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1.
Zhongguo Yi Liao Qi Xie Za Zhi ; 45(2): 176-182, 2021 Apr 08.
Artículo en Chino | MEDLINE | ID: mdl-33825378

RESUMEN

The methods of monitoring the thermal ablation of tumor are compared and analyzed in recent years. The principle method results and insufficient of ultrasound elastography and quantitative ultrasound imaging are discussed. The results show that ultrasonic tissue signature has great development space in the field of real-time monitoring of thermal ablation, but there are still some problems such as insufficient monitoring accuracy difficulty in whole-course monitoring and insufficient in vivo experiments, so it is impossible to realize clinical application. It is necessary to further study the monitoring method which can realize accurate and real-time detection of ablation zone and transition zone and can be easily combined with the existing ultrasonic equipment.


Asunto(s)
Ablación por Catéter , Diagnóstico por Imagen de Elasticidad , Hipertermia Inducida , Neoplasias , Humanos , Hígado/diagnóstico por imagen , Hígado/cirugía , Neoplasias/diagnóstico por imagen , Neoplasias/cirugía , Ultrasonografía
2.
Am J Vet Res ; 82(4): 286-291, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33764829

RESUMEN

OBJECTIVE: To evaluate stiffness of the liver parenchyma in healthy adult cats by means of point shear wave elastography (PSWE). ANIMALS: 18 client-owned adult (1- to 6-year-old) healthy cats. PROCEDURES: Echogenicity and echotexture of the liver parenchyma were assessed by means of conventional B-mode ultrasonography. The shear wave velocity (Vs) of the right and left portions of the liver were measured by means of PSWE. RESULTS: B-mode ultrasonography revealed no abnormalities in echotexture or echogenicity of the liver parenchyma in any cat. Mean (95% CI) Vs in the liver parenchyma was 1.46 m/s (1.36 to 1.55 m/s) for the right portion, 1.36 m/s (1.26 to 1.47 m/s) for the left portion, and 1.43 m/s (1.35 to 1.51 m/s) overall. The difference in mean Vs between the 2 portions of the liver was significant. No significant correlation was found between Vs and body weight or between Vs and the depth at which this variable was measured. CONCLUSIONS AND CLINICAL RELEVANCE: Quantitative PSWE of the liver was feasible in healthy adult cats. The obtained values for Vs may be useful for interpretation of and comparison with values measured in cats with liver disease. Additional research is needed to explore the potential usefulness of PSWE for diagnostic purposes.


Asunto(s)
Enfermedades de los Gatos , Diagnóstico por Imagen de Elasticidad , Hepatopatías , Animales , Peso Corporal , Gatos , Diagnóstico por Imagen de Elasticidad/veterinaria , Hígado/diagnóstico por imagen , Hepatopatías/diagnóstico por imagen , Hepatopatías/veterinaria , Reproducibilidad de los Resultados
3.
Medicine (Baltimore) ; 100(11): e25196, 2021 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-33726013

RESUMEN

ABSTRACT: The aim of the study was to study sonoelastographic features of thesartorius muscle, and its relation to the demographic factors.The study included 70 muscles in 35 healthy subjects. High-resolution ultrasound and shearwave elastography were used to evaluate the sartorius muscle. Stiffness values were measured.The mean shear elastic modulus of the sartorius muscle was 21.96 ±â€Š5.1 kPa. Demographic factors showed no relation to the elastic modulus of the left sartorius muscle. Positive statistical correlation was noted between the elastic modulus of the right sartorius muscle, weight, and body mass index.Our results could be a reference point for evaluating sartorius muscle stiffness in future research considering different pathologies.


Asunto(s)
Módulo de Elasticidad , Diagnóstico por Imagen de Elasticidad/estadística & datos numéricos , Músculo Esquelético/diagnóstico por imagen , Muslo/diagnóstico por imagen , Ultrasonografía/estadística & datos numéricos , Adulto , Diagnóstico por Imagen de Elasticidad/métodos , Femenino , Voluntarios Sanos , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , Ultrasonografía/métodos , Adulto Joven
4.
Artículo en Japonés | MEDLINE | ID: mdl-33746174

RESUMEN

PURPOSE: Magnetic resonance elastography (MRE) of the liver was performed to examine the appropriate external driver amplitude according to the physique of the subject and the index useful for determining the physique. METHODS: For 60 subjects who underwent MRE examination, we measured the unmeasurable elastic modulus area in the liver based on the stiffness map obtained from MRE. The external driver amplitude with the smallest unmeasurable elastic modulus area was taken as the appropriate external driver amplitude for the subject. The receiver operating characteristic (ROC) analysis was performed on the indicators of physical constitution (abdominal depth, waist circumference, body weight and body mass index (BMI) ) and external driver amplitude of 30%, 50% and 70%. BMI was the most appropriate tool for the comparison of indicators of physical constitution. RESULT: The appropriate external driver amplitude was 30% when the cutoff value of BMI was less than 25.3 kg/m², 70% when it was 31.0 kg/m² or more, and 50% when it was between them. CONCLUSION: It is considered that an accurate elastic modulus can be obtained by setting an appropriate indicator of physical constitution and external driver amplitude according to physique in MRE.


Asunto(s)
Diagnóstico por Imagen de Elasticidad , Módulo de Elasticidad , Humanos , Hígado/diagnóstico por imagen , Cirrosis Hepática/patología , Imagen por Resonancia Magnética , Curva ROC , Reproducibilidad de los Resultados
6.
Sensors (Basel) ; 21(5)2021 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-33673664

RESUMEN

Ultrasound-based shear wave elastography (SWE) provides the means to quantify tissue mechanical properties in vivo and has proven valuable in detecting degenerative processes in tendons. Its current mode of use is for two-dimensional rendering measurements, which are highly position-dependent. We therefore propose an approach to create a volumetric reconstruction of the mechano-acoustic properties of a structure of interest based on optically tracking the ultrasound probe during free-hand measurement sweeps. In the current work, we aimed (1) to assess the technical feasibility of the three-dimensional mapping of unidirectional shear wave velocity (SWV), (2) to evaluate the possible artefacts associated with hand-held image acquisition, (3) to investigate the reproducibility of the proposed technique, and (4) to study the potential of this method in detecting local adaptations in a longitudinal study setting. Operative and technical feasibility as well as potential artefacts associated with hand-held image acquisition were studied on a synthetic phantom containing discrete targets of known mechanical properties. Measurement reproducibility was assessed based on inter-day and inter-reader scans of the patellar, Achilles, and supraspinatus tendon of ten healthy volunteers and was compared to traditional two-dimensional image acquisition. The potential of this method in detecting local adaptations was studied by testing the effect of short-term voluntary isometric loading history on SWV along the tendon long axis. The suggested approach was technically feasible and reproducible, with a moderate to very good reliability and a standard error of measurement in the range of 0.300-0.591 m/s for the three assessed tendons at the two test-retest modalities. We found a consistent variation in SWV along the longitudinal axis of each tendon, and isometric loading resulted in regional increases in SWV in the patellar and Achilles tendons. The proposed method outperforms traditional two-dimensional measurement with regards to reproducibility and may prove valuable in the objective assessment of pathological tendon changes.


Asunto(s)
Tendón Calcáneo , Diagnóstico por Imagen de Elasticidad , Tendón Calcáneo/diagnóstico por imagen , Humanos , Estudios Longitudinales , Prueba de Estudio Conceptual , Reproducibilidad de los Resultados , Ultrasonografía
7.
Zhonghua Gan Zang Bing Za Zhi ; 29(2): 108-110, 2021 Feb 20.
Artículo en Chino | MEDLINE | ID: mdl-33685076

RESUMEN

Liver cirrhosis is the final stage of many chronic liver diseases, and is still a heavy disease burden. The proportion of liver cirrhosis caused by the hepatitis B virus is declining, while that caused by the non-alcoholic fatty liver disease (metabolic-associated fatty liver disease) is rising. Several predictive models and techniques such as transient elastography have been used for the early non-invasive evaluation of liver cirrhosis. Effective etiological treatment and complication management are the possible key to reverse and recompense liver function during liver cirrhosis treatment. In recent years, the effectiveness and availability of anti-hepatitis B and C virus drugs have been significantly improved, which provides the basis for effective etiological treatment of liver cirrhosis. However, there is still a lack of etiological treatment measures for non-alcoholic fatty liver disease. Therefore, in addition to focusing on common complications, we should also manage "rare" complications. This article reviews the changes in epidemiological characteristics, the update of the natural history concepts, diagnostic evaluation methods, and the treatment measures for liver cirrhosis.


Asunto(s)
Diagnóstico por Imagen de Elasticidad , Hepatitis B , Enfermedad del Hígado Graso no Alcohólico , Hepatitis B/complicaciones , Humanos , Cirrosis Hepática , Enfermedad del Hígado Graso no Alcohólico/diagnóstico , Enfermedad del Hígado Graso no Alcohólico/epidemiología , Enfermedad del Hígado Graso no Alcohólico/etiología
8.
Eur J Endocrinol ; 184(4): 587-596, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33606661

RESUMEN

Objective: To investigate the prevalence and risks factors associated with the presence of liver fibrosis in subjects with nonalcoholic fatty liver disease (NAFLD) with and without type 2 diabetes mellitus (T2D). Design and methods: This study was part of a population-based study conducted in the Barcelona metropolitan area among subjects aged 18-75 years old. Secondary causes of steatosis were excluded. Moderate-to-advanced liver fibrosis was defined as a liver stiffness measurement (LSM) ≥ 8.0 kPa assessed by transient elastography. Results: Among 930 subjects with NAFLD, the prevalence of moderate-to-advanced liver fibrosis was higher in subjects with T2D compared those without (30.8% vs 8.7%). By multivariable analysis, one of the main factors independently associated with increased LSM in subjects with NAFLD was atherogenic dyslipidemia but only in those with T2D. The percentage of subjects with LSM ≥ 8.0 kPa was higher in subjects with T2D and atherogenic dyslipidemia than in those with T2D without atherogenic dyslipidemia both for the cut-off point of LSM ≥8.0 kPa (45% vs 24% P = 0.002) and ≥13 kPa (13% vs 4% P = 0.020). No differences were observed in the prevalence of LSM ≥8.0 kPa regarding glycemic control among NAFLD-diabetic subjects. Conclusions: Factors associated with moderate-to-advanced liver fibrosis in NAFLD are different in subjects with and without T2D. Atherogenic dyslipidemia was associated with the presence of moderate-to-advanced liver fibrosis in T2D with NAFLD but not in non-diabetic subjects. These findings highlight the need for an active search for liver fibrosis in subjects with T2D NAFLD and atherogenic dyslipidemia.


Asunto(s)
Aterosclerosis/epidemiología , Diabetes Mellitus Tipo 2/epidemiología , Dislipidemias/epidemiología , Hiperglucemia/epidemiología , Cirrosis Hepática/epidemiología , Enfermedad del Hígado Graso no Alcohólico/epidemiología , Adolescente , Adulto , Anciano , Aterosclerosis/etiología , Comorbilidad , Diabetes Mellitus Tipo 2/complicaciones , Dislipidemias/complicaciones , Diagnóstico por Imagen de Elasticidad , Femenino , Humanos , Hiperglucemia/complicaciones , Cirrosis Hepática/diagnóstico , Cirrosis Hepática/etiología , Cirrosis Hepática/patología , Masculino , Persona de Mediana Edad , Enfermedad del Hígado Graso no Alcohólico/complicaciones , Prevalencia , Factores de Riesgo , Índice de Severidad de la Enfermedad , España/epidemiología , Adulto Joven
9.
Medicine (Baltimore) ; 100(4): e23905, 2021 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-33530187

RESUMEN

BACKGROUND: Papillary thyroid microcarcinoma is easy to be missed because of its small focus, concealed incidence and lack of clinical features. Ultrasound examination is one of the main methods for the detection and diagnosis of papillary thyroid microcarcinoma. The detection rate of conventional ultrasound is not ideal. Combined ultrasound elastography can improve the detection rate, but there is lack of evidence-based evidence. The purpose of this study was to systematically evaluate the value of conventional ultrasound combined with ultrasound elastography in the diagnosis of papillary thyroid microcarcinoma. METHODS: A systematic search was performed by retrieving on English databases (PubMed, Embase, Web of Science, the Cochrane Library) and Chinese databases (CNKI, Wanfang, Weipu (VIP), CBM). The retrieval time limit was from the establishment of the database to November 2020 and manually search for the conventional ultrasound combined with ultrasound elastography in the diagnosis of papillary thyroid microcarcinoma. Two researchers extracted and evaluated the quality of the data in the included study independently. A meta-analysis was performed using Meta Disc1.4 and RevMan5.3 software. CONCLUSIONS: This study will evaluate the accuracy and practicability of conventional ultrasound combined with ultrasonic elastography in the diagnosis of papillary thyroid microcarcinoma, and provide evidence-based basis for clinicians to choose the appropriate or best diagnostic method. ETHICS AND DISSEMINATION: The private information from individuals will not be published. This systematic review also will not involve endangering participant rights. Ethical approval is not required. OSF REGISTRATION NUMBER: DOI: 10.17605 / OSF.IO / V6HK7.


Asunto(s)
Carcinoma Papilar/diagnóstico por imagen , Metaanálisis como Asunto , Revisiones Sistemáticas como Asunto , Neoplasias de la Tiroides/diagnóstico por imagen , Protocolos Clínicos , Diagnóstico Diferencial , Diagnóstico por Imagen de Elasticidad , Humanos , Proyectos de Investigación , Ultrasonografía
10.
Medicine (Baltimore) ; 100(3): e23561, 2021 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-33545931

RESUMEN

BACKGROUND: Some studies reported the correlations between renal parenchymal stiffness measured by transient elastography or acoustic radiation force impulse (ARFI) and the extent of interstitial fibrosis. This study was prospectively designed to evaluate the correlation between clinical, histological findings and the kidney shear wave velocity (SWV, m/s) assessed by ARFI elastography to identify factors affecting the kidney SWV in normal patients. METHODS: Seventy-three adult living kidney transplantation donors were enrolled in our center between September 2010 and January 2013. Before transplantation, all donors were evaluated by ARFI elastography to identify the range of SWV in kidneys. Time-zero biopsies were performed on all graft kidneys before implantation. RESULTS: Mean age of donors was 42.0 ±â€Š11.3 years. The mean SWV and depth were 2.21 ±â€Š0.58 m/s and 5.37 ±â€Š1.06 cm. All histological findings showed mild degree of the Banff score, only grade I. In univariate analyses, the SWV was not associated with all histological parameters. Age (r = -0.274, P = .019) diastolic blood pressure (DBP, r = -0.255, P = .030) and depth for SWV measurement (r = -0.345, P = .003) were significantly correlated with the SWV. In multivariate linear regression analysis, age, gender, body mass index (BMI), and depth for SWV measurement were significantly correlated with the SWV (P = .003, .005, .002, and .004, respectively). CONCLUSIONS: We demonstrated that all histological findings are not correlated with the SWV of donor kidney. Otherwise, factors influencing the kidney SWV assessed by ARFI elastography are age, gender, BMI, and depth for the SWV measurement in donors for kidney transplantation.


Asunto(s)
Trasplante de Riñón , Riñón/diagnóstico por imagen , Donadores Vivos , Adulto , Diagnóstico por Imagen de Elasticidad , Femenino , Humanos , Interpretación de Imagen Asistida por Computador , Riñón/patología , Masculino , Estudios Prospectivos , Sensibilidad y Especificidad
11.
Acta Gastroenterol Belg ; 84(1): 43-50, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33639692

RESUMEN

Background: Assessment of liver disease severity in chronic Hepatitis C (CHC) is essential both in pretreatment and posttreatment period. We assessed the impact of direct-acting antiviral therapy on liver stiffness regression measured by Vibration Controlled Transient Elastography (VCTE) in patients with CHC and evaluated the diagnostic performance of the APRI and FIB-4 scores compared to VCTE in detecting advanced fibrosis and cirrhosis (F3/F4). Methodology: Retrospective analysis of consecutive patients with CHC who underwent VCTE before and after DAA therapy was done. APRI and FIB-4 scores were compared to VCTE. Results: 88 (56.78%) patients-12 (F3) and 76 (F4) according to VCTE, had advanced fibrosis pretreatment, which reduced to 69 (44.52%) - 10 (F3) and 59 (F4) after 12 weeks DAA therapy. Significant reduction in VCTE value from 14.08 ± 9.05 KPa to 11.84 ± 8.31 KPa (p=0.002) was noted. There is significant reduction in APRI, FIB-4 and GUCI score posttreatment which was not the case with Lok score and Bonacini score. Before therapy, FIB-4 outperformed others to predict advanced fibrosis with score >2.13 (AUC 0.93), having sensitivity 76%, specificity 96% and accuracy 86%. However posttreatment, APRI and GUCI score performed best to predict F3/F4 fibrosis with score >0.63 (AUC 0.97) and >0.64 (AUC 0.96), having sensitivity, specificity and accuracy of 85%, 96.6% and 92% ; 85%, 6.6% and 92% respectively. Conclusion: Before therapy, FIB-4 had the best accuracy in predicting advanced fibrosis whereas APRI and GUCI score were the best indices post-treatment.


Asunto(s)
Diagnóstico por Imagen de Elasticidad , Hepatitis C Crónica , Antivirales , Aspartato Aminotransferasas , Biomarcadores , Hepatitis C Crónica/complicaciones , Hepatitis C Crónica/tratamiento farmacológico , Humanos , Cirrosis Hepática/diagnóstico por imagen , Estudios Retrospectivos , Vibración
12.
Medicine (Baltimore) ; 100(3): e23999, 2021 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-33545992

RESUMEN

ABSTRACT: The purpose of this study is to investigate sonoelastographic features of the tibial nerve.The study included 72 tibial nerves in 36 healthy subjects. High resolution ultrasound and Shear wave elastography were used to evaluate the tibial nerve. Cross sectional area and stiffness were measured.The mean cross sectional area of the tibial nerve was 13.4 mm2. The mean shear elastic modulus of the tibial nerve in the short axis was 23.3 kPa. The mean shear elastic modulus of the tibial nerve in long axis was 26.1 kPa. The tibial nerve elastic modulus also showed no correlation with cross sectional area neither in the long axis nor short axis. Age, height, weight, and body mass index showed no correlation with tibial nerve elastic modulus in short or long axes.The elastic modulus of the tibial nerve has been determined in healthy subjects and can serve as a reference for future assessment of polyneuropathy.


Asunto(s)
Diagnóstico por Imagen de Elasticidad/estadística & datos numéricos , Nervio Tibial/diagnóstico por imagen , Ultrasonografía/estadística & datos numéricos , Adulto , Módulo de Elasticidad/fisiología , Diagnóstico por Imagen de Elasticidad/métodos , Femenino , Voluntarios Sanos , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , Nervio Tibial/fisiología , Ultrasonografía/métodos , Adulto Joven
13.
Aliment Pharmacol Ther ; 53(7): 774-783, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33608929

RESUMEN

BACKGROUND: Several prognostic tests for primary sclerosing cholangitis (PSC) have been developed, including biochemical models, elastography and magnetic resonance imaging scores. AIM: To conduct a systematic review of non-invasive prognostic tests for PSC. METHODS: A systematic review was conducted from 1987 to 2020 of blood tests, biochemical models, elastography and imaging scores associated with outcomes in PSC. RESULTS: Forty studies of prognostic tests that collectively included 16 094 subjects with PSC were reviewed, of which 26 studies of non-invasive tests including 13 759 subjects with PSC were included. Normalisation or reduction of alkaline phosphatase with or without therapy was associated with transplant-free survival and reduced risk of hepatobiliary cancers but cut-off values for alkaline phosphatase were not consistent among studies. The most studied prognostic biochemical model was the Mayo Risk Score (MRS) evaluated in 18 studies with a c-statistic from 0.63 to 0.85 for clinical outcomes. One study demonstrated that the UK-PSC score outperforms MRS for predicting clinical outcomes with a c-statistics of 0.81and 0.75 respectively. A transient elastography score greater than 11.1 kPa is associated with survival and liver-related complications. The Anali score, derived from specific MRI and MRCP features, is associated with the development of cholangiocarcinoma and decompensated cirrhosis. Promising prognostic models include the enhanced liver fibrosis (ELF) score, ELF test and PREsTo scores. CONCLUSION: MRS is the most studied prognostic score for clinical outcomes in PSC but the UK-PSC score and PREsTo have better test performance. Further studies comparing MRS to UK-PSC score, PREsTo or ELF with elastography or imaging-based scores are warranted.


Asunto(s)
Neoplasias de los Conductos Biliares , Colangitis Esclerosante , Diagnóstico por Imagen de Elasticidad , Conductos Biliares Intrahepáticos , Colangitis Esclerosante/diagnóstico por imagen , Humanos , Pronóstico
14.
Br J Radiol ; 94(1119): 20200265, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33605783

RESUMEN

Brain magnetic resonance elastography (MRE) is an imaging technique capable of accurately and non-invasively measuring the mechanical properties of the living human brain. Recent studies have shown that MRE has potential to provide clinically useful information in patients with intracranial tumors, demyelinating disease, neurodegenerative disease, elevated intracranial pressure, and altered functional states. The objectives of this review are: (1) to give a general overview of the types of measurements that have been obtained with brain MRE in patient populations, (2) to survey the tools currently being used to make these measurements possible, and (3) to highlight brain MRE-based quantitative biomarkers that have the highest potential of being adopted into clinical use within the next 5 to 10 years. The specifics of MRE methodology strategies are described, from wave generation to material parameter estimations. The potential clinical role of MRE for characterizing and planning surgical resection of intracranial tumors and assessing diffuse changes in brain stiffness resulting from diffuse neurological diseases and altered intracranial pressure are described. In addition, the emerging technique of functional MRE, the role of artificial intelligence in MRE, and promising applications of MRE in general neuroscience research are presented.


Asunto(s)
Encefalopatías/diagnóstico por imagen , Diagnóstico por Imagen de Elasticidad/métodos , Encéfalo/diagnóstico por imagen , Humanos
15.
Methods Mol Biol ; 2216: 301-323, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33476008

RESUMEN

Magnetic resonance elastography (MRE) is an emerging imaging modality that maps the elastic properties of tissue such as the shear modulus. It allows for noninvasive assessment of stiffness, which is a surrogate for fibrosis. MRE has been shown to accurately distinguish absent or low stage fibrosis from high stage fibrosis, primarily in the liver. Like other elasticity imaging modalities, it follows the general steps of elastography: (1) apply a known cyclic mechanical vibration to the tissue; (2) measure the internal tissue displacements caused by the mechanical wave using magnetic resonance phase encoding method; and (3) infer the mechanical properties from the measured mechanical response (displacement), by generating a simplified displacement map. The generated map is called an elastogram.While the key interest of MRE has traditionally been in its application to liver, where in humans it is FDA approved and commercially available for clinical use to noninvasively assess degree of fibrosis, this is an area of active research and there are novel upcoming applications in brain, kidney, pancreas, spleen, heart, lungs, and so on. A detailed review of all the efforts is beyond the scope of this chapter, but a few specific examples are provided. Recent application of MRE for noninvasive evaluation of renal fibrosis has great potential for noninvasive assessment in patients with chronic kidney diseases. Development and applications of MRE in preclinical models is necessary primarily to validate the measurement against "gold-standard" invasive methods, to better understand physiology and pathophysiology, and to evaluate novel interventions. Application of MRE acquisitions in preclinical settings involves challenges in terms of available hardware, logistics, and data acquisition. This chapter will introduce the concepts of MRE and provide some illustrative applications.This publication is based upon work from the COST Action PARENCHIMA, a community-driven network funded by the European Cooperation in Science and Technology (COST) program of the European Union, which aims to improve the reproducibility and standardization of renal MRI biomarkers. This introduction chapter is complemented by another separate chapter describing the experimental protocol and data analysis.


Asunto(s)
Abdomen/fisiología , Biomarcadores/análisis , Diagnóstico por Imagen de Elasticidad/métodos , Procesamiento de Imagen Asistido por Computador/métodos , Imagen por Resonancia Magnética/métodos , Monitoreo Fisiológico/métodos , Animales , Humanos , Programas Informáticos
16.
Methods Mol Biol ; 2216: 519-546, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33476022

RESUMEN

Application of MRE for noninvasive evaluation of renal fibrosis has great potential for noninvasive assessment in patients with chronic kidney disease (CKD). CKD leads to severe complications, which require dialysis or kidney transplant and could even result in death. CKD in native kidneys and interstitial fibrosis in allograft kidneys are the two major kidney fibrotic pathologies where MRE may be clinically useful. Both these conditions can lead to extensive morbidity, mortality, and high health care costs. Currently, biopsy is the standard method for renal fibrosis staging. This method of diagnosis is painful, invasive, limited by sampling bias, exhibits inter- and intraobserver variability, requires prolonged hospitalization, poses risk of complications and significant bleeding, and could even lead to death. MRE based methods can potentially be useful to noninvasively detect, stage, and monitor renal fibrosis, reducing the need for renal biopsy. In this chapter, we describe experimental procedure and step by step instructions to run MRE along with some illustrative applications. We also includes sections on how to perform data quality check and analysis methods.This publication is based upon work from the COST Action PARENCHIMA, a community-driven network funded by the European Cooperation in Science and Technology (COST) program of the European Union, which aims to improve the reproducibility and standardization of renal MRI biomarkers.


Asunto(s)
Abdomen/fisiología , Diagnóstico por Imagen de Elasticidad/métodos , Procesamiento de Imagen Asistido por Computador/métodos , Imagen por Resonancia Magnética/métodos , Monitoreo Fisiológico/métodos , Abdomen/diagnóstico por imagen , Animales , Ratas , Ratas Endogámicas Lew , Ratas Sprague-Dawley , Ratas Wistar , Programas Informáticos
18.
Lancet Gastroenterol Hepatol ; 6(3): 185-198, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33460567

RESUMEN

BACKGROUND: Diagnostic tools for liver disease can now include estimation of the grade of hepatic steatosis (S0 to S3). Controlled attenuation parameter (CAP) is a non-invasive method for assessing hepatic steatosis that has become available for patients who are obese (FibroScan XL probe), but a consensus has not yet been reached regarding cutoffs and its diagnostic performance. We aimed to assess diagnostic properties and identify relevant covariates with use of an individual patient data meta-analysis. METHODS: We did an individual patient data meta-analysis, in which we searched PubMed and Web of Science for studies published from database inception until April 30, 2019. Studies reporting original biopsy-controlled data of CAP for non-invasive grading of steatosis were eligible. Probe recommendation was based on automated selection, manual assessment of skin-to-liver-capsule distance, and a body-mass index (BMI) criterion. Receiver operating characteristic methods and mixed models were used to assess diagnostic properties and covariates. Patients with non-alcoholic fatty liver disease (NAFLD) were analysed separately because they are the predominant patient group when using the XL probe. This study is registered with PROSPERO, CRD42018099284. FINDINGS: 16 studies reported histology-controlled CAP including the XL probe, and individual data from 13 papers and 2346 patients were included. Patients with a mean age of 46·5 years (SD 14·5) were recruited from 20 centres in nine countries. 2283 patients had data for BMI; 673 (29%) were normal weight (BMI <25 kg/m2), 530 (23%) were overweight (BMI ≥25 to <30 kg/m2), and 1080 (47%) were obese (BMI ≥30 kg/m2). 1277 (54%) patients had NAFLD, 474 (20%) had viral hepatitis, 285 (12%) had alcohol-associated liver disease, and 310 (13%) had other liver disease aetiologies. The XL probe was recommended in 1050 patients, 930 (89%) of whom had NAFLD; among the patients with NAFLD, the areas under the curve were 0·819 (95% CI 0·769-0·869) for S0 versus S1 to S3 and 0·754 (0·720-0·787) for S0 to S1 versus S2 to S3. CAP values were independently affected by aetiology, diabetes, BMI, aspartate aminotransferase, and sex. Optimal cutoffs differed substantially across aetiologies. Risk of bias according to QUADAS-2 was low. INTERPRETATION: CAP cutoffs varied according to cause, and can effectively recognise significant steatosis in patients with viral hepatitis. CAP cannot grade steatosis in patients with NAFLD adequately, but its value in a NAFLD screening setting needs to be studied, ideally with methods beyond the traditional histological reference standard. FUNDING: The German Federal Ministry of Education and Research and Echosens.


Asunto(s)
Diagnóstico por Imagen de Elasticidad/métodos , Hígado/patología , Enfermedad del Hígado Graso no Alcohólico/diagnóstico por imagen , Adulto , Área Bajo la Curva , Biopsia , Índice de Masa Corporal , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedad del Hígado Graso no Alcohólico/etiología , Curva ROC , Índice de Severidad de la Enfermedad
19.
Radiologe ; 61(2): 170-176, 2021 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-33459812

RESUMEN

BACKGROUND: Elasticity assessment of breast lesions can also be used as an associated criterion in the B­mode ultrasound (US) assessment for differentiation between benign or malignant lesions. OBJECTIVES: The goal was to identify techniques available to measure US elasticity, assess the use of B­mode BI-RADS® classification combined with elastography, and identify which artefacts influence the US elasticity result. MATERIALS AND METHODS: Based on different studies and meta-analyses, clinical application in daily routine of the presented US elastography techniques will be investigated concerning the statistical performance of semi-quantitative and quantitative cut-off values to differentiate benign from malignant lesions. RESULTS: Supported by meta-analyses, all presented US elastography techniques improve the specificity by decreasing the B­mode sensitivity. In the literature the semi-quantitative and quantitative cut-off values often vary considerably. The interobserver variability of strain elastography shows a fair agreement and the interobserver variability of shear wave elastography a substantial agreement. CONCLUSIONS: Considering the limitations and artefacts of each technique, US elastography is able to enhance the true positive and true negative results. In the case of a higher B­mode BI-RADS® classification (4b, 4c, 5) or in a high-risk situation to develop breast cancer, a large core needle biopsy should be performed despite lesion softness in elastography.


Asunto(s)
Neoplasias de la Mama , Diagnóstico por Imagen de Elasticidad , Neoplasias de la Mama/diagnóstico por imagen , Femenino , Humanos , Metaanálisis como Asunto
20.
Medicine (Baltimore) ; 100(2): e24071, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33466166

RESUMEN

ABSTRACT: The study included 38 ulnar nerves in 20 healthy subjects. High-resolution ultrasound and Shear wave elastography were used to evaluate the ulnar nerve at the mid forearm. The mean cross-sectional area of the ulnar nerve was 7.1 mm2. The mean shear elastic modulus of the nerve in the short axis was 27.4 kPa. The mean shear elastic modulus of the nerve in long axis was 24.7 kPa. No statistical relation could be noted between elasticity measurements in long and short axes. The ulnar nerve elastic modulus also showed no correlation with CSA neither in the long axis nor short axis. Age, height, weight, and body mass index showed no correlation with the ulnar elastic modulus in short or long axes. The elastic modulus of the ulnar nerve has been determined in healthy subjects and can serve as a reference for future assessment of compressive neuropathies of the ulnar nerve.


Asunto(s)
Diagnóstico por Imagen de Elasticidad/métodos , Antebrazo/diagnóstico por imagen , Antebrazo/inervación , Nervio Cubital/diagnóstico por imagen , Adulto , Femenino , Voluntarios Sanos , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia
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