剪切波弹性成像评估不同大小人源性裸鼠三阴性乳腺癌弹性特征与临床病理的关系

目的:探讨剪切波弹性成像(SWE)评估不同大小人源性裸鼠三阴性乳腺癌弹性特征与临床病理特征的关系。方法:选择人乳腺癌MDA-MB-231细胞株,采用细胞悬液注射法对30只雌性BALB/c裸鼠建立人源性三阴性乳腺癌模型,其中27只裸鼠成瘤。选择其中行超声和SWE检查的21只裸鼠21个瘤体作为研究对象。根据移植瘤大小分为三...     

剪切波弹性成像中不同定量测量方法预测乳腺癌腋下淋巴结转移能力

目的:探讨剪切波弹性成像技术(shear wave elastography,SWE)定量测量乳腺癌的硬度参数与腋下淋巴结转移(axillary lymph node metastasis,ALNM)状态的相关性,并比较SWE不同定量测量方法预测乳腺癌ALNM的能力,以获得最佳的预测参数。方法:纳入经SWE定量测量并获得肿物及淋巴结病理证实的304例乳腺癌患者进行前瞻性研究。用超声探头分别利用Q-box及Q-box trace不规则描记方法获取肿物弹性的定量参数,将纵、横两个切面的平均硬度、最大硬度和标准差的平均值作为各自的硬度平均值(Emean)、弹性最大值(Ema x)和标准差(SD)。用单变量和多变量回归分析评估ALNM与不同定量测量方法的各个参数之间存在的关系。结果:在单变量分析中,肿物大小,肿物位置,ER,PR,HER-2和SWE不同定量测量方法的各个参数值与淋巴结转移有显著的关联。在多因素分析中,肿物大小(P<0.001),HER-2(P=0.002),Q-box trace方法的SD(P=0.001)及Q-box的Mmean(P=0.028)对预测淋巴结状态具有独立意义。结论:剪切波弹性成像定量测量乳腺癌的硬度参数可作为预测ALNM的独立因素,为术前淋巴结状态的评估、手术方式的选择以及患者预后提供重要的信息。     

实时剪切波超声弹性成像对正常甲状腺的定量研究

目的应用实时剪切波超声弹性成像(SWE)技术检测正常成人甲状腺的硬度,初步建立正常成人甲状腺硬度的弹性模量值参考范围。方法对465例正常成人甲状腺行实时剪切波超声弹性成像检查,比较甲状腺左右叶、不同性别及年龄组之间弹性模量值的差异。结果正常成人甲状腺弹性模量值参考范围:Mean(19.62±5.48)kPa,Max(26.84±6.34)kPa,Min(12.96±5.78)kPa,SD(3.08±0.91)kPa。左右两侧甲状腺弹性模量值差异无统计学意义(P>0.05);不同性别甲状腺弹性模量值差异无统计学意义(P>0.05);不同年龄组甲状腺弹性模量值差异有统计学意义(P<0.05),随着年龄的增长,甲状腺组织的Mean、Max逐渐减低。结论实时剪切波超声弹性成像作为一种定量、无创性测量甲状腺硬度的检查方法,为甲状腺疾病的进一步诊断提供了更为准确的依据。     

乳腺癌剪切波弹性成像影响因素及其与蛋白分子水平表达的关系

剪切波弹性成像技术(shear wave elastography,SWE)是一种全新的超声弹性成像技术,在乳腺病变的临床诊断中其成像表现由多种因素共同决定。同时,乳腺癌组织硬度(即弹性值)的增加与蛋白分子水平表达存在一定的关联,乳腺癌蛋白分子水平表达的不同,提供的治疗及预后信息也不尽相同。本文就乳腺癌SWE影响因素及SWE参数与蛋白分子水平表达关系的研究现状进行综述。     

实时剪切波弹性成像定量评价正常脾脏组织弹性

目的 探讨实时剪切波弹性成像（SWE）应用于正常脾脏组织的可行性及影响因素,并建立正常人脾脏组织的杨氏模量值参考范围。方法 对280名健康人行肝脏、脾脏弹性模量值检测,记录相关定量分析数据,收集受检者基本信息,分析其性别、年龄、体质量指数（BMI）与肝、脾弹性模量值的相关性。结果 280名健康人正常肝脏杨氏模量均值为（5.54±1.08）kPa,95% CI为（5.41,5.67）kPa;正常脾脏杨氏模量均值为（11.67±2.90）kPa,95% CI（11.33,12.02）kPa。男性与女性间肝、脾弹性测量值差异均有统计学意义（P均<0.05）。年龄、BMI与肝、脾弹性模量值均无明显相关性。男、女性中,肝与脾弹性模量值均无相关性（P均>0.05）。结论 SWE可用以定量评价正常脾脏组织硬度。     

剪切波弹性模量在剪切波弹性成像评价甲状腺结节性质中的价值分析

目的 探究剪切波弹性模量在剪切波弹性成像评价甲状腺结节性质中的价值分析.方法 回顾性选取2019年10月至2020年10月广州中医药大学第一附属医院收治的甲状腺结节患者120例,共164个病灶,进行剪切波弹性成像检查,获取剪切波弹性模量值,将手术病理结果作为金标准,制定受试者工作特征(ROC)曲线,评估其对甲状腺结节良...     

彩超剪切波弹性成像（SWE）对甲状腺癌诊断的早期价值分析

目的 探讨彩超剪切波弹性成像（Shear wave elastography,SWE）对甲状腺癌（Thyroid cancer,TC）诊断的早期价值。方法 选取2021年5月至2022年5月于我院进行健康体检人群625例。625例健康体检人群均进行常规外科触诊及彩超SWE检查。比较常规外科触诊及彩超SWE检查甲状腺异常检出率,分析甲状腺异常病例疾病类型分布。结果 彩超SWE检查检出甲状腺异常率高于常规外科触诊（P<0.05）;经进一步检查分析在235例甲状腺异常患者中结节性甲状腺肿69例、甲状腺功能亢进症45例、桥本氏甲状腺炎38例、肉芽肿性甲状腺炎36例、单纯性甲状腺结节33例、甲状腺癌12例、甲状腺瘤2例。结论 彩超SWE有利于早期发现甲状腺异常情况,利于及时发现TC并进行及时治疗。     

剪切波弹性成像检测乳腺癌患者化疗前后肝脏硬度变化

探讨剪切波弹性成像（SWE）检测乳腺癌患者化疗前后肝脏组织硬度变化和临床应用价值.方法 121例乳腺癌患者分别在化疗前、化疗4周期后、化疗8周期后检测肝功能（AST、ALT、ALP、GGT）及行肝脏常规超声和剪切波弹性成像检查,测量肝脏的杨氏模量最大值（Emax）、最小值（Emin）、平均值（Emean）,并比较不同化疗周期杨氏模量之间的差异。结果 化疗前E max、E min、E mean分别为（5.74±0.39）kPa、（4.16±0.28）kPa、（4.91±0.18）kPa;化疗4周期后E max、E min、E mean分别为（5.43±0.25）kPa、（3.85±0.17）kPa、（4.50±0.27）kPa;化疗8周期后肝E max、E min、E mean分别为（5.24±0.36）kPa、（3.47±0.26）kPa、（4.28±0.16）kPa;化疗后杨氏模量较化疗前均明显减低（P<0.05）。化疗后ALT、ALP、GGT比化疗前有升高（P<0.05）,而AST化疗前后无差异（P>0.05）;肝杨氏模量与化疗前、化疗4周期后AST、ALT、ALP、GGT及化疗8周期后ALT、ALP均无相关性（P>0.05）,化疗8周期后肝杨氏模量与AST、GGT呈负相关（r=-0.71,P=0.042;r=-0.67,P=0.035）。结论 SWE有望成为一种无创、定量评估乳腺癌化疗前后肝硬度变化的方法。     

剪切波弹性成像定量评估正常成人眼外肌

目的探讨剪切波弹性成像(SWE)在正常成人眼外肌中的应用价值,初步建立正常成人眼外肌平均弹性值(Emean)的参考范围。方法选取121例我院健康体检者,按年龄分为15～≤36岁组51例、36～≤57岁组40例及57～78岁组30例。应用常规超声及SWE检测各组眼外肌厚径和Emean并进行比较;分析正常成人年龄、身高、体质量、眼外肌厚径与眼外肌Emean的相关性。结果 121例正常成人上直肌、下直肌、外直肌、内直肌Emean分别为(8.04±2.56)kPa、(8.14±2.61)kPa、(8.35±2.51)kPa、(8.39±2.63)kPa,4条眼外肌Emean两两比较差异无统计学意义;正常成人除内直肌与上直肌厚径比较差异有统计学意义外,其余眼外肌厚径比较差异均无统计学意义。不同年龄组同一眼外肌Emean值两两比较差异均有统计学意义(均P0.05)。相关性分析显示,年龄与上直肌、下直肌、外直肌、内直肌Emean均呈高度正相关(r=0.991、0.991、0.986、0.984,均P0.01),且随着年龄增加Emean也随之增加。上直肌、下直肌、外直肌、内直肌厚径与其对应的眼直肌Emean均呈中度正相关(r=0.311、0.282、0.329、0.479,均P0.01),体质量与上直肌、下直肌、外直肌、内直肌Emean均呈弱正相关(r=0.229、0.231、0.224、0.227,均P0.05)。结论 SWE可定量评估正常成人眼外肌弹性。     

Predicting Prognostic Factors of Breast Cancer Using Shear Wave Elastography

The purpose of the study described here was to investigate the correlation between histologic factors, including immunohistochemical factors, related to the prognosis of breast cancer and shear wave elastography (SWE) measurements. One hundred twenty-two breast cancers from 116 women were subjected to sonoelastography. Of the SWE features, mean and maximum elasticity and SWE ratio were extracted. The SWE ratio was calculated as the ratio of the stiffness of a portion of the lesion to that of a similar region of interest in fatty tissue. High ratios indicate stiffer lesions. The Mann-Whitney U-test, Kruskal-Wallis test and receiver operating characteristic (ROC) curve were used for statistical analysis. Estrogen receptor negativity, progesterone receptor negativity, p53 positivity, Ki-67 positivity, high nuclear grade, high histologic grade and large tumor (invasive) size were associated with a significantly high SWE ratio (p < 0.05). ROC curve analysis yielded SWE ratio cutoff values of 2.74–3.69 for significant immunohistochemical factors and 4.21 for the basal-like subtype by maximizing specificity while ensuring more than 80% sensitivity. Breast cancers with aggressive histologic features had high SWE ratios. Shear wave elastography may provide useful information for determining prognosis.     

实时剪切波弹性成像中乳腺肿块的各向异性对良恶性病灶的诊断价值

目的探讨实时剪切波弹性成像(SWE)中乳腺肿块的各向异性在评价肿块良恶性中的价值。方法收集98例患者共100个病灶的最大直径平面与正交直径平面的弹性图像,记录下BI-RADS分类的结果和肿块的模量参数,计算得到各向异性因子(AF)。以病理结果为金标准构建ROC曲线,比较各模量参数与AF的诊断效能,并分析AF与肿瘤大小、组织学分级的相关性。结果最大直径平面中的Emean、Emax、Eratio、Esd均高于正交直径平面(P<0.001)。恶性肿块中各向异性因子明显高于良性肿块(P<0.001)。各向异性因子AFmean、AFmax、AFratio、AFsd的AUC分别为0.937、0.890、0.919、0.974。Ⅰ级浸润性导管癌AFmax明显低于Ⅱ、Ⅲ级浸润性导管癌(P<0.001、0.006)。结论乳腺肿块的各向异性可由剪切波模量参数进行定量分析,在乳腺肿瘤的良恶性鉴别中有一定的临床应用价值,并且与乳腺癌中的组织学分级具有一定相关性。     

Differential Diagnosis of Breast Category 3 and 4 Nodules Through BI-RADS Classification in Conjunction with Shear Wave Elastography

Ultrasound (US) has become one of the important imaging methods for differentiating benign from malignant breast lesions. In 2013, the American College of Radiology published the fifth edition of the Breast Imaging-Reporting and Data System (BI-RADS). BI-RADS is a guide with recommendations for the standardization of breast imaging (US, mammography and magnetic resonance imaging) reports and for the auditing of centers employing such methods. Its objective is to standardize the nomenclature used in the reports. However, current US examinations are neither adequately sensitive nor sufficiently specific enough. The average Young's modulus was measured through shear wave elastography (SWE) to evaluate the diagnostic value of the BI-RADS classification in conjunction with SWE in differentiating BI-RADS 3 and 4 nodules. A total of 100 consecutive women with 126 breast lesions, including 65 benign and 61 malignant lesions, were included. The average Young's modulus of breast nodules and peri-nodule tissue (Emean1 and Emean2) was also determined through SWE. A receiver operating characteristic curve was drawn on the basis of pathologic results. The highest cut-off values were C1 and C2. At Emean1 > C1 or Emean2 > C2, BI-RADS 3 was increased to 4a and BI-RADS 4a was increased to 4b. At Emean1 ≤ C1 and Emean2 ≤ C2, BI-RADS 4b was decreased to 4a. Other BI-RADS classifications remained unchanged. BI-RADS 3 and 4a were considered benign. BI-RADS 4b and 4c were malignant. The area under the curve, sensitivity and specificity of the BI-RADS classification in conjunction with SWE were 0.952, 93.4% and 95.4%, respectively. The area under the curve, sensitivity and specificity of the original BI-RADS classification were 0.883, 82.0% and 87.7%, respectively. Differences were statistically significant (p = 0.028, Z-test). The diagnostic sensitivity and specificity were increased effectively. As a new method, BI-RADS classification in conjunction with SWE that combines the average Young's modulus yields a high value in terms of the differential diagnosis of breast nodules.     

Comparison of Strain and Shear Wave Elastography for the Differentiation of Benign From Malignant Breast Lesions,Combined With B-mode Ultrasonography: Qualitative and Quantitative Assessments

Our aim was to compare the diagnostic performance of strain elastography (SE) and shear-wave elastography (SWE), combined with B-mode ultrasonography (US), in breast cancer. For 79 breast lesions that underwent SE and SWE, two radiologists reviewed five data sets (B-mode US, SWE, SE and two combined sets). Qualitative and quantitative elastographic data and Breast Imaging Reporting and Data System (BI-RADS) categories were recorded. The area under the receiver operating characteristic curve (AUC) was evaluated. No significant difference in the AUC between the two elastography methods was noted. After subjective assessment by reviewers, the AUC for the combined sets was improved (SWE, 0.987; SE, 0.982; B-mode US, 0.970; p < 0.05). When SE and SWE were added, 38% and 56% of benign BI-RADS category 4a lesions with a low suspicion of cancer were downgraded without false-negative results, respectively. SE and SWE performed similarly. Therefore, addition of SE or SWE improved the diagnostic performance of B-mode US, potentially reducing unnecessary biopsies.     

剪切波弹性成像对乳腺癌放射性臂丛神经病变的诊断价值

目的 探讨剪切波弹性成像(SWE)技术对乳腺癌患者放射性臂丛神经病变(RBP)的诊断价值.方法 选取行乳腺癌术后放疗患者84例,根据改良放射性神经病变症状分级量表(LENT-SOMA量表)结果分为A组(1级,45例)、B组(2级,34例)和C组(3级,5例);另选取同期健康女性40例作为对照组.应用常规超声测量臂丛神经...     

Development of Oil-in-Gelatin Phantoms for Viscoelasticity Measurement in Ultrasound Shear Wave Elastography

Because tissues consist of solid and fluid materials, their mechanical properties should be characterized in terms of both elasticity and viscosity. Although the elastic properties of tissue-mimicking phantoms have been extensively studied and well characterized in commercially available phantoms, their viscous properties have not been fully investigated. In this article, a set of 14 tissue-mimicking phantoms with different concentrations of gelatin and castor oil were fabricated and characterized in terms of acoustic and viscoelastic properties. The results indicate that adding castor oil to gelatin phantoms decreases shear modulus, but increases shear wave dispersion. For 3% gelatin phantoms containing 0%, 10%, 20% and 40% oil, the measured shear moduli are 2.01 ± 0.26, 1.68 ± 0.25, 1.10 ± 0.22 and 0.88 ± 0.17 kPa, and the Voigt-model coupled shear viscosities are 0.60 ± 0.11, 0.89 ± 0.07, 1.05 ± 0.11 and 1.06 ± 0.13 Pa·s, respectively. The results also confirm that increasing the gelatin concentration increases shear modulus. For phantoms containing 3%, 4%, 5%, 6% and 7% gelatin, the measured shear moduli are 2.01 ± 0.26, 3.10 ± 0.34, 4.18 ± 0.84, 8.05 ± 1.00 and 10.24 ± 1.80 kPa at 0% oil and 1.10 ± 0.22, 1.97 ± 0.20, 3.13 ± 0.63, 4.60 ± 0.60 and 8.43 ± 1.39 kPa at 20% oil, respectively. The phantom recipe developed in this study can be used in validating ultrasound shear wave elastography techniques for soft tissues.     

Value of Shear Wave Elastography in the Diagnosis of Gouty and Non-Gouty Arthritis

Our aim was to analyze the diagnostic performance of shear wave elastography (SWE) in the diagnosis of gouty arthritis (GA) and non-gouty arthritis (non-GA). Thirty-nine patients in the GA group and 55 patients in the non-GA group were included in the study. Based on the echo intensity of the joint lesions, the GA group was subdivided into hypo-echoic GA, slightly hyper-echoic GA and hyper-echoic GA subgroups. Quantitative SWE features were evaluated and receiver operating characteristic analysis was performed. On the basis of the study, the elastic modulus (E_max), mean elastic modulus (E_mean), minimum elastic modulus (E_min) and elastic modulus standard deviation (E_SD) were significantly higher in the GA group than in the non-GA group and were highest in the hyper-echoic GA subgroup (p < 0.01 for all). E_min, E_mean and E_max were significantly higher in the hyper-echoic GA subgroup than in the hypo-echoic GA subgroup and non-GA group (p < 0.001 for all), and E_SD was significantly higher in the hyper-echoic GA subgroup than in the non-GA group (p = 0.001). E_min, E_mean, E_max and E_SD were higher in the hypo-echoic GA subgroup than in the non-GA group, and the differences were significant (p < 0.001 for all). Based on the hypo-echoic GA subgroup and non-GA group, areas under the receiver operating characteristic curves for the prediction of GA were 0.749 for E_min, 0.877 for E_mean, 0.896 for E_max and 0.886 for E_SD, with optimal cutoff values of 29.40 kPa for E_min, 45.35 kPa for E_mean, 67.54 kPa for E_max and 7.85 kPa for E_SD. Our results indicate that SWE can differentially diagnose GA and non-GA, especially when the ultrasound manifestations are not typical.     

剪切波弹性成像鉴别淋巴瘤与转移性淋巴结的价值

目的 探讨应用实时剪切波弹性成像(SWE)技术鉴别诊断淋巴瘤和转移淋巴结的临床价值。方法 对可疑结内淋巴瘤患者于活检前行常规超声及剪切波弹性成像检查,获取图像和指标。以病理结果为标准,得到淋巴瘤组25例,转移组30例。分析两组淋巴结各指标差异。通过ROC曲线评价用弹性模量均值鉴别两种恶性淋巴结的诊断效能。结果 二维超声指标中仅淋巴门消失与否存在统计学差异。两组间在取样框色彩充填是否完整及弹性模量值间存在显著差异。转移组淋巴结的弹性模量均值（30.01±13.26）kPa高于淋巴瘤组（14.43±2.46）kPa。淋巴结弹性模量均值鉴别淋巴瘤和转移淋巴结的灵敏度为83.3％。结论 SWE获取的颈部淋巴结弹性图像及弹性模量值可以为鉴别恶性淋巴结性质提供诊断依据。     

剪切波弹性成像检测肌肉骨骼系统的应用进展

剪切波弹性成像技术可评估肌肉、肌腱、韧带与神经等组织内部力学特性的变化,对早期诊断以上组织疾病及制定治疗方案具有重要的参考价值。本文综述了剪切波超声弹性技术的成像原理及其在肌肉骨骼系统的应用研究进展,并对此技术的前景进行展望。     

常规超声联合实时剪切波弹性成像定量参数对大网膜结核的诊断价值

目的探讨常规超声与剪切波弹性成像(SWE)定量参数单独及联合应用时对大网膜结核的诊断价值。方法选取于我院在网膜穿刺活检前均行常规超声及SWE检查的80例患者,根据病理结果将其分为结核组(30例)和非结核组(50例),分析常规超声对网膜结核诊断的灵敏度、特异度及准确度;对结核组与非结核组SWE定量参数(Emean、Emin、Emax、SD)进行统计分析并建立ROC曲线评价其诊断效能;分析常规超声联合SWE后对网膜结核的诊断效能。结果常规超声检查诊断网膜结核的灵敏度、特异度及准确度分别为86.67%、82.00%、83.75%;结核组与非结核组杨氏模量值Emean、Emin、Emax、SD差异均有统计学意义(P<0.001),其中Emean诊断效能最大,以29.7kPa为诊断网膜结核的界值时,其灵敏度、特异度及准确度分别为100%、63.83%、82.50%;常规超声联合SWE诊断网膜结核的灵敏度、特异度、准确度分别为96.67%、94.00%、95.00%。结论实时剪切波弹性成像可作为网膜结核穿刺前有效、无创的辅助检查方法,联合常规超声检查后对网膜结核的诊断效能优于两者的独立应用。