Shear wave elastography (SWE) is an emerging technology that provides information about the inherent elasticity of tissues by producing an acoustic radiofrequency force impulse, sometimes called an "acoustic wind," which generates transversely-oriented shear waves that propagate through the surrounding tissue and provide biomechanical information about tissue quality. Interobserver agreement was excellent for SWE measurements. Terms and Conditions The continuous mode provides a live acquisition of the elastographic and propagation maps, and multiple images are acquired over time. 39, No. These techniques utilize sound waves for assessing the mechanical properties of tissues such as stiffness and elasticity in . Figure 6: Quantification of the degree of tissue differentiation and elasticity of HCC. (c) Axial T2-weighted fat-saturated MR image of the same hand shows a high-signal-intensity mass centered at the ulnar aspect of the second digit flexor tendons (arrow). Enter your email address below and we will send you the reset instructions. 60, No. Pathologically proven telangiectatic osteosarcoma of the distal femur in a 20-year-old woman. Ultrasound Elastography in Children: How We Do it and What is it Helpful For? Figure 6b. (b) Long-axis gray-scale US image in the region of palpable abnormality shows a nonspecific echogenic solid intramuscular mass (arrows) in the distal supinator muscle. 46, No. PP = proximal phalanx. SWE was performed using a modified clinical US scanner. (b) Color elastogram of the same region shows low shear-wave velocities in the gastrocnemius muscle (mean, 2.89 m/sec) and intermediate velocities at the aponeurosis (arrow) (mean, 4.915 m/sec). (a) Long-axis gray-scale US image in the region of palpable abnormality shows a relatively hypoechoic subcutaneous soft-tissue mass consistent with a lipoma (arrows). Shear wave elastography is a novel, upcoming modality in musculoskeletal imaging especially in the evaluation of peripheral neuropathy. 4.2 Shear wave elastography images use a color overlay on the B-mode image to provide the shear wave velocity (Vs) in m/s (or estimated Young modulus in kPa) for each pixel in the field of view. Long-axis gray-scale US image shows normal echogenic fibrillar appearance of the Figure 6a. About the authors. SWE is an exciting and rapidly evolving US technique that allows quantification of mechanical and elastic tissue properties. Do quantitative and qualitative shear wave elastography have a role in evaluating musculoskeletal soft tissue masses? Normal medial head of gastrocnemius and soleus aponeurosis in the relaxed and contracted (maximal dorsiflexion of the ankle) states in an asymptomatic 48-year-old woman. Shear-wave elastography for interventional monitoring of pediatric Budd-Chiari syndrome Liver stiffness measurements obtained by 2D shear-wave elastography may serve as a useful quantitative . Epub 2020 May 21. However, sometimes pathologic and healthy tissues may display similar echogenicities at conventional US, particularly in early-stage and preclinical disease. The shear modulus is defined as the ratio of stress to strain that is given by G = ρcs2, where ρ is the material density. Because soft tissues with small deformations (ie, quasi-static displacements) are usually assumed to be incompressible (ie, υ = 0.5), G is sometimes converted to E by the simple equation E = 3G for incompressible media (39). (c) Short-axis gray-scale US image of the soft-tissue component of the lesion shows a heterogeneous relatively echogenic lesion (white arrows) with multiple fluid levels (black arrow), consistent with an aneurysmal bone cyst containing blood products. F…, MeSH Shear wave elastography with ultrasound differs from transient elastography initiated by mechanical stimulus, and also by the user compression or physiological motion of strain imaging. Depending on tissue properties, shear waves travel at varying speed. Pol J Radiol. In the past 2 decades, sonoelastography has been progressively used as a tool to help evaluate soft-tissue elasticity and add to information obtained with conventional gray-scale and Doppler ultrasonographic techniques. (c) Color elastogram of the same region shows lower shear-wave velocities (mean, 1.74 m/sec) in the mass (arrows) than in the region of the pseudocapsule, which shows intermediate velocities (mean, 5.52 m/sec). Note the partial-thickness tear (arrow) at the deep aspect of the Normal anterior band of the medial ulnar collateral ligament (MUCL) of the elbow | Privacy Policy The malignant lesions exhibited G = 146.6 kPa ± 40.1, whereas the benign lesions showed G = 45.3 kPa ± 41.1. Figure 14a. Bottom image: In this case the elastogram overlaid on B-mode image is the upper image, whereas the B-mode image is the lower image. Tenosynovitis of the first extensor compartment tendons of the wrist in a Dr Wayland Wang, Radiologist from the Royal Melbourne Hospital, presents on the reporting aspect of a shear wave elastography examination. 8, World Journal of Pediatrics, Vol. Note the signal void (arrow) in the region of the partial-thickness tear. However, compression sonoelastography is operator dependent and provides only a qualitative measure of tissue elasticity. 8, Journal of Clinical Medicine, Vol. (c) Short-axis gray-scale US image of the soft-tissue component of the lesion shows a heterogeneous relatively echogenic lesion (white arrows) with multiple fluid levels (black arrow), consistent with an aneurysmal bone cyst containing blood products. New methods in SWE, such as continuous-wave and 3D SWE, may add new information not provided by conventional two-dimensional SWE. (a) Short-axis power Doppler US image of the palmar aspect of the hand in the region of the palpable lump shows a hypoechoic mass (arrows) with associated moderate hyperemia. Current Potential Clinical Applications of SWE in the Evaluation of Musculoskeletal Tissues and Expected Findings for Shear-Wave Velocity and Shear Modulus. If the address matches an existing account you will receive an email with instructions to reset your password. Prevention and treatment information (HHS). (a) Short-axis power Doppler US image of the palmar aspect of the hand in the region of the palpable lump shows a hypoechoic mass (arrows) with associated moderate hyperemia. Liver stiffness measurement before (A) and 24 hours after (B . Large popliteal (Baker) cyst in a 66-year-old woman. A few studies evaluated the patellar tendon with SWE. Recent work showed that changes in diaphragm shear modulus (ΔSMdi) assessed using ultrasound shear wave elastography (SWE) are strongly related to changes in Pdi (ΔPdi) in healthy subjects. Figure 18b. SWE data were collected using an Acuson S3000 US scanner with an L9–4-MHz linear transducer. We evaluated the performance of SWE for detecting liver changes (fatty liver, steatohepatitis) in . Nalezeno v knize – Stránka iPrvní domácí učebnice a monografie, která propojuje dva základní předměty studia medicíny. Note that there is a direct relationship between the shear and the Young moduli, reported in some studies to be E = 2G(1+ υ), where υ is the Poisson ratio. The shear wave elastography technologies may vary between the systems from different manufacturers; furthermore, similar techniques applied in different systems may result in different values of shear wave speed measurements based on variations related to frequencies and to the algorithms used to determine tissue properties. SWE data were collected using an Acuson S3000 US scanner (Siemens Healthineers, Erlangen, Germany) with a L9–4-MHz linear transducer. Figure 16a. From the Departments of Medical Imaging (M.S.T., L.H.G., D.M.M., R.S.W.) The mean cs was significantly lower in patients with GNE-related myopathy than in the healthy control group, with diminished muscle anisotropy in GNE-related myopathy. The right side of the image is distal. The distribution of shear-wave velocities at each pixel is directly related to the shear modulus G, which is calculated by a simple mathematical equation and expresses the tissue stiffness and elasticity in units of pressure—normally kilopascals. 1, American Journal of Roentgenology, Vol. (c) Long-axis gray-scale US image of the same region with maximal dorsiflexion of the ankle shows normal echotexture of the gastrocnemius (G) and soleus (S) muscles and of the aponeurosis (arrow). 5, American Journal of Respiratory and Critical Care Medicine, Vol. 5, Journal of Bodywork and Movement Therapies, Vol. 86, No. Our unique propagation mode can be used to confirm the quality of the shear wave generation (breast carcinoma). Ultrasound elastography has been proposed for differentiating different degrees of intestinal fibrosis in CD, but this was mostly tested in animal models or ex vivo and human studies are lacking. 8, No. Pathologically proven, painless, palpable, epidermoid inclusion cyst at the anterior aspect of the proximal tibia in an 18-year-old woman. The purpose of this study was to evaluate the repeatability and reproducibility of SWE on porcine meat specimens and the human biceps femoris muscle. As shown in Figure 1, Shear Waves are a type of mechanical wave which can only propagate in a solid. Transperineal ultrasound shear-wave elastography is a reliable tool for assessment of the elastic properties of the levator ani muscle in women (d) Color elastogram of the same region shows increased shear-wave velocity of the contracted gastrocnemius muscle (6.79 m/sec) and at the aponeurosis (arrow) (mean, 10.83 m/sec). 14, The Tohoku Journal of Experimental Medicine, Vol. As a result, it has limitations with reproducibility and often suffers from the eggshell effect, in which harder tissues on the boundary of a lesion cannot be deformed, limiting the determination of internal strain (2). Due to medical device regulatory reasons, not all products/service displayed on this Canon Medical Systems ANZ webpage are available in all countries, regions or markets. In the past 2 decades, sonoelastography has been progressively used as a tool to help evaluate soft-tissue elasticity and add to information obtained with conventional gray-scale and Doppler ultrasonographic techniques. SWE data were collected using an L9–4-MHz linear transducer. Liver shear wave elastography provides stiffness measurements for assessment of diffuse liver disease and possibly neoplastic lesions of the liver. (b) Color elastogram of the same region shows intermediate shear-wave velocities (mean, 5.93 m/sec) within the mass (arrows). Users also Ultrasound elastography has been proposed for differentiating different degrees of intestinal fibrosis in CD, but this was mostly tested in animal models or ex vivo and human studies are lacking. The authors concluded that although there may be some evidence of an association between lower shear-wave velocity and soft-tissue malignancy, particularly in the transverse plane, this did not result in a substantive improvement in the ability to detect malignancy over B-mode consensus classification (50). Mean elasticity is 7.5 kPa, corroborating a METAVIR fibrosis score of F2. The velocities within the gouty tophi depend on their consistency, with harder tophi displaying higher velocities than soft tophi and thickened synovium. SHEAR WAVE ELASTOGRAPHY; ASSESSMENT OF LIVER FIBROSIS IN A PATIENT OF CHRONIC LIVER DISEASE ASSOCIATED INFECTED BY HEPATITIS B AND C Dr. Kausar Saldera1, Dr. Nargis Fatima Naqvi2, Prof. Tariq Mahmood3, Dr. Shazia Sarwar Shaikh4 ORIGINAL PROF-3163 ABSTRACT… Objectives: Assessment of liver fibrosis by shear wave elastography in a patient In our experience, normal ligaments in the relaxed state display intermediate shear-wave velocities, whereas the velocities increase in the contracted state. 15, Neurourology and Urodynamics, Vol. (b) Axial T2-weighted fat-saturated MR image of the distal femur shows an expansile heterogeneous osseous matrix tumor with associated cortical breakthrough and a large soft-tissue component (white arrows), with a secondary aneurysmal bone cyst containing multiple fluid levels (black arrows). Turk J Pediatr. Three recent studies compared the results of conventional with continuous SWE (11–13). Figure 4: Bland-Altman Plot of Continuous vs One-shot for elasticity, showing line of mean bias (0.143) and 95% tolerance limits about zero bias line. Gain valuable diagnostic information in easy to understand visual, parametric and quantitative formats, our ­advanced suite helps you avoid extra exams in order to get your diagnostic answer. Ultrasound Shear Wave Elastography for Liver Disease. Shear waves travel through soft tissues approximately 1000 times slower and attenuate approximately 10 000 times faster than longitudinal conventional ultrasound waves. Recently introduced on clinical scanners, shear-wave elastography (SWE) is considered to be more objective, quantitative, and reproducible than compression sonoelastography with increasing applications to the musculoskeletal system. Following the introduction of ultrasound contrast agents, estimation of the severity of liver diseases based on the times required for contrast agent to reach the hepatic arteries, portal vein, and hepatic veins and functional diagnosis based on the phagocytic activity of Kupffer cells have also been performed. Show all. Saving your patients, clinicians and practice while enhancing productivity. When compared with compression sonoelastography, tension elastography provides quantitative information related to tissue elasticity (elastic modulus), which is relevant as the primary function of tendons is to transmit tensile force from muscle to bone. Figure 6: Shear wave propagation and ROI placement. echogenicity, and disorganized echotexture of the Achilles tendon fibers, with an Ultrasound and shear-wave elastography characteristics of the iliocapsularis muscle in pincer-type femoroacetabular impingement. 52, No. It can be used to complement conventional US in the initial characterization and posttreatment follow-up of various traumatic and pathologic conditions of the musculoskeletal system. SWE data were collected using an L9–4-MHz linear transducer. Background: The aim of this study was to evaluate the usefulness of two different types of 2-dimensional shear wave elastography (2D-SWE) for predicting liver fibrosis stages in comparison to transient elastography (TE), using a histologic METAVIR scoring system as the reference method. 5.4.5.2 Shear Wave Elastography. (b) Long-axis gray-scale US image in the region of palpable abnormality shows a nonspecific echogenic solid intramuscular mass (arrows) in the distal supinator muscle. Shear wave elastography (SWE) is an ultrasound technique for the noninvasive quantification of tissue stiffness. with a pathologically proven fibroma of the tendon sheath. SWE data were collected using an Acuson S3000 US scanner with an L9–4-MHz linear transducer. 5, IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control, Vol. Nalezeno v knize – Stránka 145elastografie. Palpační vyšetření jater s hodnocením jejich tuhosti a konzistence provádějí lékaři již po staletí. ... Princip shear wave elastografie – indukce příčného vlnění Diagnostika jaterních chorob 145 4.10.2 Jaterní elastografie ... Chronic liver disease is a substantial world-wide problem. Figure 15 demonstrates spuriously elevated shear-wave velocities in a subcutaneous lipoma, which saturated the maximum setting for the shear-wave velocity of 6.5 m/sec. 22, No. The quality index is related to the correlation coefficient for tracking the shear displacements. QElaXto The shear waves are lateral waves, with a motion perpendicular to the direction of the force that has generated them. doi: 10.5114/pjr.2021.108879. Acute tennis leg injury in a 51-year-old man. The lesion at the anterior aspect of the humeral head was pathologically proven to be an enchondroma. Nalezeno v knizeTo obtain individual values of shear wave speed, one or several areas within the ROI must be chosen for analysis. ... Bauermeister, W. (2017) Optimierung des Strain-Elastografie durch Computer assistierte Steuerung der Ultraschallsonde. In this study, shear-wave velocities of the sciatic nerve significantly increased during ankle dorsiflexion with the knee in maximal extension, but no changes were noted at 90° of knee flexion. 4, Journal of Clinical Medicine, Vol. When using the shear wave elastography mode, the Aplio 500 system supplies two methods to obtain readings of meters per second (m/s), and kilopascals (kPa) to assess the stiffness of tissues in the human body; the one-shot and continuous methods. 8, International Journal of Molecular Sciences, Vol. 24, No. SWE has previously been proven to be able to detect myocardial scar, however this has never . Bethesda, MD 20894, Help (b) Long-axis gray-scale US image in the region of palpable abnormality shows a nonspecific echogenic solid intramuscular mass (arrows) in the distal supinator muscle. Snoj Ž, Wu CH, Taljanovic MS, Dumić-Čule I, Drakonaki EE, Klauser AS. • Auto sequencing - Automatic placement of measurement ROI helps reduce keystrokes • Multiple measurement regions of interest (ROIs) in the Shear Wave image - Helps increase exam speed by reducing Intramuscular lipoma in a 48-year-old woman with a palpable painless lump in her forearm. (a) Long-axis gray-scale US image along the medial aspect of the first metatarsophalangeal joint shows echogenic intra-articular gouty tophus (arrow) abutting the metatarsal head (MT). Study discusses SWE approach to liver tumors, including the differential diagnosis of tumors and the applications of SWE in local treatment. eCollection 2021. In the authors’ experience, normal tendons display predominantly intermediate shear-wave velocities as measured along their long axes, acquired on the Acuson S3000 US scanner (Figs 2 and 5). A recent SWE study of Achilles tendons revealed higher stiffness in frequent exercisers than in infrequent exercisers of the nondominant ankle but not of the dominant ankle (9). The authors concluded that SWE is reproducible for assessment of the supraspinatus muscle, and that shear-wave velocity values greater than 3.0 m/sec in this muscle can be considered normal (28). Finally, future SWE studies that characterize musculoskeletal soft-tissue masses may reveal yet another application of this evolving technology, which offers much promise as an adjunct to conventional US. 60, No. 4, Gastroenterología y Hepatología, Vol. 3 Young modulus is displayed as a color map superimposed on a B-mode image and quantified within regions of interest. However, it would be premature to draw definite conclusions on the utility of SWE in the evaluation of soft-tissue tumors on the basis of the results of these two studies. Generated shear waves then propagate through the adjacent tissues in the transverse plane, perpendicular to the primary wave that produces the acoustic radiation force, at a much slower velocity, causing shear displacements in tissue. psoriatic arthritis and median neuropathy. Figure 3. Compared with normal muscle and fascia (Fig 8), acute muscle and fascial tears in the same anatomic location show lower shear-wave velocities (Fig 9). The mean elasticity values for the examined musculature and the Achilles tendon were greater in men than in women in the longitudinal plane, but there was no statistically significant difference for the elasticities of the Achilles tendon in the transverse plane between sexes. SWE was performed using an Aixplorer US scanner. This article reviews the results that have been obtained with shear wave elastography for assessment of liver fibrosis. 8, Revista da Associação Médica Brasileira, Vol. Careers. Armin Schneider, Hubertus Feussner, in Biomedical Engineering in Gastrointestinal Surgery, 2017. In step 2, fast plane wave excitation is used to track the tissue displacement and shear wave velocities as the shear waves propagate. There were no signifi- analyzed in kilopascals in the elasticity imaging range cant differences between the right and left hands (0-150 kPa). Shear wave elastography. Actual density estimates will vary for different types of soft tissue and can also be found using values published in the literature. Note that the shear-wave velocities in both the gastrocnemius muscle and at the aponeurosis are lower than in the healthy tissues in the same region in the patient in Figure 8. The current literature suggests that shear waves propagate faster in healthy tendons than in those that are tendinopathic, and faster in contracted tendons and muscles than in those that are relaxed. Normal ulnar nerve in the cubital tunnel in an asymptomatic 58-year-old woman. There are a few studies on SWE of the supraspinatus muscle (27,28). Speed of sound and shear wave speed for calf soft tissue composition and nonlinearity assessment. Background and aims: No studies yet have evaluated real-time shear wave elastography (SWE) to assess liver fibrosis by measuring liver stiffness (LS) in NAFLD. Additionally, several studies evaluated viscoelastic properties of the Achilles tendon (5–14). Nalezeno v knizeShear wave elastography of thyroid nodules in routine clinical practice: preliminary observations and utility for detecting malignancy. Eur Radiol 2012; 22(11):2397–2406 [92] Lyshchik A, Higashi T, Asato R et al. 13, IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control, Vol. Athanasiou and collaborators (45) studied both conventional US and SWE of 28 benign and 20 malignant breast lesions in 46 patients, with all lesions detected at SWE. Shear Wave Elastography (SWE), which has been developed by Canon Medical Systems, employs the latter method and also allows the propagation velocities of shear waves to be quantified and mapped. Innovations in Ultrasound Shear Wave Elastography. (b) Color elastogram of the same region shows intermediate shear-wave velocity (arrow) (mean, 7.32 m/sec) in the gouty tophus. Top image: Color elastogram of the same region shows a lower G, 41.2 kPa ± 17.6, for the tendon. 3, Journal of International Medical Research, Vol. The other advantage is reproducibility and being less operator-dependent than strain type. In our practice, in addition to conventional US, we frequently perform SWE of musculoskeletal tumors during routine diagnostic examinations or at the time of biopsy. Intramuscular lipoma in the left upper back of a 55-year-old woman with spuriously high shear-wave velocities. 27, Supportive Care in Cancer, Vol. 2014 Sep;272(3):622-33. doi: 10.1148/radiol.14121765. 3, No. Ultrasound elastography, also called as sono-elastography, is a modern evolutionary method of sonographic imaging.Techniques include shear wave elastography (also known as transient elastography) and strain elastography (also known as static or compression elastography). Ultrasound and shear-wave elastography characteristics of the iliocapsularis muscle in pincer-type femoroacetabular impingement. The right side of the image is distal. R.S.W. Nalezeno v knize – Stránka 1Publikace nabízí nový, moderní přístup k výuce gymnastiky, k nácviku gymnastických dovedností, netradiční pojetí chápání celé gymnastiky a jejího významu pro pohybové vzdělávání. Shear wave elastography is an ultrasound applied technique used to measure tissue stiffness as a result of a disease. doi: 10.5114/pjr.2021.108537. (b) Color elastogram of the same region shows low shear-wave velocities (arrows) (mean, 3.15 m/sec) in the deltoid muscle. Shear wave elastography was digitally recorded respect to age, sex, and cross-sectional area measure- for analysis in a video format.

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