC >0.9, while interobserver reliability was moderate with ICC of 0.7. There were no clinically significant differences in intraobserver reliability when SWE was performed in lesions categorized as BI-RADS 3 or 4 as well as in histopathologically benign or malignant lesions. CONCLUSION Reliability of additional SWE was evaluated on a study cohort consisting of 1288 breast lesions categorized as BI-RADS 3 and 4. SWE shows an excellent intraobserver reliability and a moderate interobserver reliability in the evaluation of solid breast masses.
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Affiliation(s)
- Riku Togawa
- University Breast Unit, Department of Obstetrics and Gynecology, Heidelberg University Hospital, Heidelberg, Germany
| | - André Pfob
- University Breast Unit, Department of Obstetrics and Gynecology, Heidelberg University Hospital, Heidelberg, Germany
| | - Christopher Büsch
- Institute of Medical Biometry (IMBI), University of Heidelberg, Heidelberg, Germany
| | - Sarah Fastner
- Breast Unit, Sankt Elisabeth Hospital, Heidelberg, Germany
| | | | - Manuela Goncalo
- Department of Radiology, University of Coimbra, Coimbra, Portugal
| | - André Hennigs
- Breast Unit, Sankt Elisabeth Hospital, Heidelberg, Germany
| | - Kristina Killinger
- University Breast Unit, Department of Obstetrics and Gynecology, Heidelberg University Hospital, Heidelberg, Germany
| | - Juliane Nees
- University Breast Unit, Department of Obstetrics and Gynecology, Heidelberg University Hospital, Heidelberg, Germany
| | - Fabian Riedel
- University Breast Unit, Department of Obstetrics and Gynecology, Heidelberg University Hospital, Heidelberg, Germany
| | - Benedikt Schäfgen
- University Breast Unit, Department of Obstetrics and Gynecology, Heidelberg University Hospital, Heidelberg, Germany
| | - Anne Stieber
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Jörg Heil
- University Breast Unit, Department of Obstetrics and Gynecology, Heidelberg University Hospital, Heidelberg, Germany
- Breast Unit, Sankt Elisabeth Hospital, Heidelberg, Germany
| | - Richard Barr
- Department of Radiology, Northeast Ohio Medical University, Ravenna, USA
| | - Michael Golatta
- University Breast Unit, Department of Obstetrics and Gynecology, Heidelberg University Hospital, Heidelberg, Germany
- Breast Unit, Sankt Elisabeth Hospital, Heidelberg, Germany
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Patidar Y, Singh J, Chatterjee N, Mukund A, Rastogi A, Kumar G, Sharma MK. Real-Time Shear Wave Elastography for Determining the Ideal Site of Liver Biopsy in Diffuse Liver Disease. Indian J Radiol Imaging 2024; 34:44-53. [PMID: 38106860 PMCID: PMC10723949 DOI: 10.1055/s-0043-1771529] [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] [Indexed: 12/19/2023] Open
Abstract
Objectives The objective of the study was to identify accurate site of liver biopsy under ultrasound and elastography guidance and compare the shear wave elastography (SWE) and transient elastography (TE) diagnostic accuracy with histopathological correlation. Methods This was a prospective single-center study where patients scheduled for nonfocal liver biopsy were divided into two groups (group U: ultrasound; group E elastography) by sequential nonrandom selection of patients. Elastography was performed before the biopsy and biopsies from the maximum stiffness segment were taken. Results There was no significant difference of intersegmental liver stiffness with mean velocity; however, biopsy segment velocities show significant difference with mean liver stiffness suggestive of heterogenous distribution of fibrosis. The rho ( r ; Spearman's correlation) value between biopsy segments and mean velocities shows excellent correlation. The diagnostic performance of TE was good for fibrosis stages F2, F3, and F4, while SWE was fair for the diagnosis of fibrosis stages F1 and F2 and fairly equal for the diagnosis stages F2 and F3. Area under the curve (AUC) values in differentiating mild (F1) or no fibrosis from significant fibrosis (≥F2) were 95.5 with cutoff value of at least 1.94 m/s. Conclusions The diagnostic performance of SWE is comparable with TE in liver fibrosis staging and monitoring. Fibrosis is heterogeneously distributed in different segments of the right lobe liver. Therefore, elastography at the time of biopsy may help in defining the accurate site for biopsy and improve histopathological yield in detecting liver fibrosis in patients with chronic liver disease. Advances in Knowledge Elastography-guided biopsy is helpful to determine the ideal site of biopsy.
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Affiliation(s)
- Yashwant Patidar
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Jitender Singh
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Navojit Chatterjee
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Amar Mukund
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Archana Rastogi
- Department of Pathology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Guresh Kumar
- Department of Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Manoj Kumar Sharma
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
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Lim Y, Do Y, Lee H. Association between abdominal muscle stiffness, diaphragm thickness and peak expiratory flow in younger versus older adults. Clin Physiol Funct Imaging 2024; 44:63-69. [PMID: 37455250 DOI: 10.1111/cpf.12850] [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: 05/06/2023] [Revised: 06/12/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Abstract
The present study aimed to evaluate forced expiration based on transverse abdominis (TrA) stiffness by identifying the relationship between TrA stiffness and peak expiratory flow (PEF) in both younger and older adults. We also assessed the relationship between diaphragm thickness and PEF. A total of 31 younger (21.24 ± 2.73 years) and 34 older (71.35 ± 5.26 years) adults were included in the present study. TrA muscle stiffness was measured at rest and during abdominal bracing using shear wave elastography. Diaphragm thickness was measured during deep inspiration and expiration using B-mode ultrasound, and respiratory function was assessed by measuring PEF using a spirometer. We found that TrA stiffness during bracing was significantly lower in older than younger adults (p < 0.05). Similarly, the difference in absolute stiffness of the TrA when bracing versus at rest was significantly lower in older than younger adults (p < 0.05). Additionally, TrA stiffness during bracing was positively associated with PEF in the younger group (r = 0.483), while a very weak correlation was found in the older group (r = 0.172). Similarly, PEF was moderately correlated with diaphragm thickness during expiration as well as during changes between inspiration and expiration in the younger group (r = 0.405 and r = 0.403); however, no significant correlation was found in the older group. These findings of the present study indicate that the variations in PEF between younger and older adults may be due to age-associated changes in the musculoskeletal structure and muscle fibre type.
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Affiliation(s)
- Youngeun Lim
- Department of Physical Therapy, Graduate School, College of Health Science, Gachon University, Incheon, Republic of Korea
| | - Yerim Do
- Department of Physical Therapy, Graduate School, College of Health Science, Gachon University, Incheon, Republic of Korea
| | - Haneul Lee
- Department of Physical Therapy, Graduate School, College of Health Science, Gachon University, Incheon, Republic of Korea
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Republic of Korea
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Althoff AD, Vance K, Plain M, Reeves RA, Pierce J, Gwathmey FW, Werner BC. Evaluation of Achilles Tendon Stiffness as Measured by Shear Wave Elastography in Female College Athletes Compared With Nonathletes. Sports Health 2024; 16:12-18. [PMID: 36856196 PMCID: PMC10732119 DOI: 10.1177/19417381231153657] [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] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND We sought to utilize a noninvasive technology to assess the effects of activity on Achilles tendon stiffness and define baseline Achilles tendon stiffness in female college athletes compared with nonathletes using tendon shear wave velocity as a marker for tendon stiffness. HYPOTHESIS Training status and exercise may affect Achilles tendon stiffness. STUDY DESIGN LEVEL OF EVIDENCE Level 4. METHODS A total of 32 college-age female athletes were prospectively enrolled (n = 17 varsity athletes and n = 15 nonathletes). Demographic characteristics, activity level, and previous injuries were recorded. Sonographic shear wave elastography (SWE) was used to assess Achilles tendon shear wave velocity bilaterally for all subjects, both at baseline and after 2 minutes of exercise. Student t tests were used to compare the mean elastography measurements between participants stratified by athlete status and pre/postexercise stimulus. Analysis of variance (ANOVA) was used to compare the mean proximal, middle, and distal Achilles tendon elastography measurements. RESULTS As seen by a greater mean shear wave velocity (8.60 ± 1.58 m/s vs 8.25 ± 1.89 m/s; P = 0.02), athletes had stiffer tendons than nonathletes. Exercise stimulus decreased average tendon shear wave velocity (8.57 ± 1.74 m/s vs 8.28 ± 1.72 m/s; P = 0.05). Tendon shear wave velocity was greatest proximally and least distally with significant differences between each region (P < 0.001). In addition, there was a significant 2-way interaction between weekly training status and foot dominance (P = 0.01). Post hoc analysis showed that this result was due to differences in tendon shear wave velocity between the dominant and nondominant lower extremity in nonathletes (7.73 ± 2.00 m/s vs 8.76 ± 1.62 m/s; P < 0.001). CONCLUSION Female varsity collegiate athletes have higher baseline Achilles tendon stiffness as measured by SWE compared with nonathletes. Mean tendon stiffness varies based on Achilles measurement location. SWE is a quick, cost-effective, and noninvasive imaging modality that can be used to evaluate tendon stiffness and elasticity. CLINICAL RELEVANCE SWE is an efficient and noninvasive imaging modality that can evaluate dynamic tendon stiffness and elasticity. SWE may be helpful to assess injuries in female college athletes and may play a role in risk stratification or clinical follow-up. In theory, SWE could be used to identify athletes with increased elasticity as a marker for potential risk for rupture in this population.
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Affiliation(s)
- Alyssa D. Althoff
- Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia
| | - Kayleigh Vance
- Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia
| | - Megan Plain
- Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia
| | - Russell A. Reeves
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Jennifer Pierce
- Department of Radiology, University of Virginia, Charlottesville, Virginia
| | - Frank W. Gwathmey
- Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia
| | - Brian C. Werner
- Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia
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Götschi T, Snedeker JG, Fitze DP, Sarto F, Spörri J, Franchi MV. Three-dimensional mapping of ultrasound-derived skeletal muscle shear wave velocity. Front Bioeng Biotechnol 2023; 11:1330301. [PMID: 38179131 PMCID: PMC10764491 DOI: 10.3389/fbioe.2023.1330301] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/08/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction: The mechanical properties of skeletal muscle are indicative of its capacity to perform physical work, state of disease, or risk of injury. Ultrasound shear wave elastography conducts a quantitative analysis of a tissue's shear stiffness, but current implementations only provide two-dimensional measurements with limited spatial extent. We propose and assess a framework to overcome this inherent limitation by acquiring numerous and contiguous measurements while tracking the probe position to create a volumetric scan of the muscle. This volume reconstruction is then mapped into a parameterized representation in reference to geometric and anatomical properties of the muscle. Such an approach allows to quantify regional differences in muscle stiffness to be identified across the entire muscle volume assessed, which could be linked to functional implications. Methods: We performed shear wave elastography measurements on the vastus lateralis (VL) and the biceps femoris long head (BFlh) muscle of 16 healthy volunteers. We assessed test-retest reliability, explored the potential of the proposed framework in aggregating measurements of multiple subjects, and studied the acute effects of muscular contraction on the regional shear wave velocity post-measured at rest. Results: The proposed approach yielded moderate to good reliability (ICC between 0.578 and 0.801). Aggregation of multiple subject measurements revealed considerable but consistent regional variations in shear wave velocity. As a result of muscle contraction, the shear wave velocity was elevated in various regions of the muscle; showing pre-to-post regional differences for the radial assessement of VL and longitudinally for BFlh. Post-contraction shear wave velocity was associated with maximum eccentric hamstring strength produced during six Nordic hamstring exercise repetitions. Discussion and Conclusion: The presented approach provides reliable, spatially resolved representations of skeletal muscle shear wave velocity and is capable of detecting changes in three-dimensional shear wave velocity patterns, such as those induced by muscle contraction. The observed systematic inter-subject variations in shear wave velocity throughout skeletal muscle additionally underline the necessity of accurate spatial referencing of measurements. Short high-effort exercise bouts increase muscle shear wave velocity. Further studies should investigate the potential of shear wave elastography in predicting the muscle's capacity to perform work.
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Affiliation(s)
- Tobias Götschi
- Orthopaedic Biomechanics Laboratory, Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
- Department of Orthopaedics, Sports Medical Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jess G. Snedeker
- Orthopaedic Biomechanics Laboratory, Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Daniel P. Fitze
- Department of Orthopaedics, Sports Medical Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Department of Orthopaedics, University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Fabio Sarto
- Department of Biomedical Sciences, Institute of Physiology, University of Padua, Padua, Italy
| | - Jörg Spörri
- Department of Orthopaedics, Sports Medical Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Department of Orthopaedics, University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Martino V. Franchi
- Department of Orthopaedics, Sports Medical Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Department of Biomedical Sciences, Institute of Physiology, University of Padua, Padua, Italy
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Almutawakel S, Halleck F, Dürr M, Grittner U, Schrezenmeier E, Budde K, Althoff CE, Hamm B, Sack I, Fischer T, Marticorena Garcia SR. Shear Wave Elastography for Assessing Liver Stiffness in HCV-Infected Kidney Transplant Recipients after Direct-Acting Antiviral Treatment: A Comparative Study with Magnetic Resonance Elastography. J Clin Med 2023; 12:7547. [PMID: 38137615 PMCID: PMC10743898 DOI: 10.3390/jcm12247547] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/22/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open
Abstract
Hepatitis C virus (HCV) infection can lead to hepatic fibrosis. The advent of direct-acting antivirals (DAAs) has substantially improved sustained virological response (SVR) rates. In this context, kidney transplant recipients (KTRs) are of particular interest due to their higher HCV infection rates and uncertain renal excretion and bioavailability of DAAs. We investigated liver stiffness after DAA treatment in 15 HCV-infected KTRs using ultrasound shear wave elastography (SWE) in comparison with magnetic resonance elastography (MRE). KTRs were treated with DAAs (daclatasvir and sofosbuvir) for three months and underwent SWE at baseline, end of therapy (EOT), and 3 (EOT+3) and 12 months (EOT+12) after EOT. Fourteen patients achieved SVR12. Shear wave speed (SWS)-as a surrogate parameter for tissue stiffness-was substantially lower at all three post-therapeutic timepoints compared with baseline (EOT: -0.42 m/s, p < 0.01; CI = -0.75--0.09, EOT+3: -0.43 m/s, p < 0.01; CI = -0.75--0.11, and EOT+12: -0.52 m/s, p < 0.001; CI = -0.84--0.19), suggesting liver regeneration after viral eradication and end of inflammation. Baseline SWS correlated positively with histopathological fibrosis scores (r = 0.48; CI = -0.11-0.85). Longitudinal results correlated moderately with APRI (r = 0.41; CI = 0.12-0.64) but not with FIB-4 scores (r = 0.12; CI = -0.19-0.41). Although higher on average, SWE-derived measurements correlated strongly with MRE (r = 0.64). In conclusion, SWE is suitable for non-invasive therapy monitoring in KTRs with HCV infection.
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Affiliation(s)
- Salma Almutawakel
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (S.A.)
| | - Fabian Halleck
- Department of Nephrology and Medical Intensive Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Michael Dürr
- Department of Nephrology and Medical Intensive Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Ulrike Grittner
- Institute of Biometry and Clinical Epidemiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Eva Schrezenmeier
- Department of Nephrology and Medical Intensive Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Klemens Budde
- Department of Nephrology and Medical Intensive Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Christian E. Althoff
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (S.A.)
| | - Bernd Hamm
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (S.A.)
| | - Ingolf Sack
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (S.A.)
| | - Thomas Fischer
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (S.A.)
| | - Stephan R. Marticorena Garcia
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (S.A.)
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Chen Z, Ying TC, Chen J, Wu C, Li L, Chen H, Xiao T, Huang Y, Chen X, Jiang J, Wang Y, Lu W, Su Z. Using elastography-based multilayer perceptron model to evaluate renal fibrosis in chronic kidney disease. Ren Fail 2023; 45:2202755. [PMID: 37073623 PMCID: PMC10120461 DOI: 10.1080/0886022x.2023.2202755] [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: 04/20/2023] Open
Abstract
BACKGROUND Given its progressive deterioration in the clinical course, noninvasive assessment and risk stratification for the severity of renal fibrosis in chronic kidney disease (CKD) are required. We aimed to develop and validate an end-to-end multilayer perceptron (MLP) model for assessing renal fibrosis in CKD patients based on real-time two-dimensional shear wave elastography (2D-SWE) and clinical variables. METHODS From April 2019 to December 2021, a total of 162 patients with CKD who underwent a kidney biopsy and 2D-SWE examination were included in this single-center, cross-sectional, and prospective clinical study. 2D-SWE was performed to measure the right renal cortex stiffness, and the corresponding elastic values were recorded. Patients were categorized into two groups according to their histopathological results: mild and moderate-severe renal fibrosis. The patients were randomly divided into a training cohort (n = 114) or a test cohort (n = 48). The MLP classifier using a machine learning algorithm was used to construct a diagnostic model incorporating elastic values with clinical features. Discrimination, calibration, and clinical utility were used to appraise the performance of the established MLP model in the training and test sets, respectively. RESULTS The developed MLP model demonstrated good calibration and discrimination in both the training [area under the receiver operating characteristic curve (AUC) = 0.93; 95% confidence interval (CI) = 0.88 to 0.98] and test cohorts [AUC = 0.86; 95% CI = 0.75 to 0.97]. A decision curve analysis and a clinical impact curve also showed that the MLP model had a positive clinical impact and relatively few negative effects. CONCLUSIONS The proposed MLP model exhibited the satisfactory performance in identifying the individualized risk of moderate-severe renal fibrosis in patients with CKD, which is potentially helpful for clinical management and treatment decision-making.
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Affiliation(s)
- Ziman Chen
- Department of Health Technology and Informatics, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Tin Cheung Ying
- Department of Health Technology and Informatics, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Jiaxin Chen
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, P.R. China
| | - Chaoqun Wu
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, P.R. China
| | - Liujun Li
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, P.R. China
| | - Hui Chen
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, P.R. China
| | - Ting Xiao
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, P.R. China
| | - Yongquan Huang
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, P.R. China
| | - Xuehua Chen
- Central Lab, Liver Disease Research Center, The Affiliated Hospital of Yunnan University, Kunming City, Yunnan Province, P.R. China
| | - Jun Jiang
- Department of Radiology, The Second People's Hospital of Shenzhen, Shenzhen, P.R. China
| | - Yingli Wang
- Ultrasound Department, EDAN Instruments, Inc, Shenzhen, P.R. China
| | - Wuzhu Lu
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, P.R. China
| | - Zhongzhen Su
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, P.R. China
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Ye R, Xiong H, Liu X, Yang J, Guo J, Qiu J. Assessment of Knee Menisci in Healthy Adults Using Shear Wave Elastography. J Ultrasound Med 2023; 42:2859-2866. [PMID: 37661827 DOI: 10.1002/jum.16326] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 07/30/2023] [Accepted: 08/16/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVES The aim of this study was to explore the application value of shear wave elastography in healthy adults with knee meniscus. METHODS One hundred adult subjects who underwent health checkups at our hospital from December 2022 to February 2023 were selected as research participants. Shear wave elastography was used to evaluate the periphery of the lateral and medial meniscus in both knees. To assess the mean differences in Young's modulus values between male and female groups, a one-way analysis of variance (ANOVA) and independent samples t-test were conducted. In addition, a Pearson correlation coefficient test was used to analyze the correlation between the elastic values of the meniscus and age, height, weight, and body mass index (BMI). RESULTS There were no significant differences in elastic values between the lateral meniscus of the left and right sides or between the medial meniscus of the left and right sides within the same gender group (P > .05). Stiffness values of the medial meniscus were higher in each gender group than those of the lateral meniscus (P < .01). Additionally, males demonstrated higher stiffness values than females (P < .01). As age increased, the Young's modulus of the meniscus increased significantly (r > .75, P < .01). CONCLUSION Shear wave elastography can serve as an adjunctive tool to aid in the assessment of knee meniscal elasticity.
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Affiliation(s)
- Ran Ye
- Department of Physical Examination, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, China
- Guaduate School, Guangzhou Medical University, Guangzhou, China
| | - Huahua Xiong
- Department of Ultrasound, Shenzhen Second People's Hospital, Shenzhen, China
| | - Xiao Liu
- Department of Ultrasound, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Junxing Yang
- Department of Orthopedics, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Jiandong Guo
- Department of Radiology, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Jianwen Qiu
- Department of Physical Examination, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, China
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Shembel AC, Morrison RA, Fetzer DT, Patterson-Lachowicz A, McDowell S, Comstock Smeltzer JC, Mau T. Extrinsic Laryngeal Muscle Tension in Primary Muscle Tension Dysphonia with Shear Wave Elastography. Laryngoscope 2023; 133:3482-3491. [PMID: 37334857 PMCID: PMC10728340 DOI: 10.1002/lary.30830] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 12/07/2022] [Revised: 05/09/2023] [Accepted: 05/30/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES It has been assumed that patients with primary muscle tension dysphonia (pMTD) have more extrinsic laryngeal muscle (ELM) tension, but tools to study this phenomenon lack. Shear wave elastography (SWE) is a potential method to address these shortcomings. The objectives of this study were to apply SWE to the ELMs, compare SWE measures to standard clinical metrics, and determine group differences in pMTD and typical voice users before and after vocal load. METHODS SWE measurements of the ELMs from ultrasound examinations of the anterior neck, supraglottic compression severities from laryngoscopic images, cepstral peak prominences (CPP) from voice recordings, and self-perceptual ratings of vocal effort and discomfort were obtained in voice users with (N = 30) and without (N = 35) pMTD, before and after a vocal load challenge. RESULTS ELM tension significantly increased from rest-to-voiced conditions in both groups. However, the groups were similar in their ELM stiffness levels at SWE at baseline, during vocalization, and post-vocal load. Levels of vocal effort and discomfort and supraglottic compression were significantly higher and CPP was significantly lower in the pMTD group. Vocal load had a significant effect on vocal effort and discomfort but not on laryngeal or acoustic patterns. CONCLUSION SWE can be used to quantify ELM tension with voicing. Although the pMTD group reported significantly higher levels of vocal effort and vocal tract discomfort and, on average, exhibited significantly more severe supraglottic compression and lower CPP values, there were no group differences in levels of ELM tension using SWE. LEVEL OF EVIDENCE 2 Laryngoscope, 133:3482-3491, 2023.
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Affiliation(s)
- Adrianna C. Shembel
- Department of Otolaryngology-Head and Neck, Voice Center, University of Texas Southwestern Medical Center, Dallas, TX, United States
- School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Richardson, TX, United States
| | - Robert A. Morrison
- School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Richardson, TX, United States
| | - David T. Fetzer
- Department of Radiology, CACTUS Lab, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Amber Patterson-Lachowicz
- Department of Radiology, CACTUS Lab, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Sarah McDowell
- School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Richardson, TX, United States
| | - Julianna C. Comstock Smeltzer
- School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Richardson, TX, United States
| | - Ted Mau
- Department of Otolaryngology-Head and Neck, Voice Center, University of Texas Southwestern Medical Center, Dallas, TX, United States
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Zhang TY, Yan J, Wu J, Yang W, Zhang S, Xia J, Che X, Li H, Li D, Ying L, Yuan X, Zhou Y, Zhang M, Mou S. Shear wave elastography parameters adds prognostic value to adverse outcome in kidney transplantation recipients. Ren Fail 2023; 45:2235015. [PMID: 37462113 DOI: 10.1080/0886022x.2023.2235015] [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: 04/04/2023] [Revised: 07/05/2023] [Accepted: 07/05/2023] [Indexed: 07/20/2023] Open
Abstract
INTRODUCTION The tissue stiffness of donor kidneys in transplantation may increase due to pathological changes such as glomerulosclerosis and interstitial fibrosis, and those changes associate worse outcomes in kidney transplantation recipients. Ultrasound elastography is a noninvasive imaging examination with the ability to quantitatively reflect tissue stiffness. Aim of this study was to evaluate the prognostic value of ultrasound elastography for adverse kidney outcome in kidney transplantation recipients. METHODS Shear wave elastography (SWE) examinations were performed by two independent operators in kidney transplantation recipients. The primary outcome was a composite of kidney graft deterioration, all-cause re-hospitalization, and all-cause mortality. Survival analysis was calculated by Kaplan-Meier curves with the log-rank test and Cox regression analysis. RESULTS A total of 161 patients (mean age 46 years, 63.4% men) were followed for a median of 20.1 months. 27 patients (16.77%) reached the primary endpoint. The mean and median tissue stiffness at the medulla (hazard ratio: 1.265 and 1.229, respectively), estimated glomerular filtration rate (eGFR), and serum albumin level were associated with the primary outcome in univariate Cox regression. Adding mean or median medulla SWE to a baseline model containing eGFR and albumin significantly improved its discrimination (C-statistics: 0.736 for the baseline, 0.766 and 0.772 for the model added mean and median medulla SWE, respectively). CONCLUSION The medullary tissue stiffness of kidney allograft measured by shear wave elastography may provide incremental prognostic value to adverse outcomes in kidney transplantation recipients. Including SWE parameters in kidney transplantation recipients management could be considered to improve risk stratification.
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Affiliation(s)
- Tian-Yi Zhang
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiayi Yan
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Academy of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jiajia Wu
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenqi Yang
- Department of Ultrasound, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Shijun Zhang
- Department of Ultrasound, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Jia Xia
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiajing Che
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongli Li
- Department of Ultrasound, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Dawei Li
- Department of Urology, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Liang Ying
- Department of Urology, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Xiaodong Yuan
- Department of Urology, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Yin Zhou
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ming Zhang
- Department of Urology, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Shan Mou
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Academy of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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50
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Zimmer M, Bunz EK, Ehring T, Kaiser B, Kienzlen A, Schlüter H, Zürn M. In Vivo Assessment of Shear Wave Propagation in Pennate Muscles Using an Automatic Ultrasound Probe Alignment System. IEEE Open J Eng Med Biol 2023; 4:259-267. [PMID: 38196975 PMCID: PMC10776096 DOI: 10.1109/ojemb.2023.3338090] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/28/2023] [Accepted: 11/28/2023] [Indexed: 01/11/2024] Open
Abstract
Goal: Skeletal muscle mechanics can be assessed in vivo using shear wave elastography. However, the impact of pennation angle on shear wave velocity (SWV) remains unclear. This study aims to quantify the effect by automatically aligning the ultrasound probe with muscle fiber orientation. Methods: We propose an automatic ultrasound probe alignment system and compare it to manual and no alignment. SWV of the gastrocnemius medialis muscle of ten volunteers was measured during rest and isometric contractions. Results: The SWV was different between the conditions (p = 0.008). The highest SWV was obtained during the automatic alignment and differences between the conditions were most pronounced during high-level contractions. The automatic system yielded more accurate alignment compared to a manual operator (p = 0.05). Conclusions: The present study indicates that pennation angle affects SWV, hence muscle fiber orientation must be considered to reliably interpret SWV. Using automatic alignment systems allows for more accurate alignment, improving the methodology of ultrasound elastography in skeletal muscles.
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Affiliation(s)
- Manuela Zimmer
- Institute of Structural Mechanics and Dynamics in Aerospace EngineeringUniversity of Stuttgart70569StuttgartGermany
| | - Elsa K. Bunz
- Institute for Modelling and Simulation of Biomechanical SystemsUniversity of Stuttgart70569StuttgartGermany
| | - Tobias Ehring
- Institute of Applied Analysis and Numerical SimulationUniversity of Stuttgart70569StuttgartGermany
| | - Benedikt Kaiser
- Institute of Electrical Energy ConversionUniversity of Stuttgart70569StuttgartGermany
| | - Annika Kienzlen
- Institute for Control Engineering of Machine Tools and Manufacturing UnitsUniversity of Stuttgart70174StuttgartGermany
| | - Henning Schlüter
- Institute for Systems Theory and Automatic ControlUniversity of Stuttgart70569StuttgartGermany
| | - Manuel Zürn
- Institute for Control Engineering of Machine Tools and Manufacturing UnitsUniversity of Stuttgart70174StuttgartGermany
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