BACKGROUND Staging diagnosis of liver fibrosis is a prerequisite for timely diagnosis and therapy in patients with chronic hepatitis B.In recent years,ultrasound elastography has become an important method for clinica...BACKGROUND Staging diagnosis of liver fibrosis is a prerequisite for timely diagnosis and therapy in patients with chronic hepatitis B.In recent years,ultrasound elastography has become an important method for clinical noninvasive assessment of liver fibrosis stage,but its diagnostic value for early liver fibrosis still needs to be further improved.In this study,the texture analysis was carried out on the basis of two dimensional shear wave elastography(2D-SWE),and the feasibility of 2D-SWE plus texture analysis in the diagnosis of early liver fibrosis was discussed.AIM To assess the diagnostic value of 2D-SWE combined with textural analysis in liver fibrosis staging.METHODS This study recruited 46 patients with chronic hepatitis B.Patients underwent 2DSWE and texture analysis;Young's modulus values and textural patterns were obtained,respectively.Textural pattern was analyzed with regard to contrast,correlation,angular second moment(ASM),and homogeneity.Pathological results of biopsy specimens were the gold standard;comparison and assessment of the diagnosis efficiency were conducted for 2D-SWE,texture analysis and their combination.RESULTS 2D-SWE displayed diagnosis efficiency in early fibrosis,significant fibrosis,severe fibrosis,and early cirrhosis(AUC>0.7,P<0.05)with respective AUC values of 0.823(0.678-0.921),0.808(0.662-0.911),0.920(0.798-0.980),and 0.855(0.716-0.943).Contrast and homogeneity displayed independent diagnosis efficiency in liver fibrosis stage(AUC>0.7,P<0.05),whereas correlation and ASM showed limited values.AUC of contrast and homogeneity were respectively 0.906(0.779-0.973),0.835(0.693-0.930),0.807(0.660-0.910)and 0.925(0.805-0.983),0.789(0.639-0.897),0.736(0.582-0.858),0.705(0.549-0.883)and 0.798(0.650-0.904)in four liver fibrosis stages,which exhibited equivalence to 2D-SWE in diagnostic efficiency(P>0.05).Combined diagnosis(PRE)displayed diagnostic efficiency(AUC>0.7,P<0.01)for all fibrosis stages with respective AUC of 0.952(0.841-0.994),0.896(0.766-0.967),0.978(0.881-0.999),0.947(0.835-0.992).The combined diagnosis showed higher diagnosis efficiency over 2D-SWE in early liver fibrosis(P<0.05),whereas no significant differences were observed in other comparisons(P>0.05).CONCLUSION Texture analysis was capable of diagnosing liver fibrosis stage,combined diagnosis had obvious advantages in early liver fibrosis,liver fibrosis stage might be related to the hepatic tissue hardness distribution.展开更多
Background:Liver fibrosis is a common pathological change caused by a variety of etiologies.Early diagnosis and timely treatment can reverse or delay disease progression and improve the prognosis.This study aimed to a...Background:Liver fibrosis is a common pathological change caused by a variety of etiologies.Early diagnosis and timely treatment can reverse or delay disease progression and improve the prognosis.This study aimed to assess the potential utility of two-dimensional shear wave elastography and texture analysis in dynamic monitoring of the progression of liver fibrosis in rat model.Methods:Twenty rats were divided into control group(n=4)and experimental groups(n=4 per group)with carbon tetrachloride administration for 2,3,4,and 6 weeks.The liver stiffness measurement was performed by two-dimensional shear wave elastography,while the optimal texture analysis subsets to distinguish fibrosis stage were generated by MaZda.The results of elastography and texture analysis were validated through comparing with histopathology.Results:Liver stiffness measurement was 6.09±0.31 kPa in the control group and 7.10±0.41 kPa,7.80±0.93 kPa,8.64±0.93 kPa,9.91±1.13 kPa in the carbon tetrachloride induced groups for 2,3,4,6 weeks,respectively(P<0.05).By texture analysis,histogram and co-occurrence matrix had the most frequency texture parameters in staging liver fibrosis.Receiver operating characteristic curve of liver elasticity showed that the sensitivity and specificity were 95.0%and 92.5%to discriminate liver fibrosis and non-fibrosis,respectively.In texture analysis,five optimal parameters were selected to classify liver fibrosis and non-fibrosis.Conclusions:Two-dimensional shear wave elastography showed potential applications for noninvasive monitoring of the progression of hepatic fibrosis,even in mild fibrosis.Texture analysis can further extract and quantify the texture features in ultrasonic image,which was a supplementary to further visual information and acquired high diagnostic accuracy for severe fibrosis.展开更多
Objective To explore the clinical value of ultrasound shear wave elastography(SWE)and contrast-enhanced ultrasound(CEUS)in transrectal prostate biopsy.Methods A total of 54 patients(average age:67.79±12.01 years)...Objective To explore the clinical value of ultrasound shear wave elastography(SWE)and contrast-enhanced ultrasound(CEUS)in transrectal prostate biopsy.Methods A total of 54 patients(average age:67.79±12.01 years)in the experimental group underwent transrectal prostate biopsy under the guidance of SWE,while 46 patients(average age:69.22±11.54 years)in the control group underwent transrectal prostate biopsy guided by CEUS.Results There were a total of 451 needles,with an average of 8.35±1.67 needles per patient in the experimental group,and a total of 462 needles,with an average of 10.04±1.33 needles per patient in the control group.The difference in puncture times between the two groups was statistically significant(P<0.05).There was no significant difference in the positive detection rate,sensitivity or specificity between the two groups(P>0.05),but there was a significant difference in the diagnostic accuracy between the two groups(P<0.05).The E_(mean)and E_(max)of prostate cancer were significantly higher in the experimental group than in benign prostatic hyperplasia(P<0.05).The receiver operating characteristic curve(ROC)analysis showed that the area under the ROC curve(AUC)of E_(mean)was 0.752(S.E.=0.072,95%CI=0.611-0.894,P=0.007),and the best cutoff value was 47.005 kPa.Conclusion In summary,both SWE-and CEUS-guided transrectal prostate biopsy can help find the focus and guide the puncture,and improve the positive detection rate.展开更多
Facial expressions are linked to movements of muscles, which can be altered by pathological diseases. Assessment of facial muscle deficits is subjective (palpation) and operator-dependent, and these deficits are curre...Facial expressions are linked to movements of muscles, which can be altered by pathological diseases. Assessment of facial muscle deficits is subjective (palpation) and operator-dependent, and these deficits are currently estimated with clinical scales. Thus, the quantification of facial muscle elastic properties is a key for the clinical adaption and evaluation of treatments for facial paralysis. We herein present a novel application of shear wave elastography (SWE) based on an ultrasound protocol to assess the morphological (thickness and texture) and elastic (Young’s modulus) properties of the zygomaticus major (ZM) muscle. Fifteen healthy volunteers underwent SWE tests, and the ultrasound acquisitions were obtained using a new linear transducer (SLH20-6, spatial resolution: 38 μm) and compared to those obtained using an SL10-2 probe (spatial resolution: 50 μm). The probe position was placed along the muscle fiber orientation. A semi-automatic method was developed to quantify the ZM muscle elasticity, and the repeatability was analyzed at one-week intervals. The mean elasticity for the two probes was about 15 kPa. The SLH20-6 probe yielded a higher mean elasticity (approximately 6 kPa) and less homogeneous echogenicity than the SL10-2 probe. Two distinct groups of texture profiles as a function of the transducer were obtained. This study will provide some guidance for clinical practices and will allow the construction of a reference database that could be used to evaluate treatments and develop numerical models of facial expression.展开更多
目的用剪切波弹性成像技术(SWE)定量测定乳腺良恶性肿瘤弹性模量值,评价对乳腺癌的诊断价值和临床意义。方法以中国医科大学附属第四医院415例女性乳腺肿瘤患者为研究对象,测定乳腺病变组织最大弹性模量值(Emax)和平均弹性模量值(Emean)...目的用剪切波弹性成像技术(SWE)定量测定乳腺良恶性肿瘤弹性模量值,评价对乳腺癌的诊断价值和临床意义。方法以中国医科大学附属第四医院415例女性乳腺肿瘤患者为研究对象,测定乳腺病变组织最大弹性模量值(Emax)和平均弹性模量值(Emean),分析与乳腺癌不同临床分期、分级及肿瘤大小的相关性,绘制ROC曲线,并计算其曲线下面积(AUC)。结果乳腺癌晚期(Ⅲ期+Ⅳ期)Emax和Emean高于早期(Ⅰ期、Ⅱ期),且Ⅱ期Emax和Emean高于Ⅰ期,组织学分级Ⅲ级(低分化)Emax和Emean高于Ⅱ级(中分化)、Ⅰ级(高分化),且Ⅱ级(中分化)高于Ⅰ级(高分化);肿瘤大小与Emax和Emean呈正相关。ROC曲线显示,良恶性肿瘤诊断Emax及Emean临界值分别为:60.5 k Pa、31.5 k Pa,其诊断灵敏度、特异度、准确性分别为:90.8%、96.2%、93.5%和89.9%、91.9%、90.8%。结论剪切波弹性成像定量技术对诊断乳腺良恶性肿瘤具有重要的价值和临床意义。展开更多
目的:探讨剪切波弹性成像定量评估鼻咽癌放疗后颈部软组织纤维化的可行性和临床应用价值。方法:使用法国Supersonic公司的AixPlorer型实时定量剪切波弹性成像诊断仪,分别对30例鼻咽癌放疗后颈部软组织纤维化患者(观察组)和30例同时期体...目的:探讨剪切波弹性成像定量评估鼻咽癌放疗后颈部软组织纤维化的可行性和临床应用价值。方法:使用法国Supersonic公司的AixPlorer型实时定量剪切波弹性成像诊断仪,分别对30例鼻咽癌放疗后颈部软组织纤维化患者(观察组)和30例同时期体检健康者(对照组)颈部软组织进行检测,在相同条件下对比分析两组颈部皮下组织、肌肉、涎腺、甲状腺的杨氏模量值。结果:(1)鼻咽癌放疗后观察组双侧颈部皮下组织、胸锁乳突肌的杨氏模量平均值,与对照组比较各项数值有明显增高:L-Sub 71.74±60.71 vs 11.79±5.74、R-Sub 84.09±87.97 vs 13.54±6.46、L-SCM 85.63±56.32 vs 18.53±5.03、R-SCM 81.02±66.33 vs20.20±5.84,P值均小于0.05,表明鼻咽癌放疗后观察组双侧颈部皮下组织和胸锁乳突肌的质硬度即纤维化有了明显增高;(2)对照组和观察组双侧颈部颌下腺、腮腺、甲状腺的杨氏模量平均值比较:L-subman7.27±1.46 vs 7.73±3.38、R-subman 6.34±1.65 vs 6.18±2.60、L-partotid 5.77±1.25 vs 6.90±3.31、Rpartotid 6.01±1.03 vs 6.91±2.09、L-thy 8.12±2.46 vs 7.87±4.19、R-thy 7.47±2.13 vs 7.81±2.80,P值均大于0.05,提示放疗对涎腺、甲状腺的质硬度或纤维化没有明显的影响。结论:剪切波弹性成像技术具有足够的灵敏度,可客观地量化鼻咽癌放疗后的软组织纤维化,具有定量评价纤维化程度、分级的临床应用潜力。展开更多
文摘BACKGROUND Staging diagnosis of liver fibrosis is a prerequisite for timely diagnosis and therapy in patients with chronic hepatitis B.In recent years,ultrasound elastography has become an important method for clinical noninvasive assessment of liver fibrosis stage,but its diagnostic value for early liver fibrosis still needs to be further improved.In this study,the texture analysis was carried out on the basis of two dimensional shear wave elastography(2D-SWE),and the feasibility of 2D-SWE plus texture analysis in the diagnosis of early liver fibrosis was discussed.AIM To assess the diagnostic value of 2D-SWE combined with textural analysis in liver fibrosis staging.METHODS This study recruited 46 patients with chronic hepatitis B.Patients underwent 2DSWE and texture analysis;Young's modulus values and textural patterns were obtained,respectively.Textural pattern was analyzed with regard to contrast,correlation,angular second moment(ASM),and homogeneity.Pathological results of biopsy specimens were the gold standard;comparison and assessment of the diagnosis efficiency were conducted for 2D-SWE,texture analysis and their combination.RESULTS 2D-SWE displayed diagnosis efficiency in early fibrosis,significant fibrosis,severe fibrosis,and early cirrhosis(AUC>0.7,P<0.05)with respective AUC values of 0.823(0.678-0.921),0.808(0.662-0.911),0.920(0.798-0.980),and 0.855(0.716-0.943).Contrast and homogeneity displayed independent diagnosis efficiency in liver fibrosis stage(AUC>0.7,P<0.05),whereas correlation and ASM showed limited values.AUC of contrast and homogeneity were respectively 0.906(0.779-0.973),0.835(0.693-0.930),0.807(0.660-0.910)and 0.925(0.805-0.983),0.789(0.639-0.897),0.736(0.582-0.858),0.705(0.549-0.883)and 0.798(0.650-0.904)in four liver fibrosis stages,which exhibited equivalence to 2D-SWE in diagnostic efficiency(P>0.05).Combined diagnosis(PRE)displayed diagnostic efficiency(AUC>0.7,P<0.01)for all fibrosis stages with respective AUC of 0.952(0.841-0.994),0.896(0.766-0.967),0.978(0.881-0.999),0.947(0.835-0.992).The combined diagnosis showed higher diagnosis efficiency over 2D-SWE in early liver fibrosis(P<0.05),whereas no significant differences were observed in other comparisons(P>0.05).CONCLUSION Texture analysis was capable of diagnosing liver fibrosis stage,combined diagnosis had obvious advantages in early liver fibrosis,liver fibrosis stage might be related to the hepatic tissue hardness distribution.
基金the National Natural Science Foundation of China(81900594)Clinical Research Plan of Shanghai Hospital Development Center(Grant 16CR3109B)Shanghai Youth Sci&Tech Talent Jump starting Program(18YF1412700).
文摘Background:Liver fibrosis is a common pathological change caused by a variety of etiologies.Early diagnosis and timely treatment can reverse or delay disease progression and improve the prognosis.This study aimed to assess the potential utility of two-dimensional shear wave elastography and texture analysis in dynamic monitoring of the progression of liver fibrosis in rat model.Methods:Twenty rats were divided into control group(n=4)and experimental groups(n=4 per group)with carbon tetrachloride administration for 2,3,4,and 6 weeks.The liver stiffness measurement was performed by two-dimensional shear wave elastography,while the optimal texture analysis subsets to distinguish fibrosis stage were generated by MaZda.The results of elastography and texture analysis were validated through comparing with histopathology.Results:Liver stiffness measurement was 6.09±0.31 kPa in the control group and 7.10±0.41 kPa,7.80±0.93 kPa,8.64±0.93 kPa,9.91±1.13 kPa in the carbon tetrachloride induced groups for 2,3,4,6 weeks,respectively(P<0.05).By texture analysis,histogram and co-occurrence matrix had the most frequency texture parameters in staging liver fibrosis.Receiver operating characteristic curve of liver elasticity showed that the sensitivity and specificity were 95.0%and 92.5%to discriminate liver fibrosis and non-fibrosis,respectively.In texture analysis,five optimal parameters were selected to classify liver fibrosis and non-fibrosis.Conclusions:Two-dimensional shear wave elastography showed potential applications for noninvasive monitoring of the progression of hepatic fibrosis,even in mild fibrosis.Texture analysis can further extract and quantify the texture features in ultrasonic image,which was a supplementary to further visual information and acquired high diagnostic accuracy for severe fibrosis.
基金The study was funded by Inner Mongolia Natural Science Foundation(2020MS08047).
文摘Objective To explore the clinical value of ultrasound shear wave elastography(SWE)and contrast-enhanced ultrasound(CEUS)in transrectal prostate biopsy.Methods A total of 54 patients(average age:67.79±12.01 years)in the experimental group underwent transrectal prostate biopsy under the guidance of SWE,while 46 patients(average age:69.22±11.54 years)in the control group underwent transrectal prostate biopsy guided by CEUS.Results There were a total of 451 needles,with an average of 8.35±1.67 needles per patient in the experimental group,and a total of 462 needles,with an average of 10.04±1.33 needles per patient in the control group.The difference in puncture times between the two groups was statistically significant(P<0.05).There was no significant difference in the positive detection rate,sensitivity or specificity between the two groups(P>0.05),but there was a significant difference in the diagnostic accuracy between the two groups(P<0.05).The E_(mean)and E_(max)of prostate cancer were significantly higher in the experimental group than in benign prostatic hyperplasia(P<0.05).The receiver operating characteristic curve(ROC)analysis showed that the area under the ROC curve(AUC)of E_(mean)was 0.752(S.E.=0.072,95%CI=0.611-0.894,P=0.007),and the best cutoff value was 47.005 kPa.Conclusion In summary,both SWE-and CEUS-guided transrectal prostate biopsy can help find the focus and guide the puncture,and improve the positive detection rate.
文摘Facial expressions are linked to movements of muscles, which can be altered by pathological diseases. Assessment of facial muscle deficits is subjective (palpation) and operator-dependent, and these deficits are currently estimated with clinical scales. Thus, the quantification of facial muscle elastic properties is a key for the clinical adaption and evaluation of treatments for facial paralysis. We herein present a novel application of shear wave elastography (SWE) based on an ultrasound protocol to assess the morphological (thickness and texture) and elastic (Young’s modulus) properties of the zygomaticus major (ZM) muscle. Fifteen healthy volunteers underwent SWE tests, and the ultrasound acquisitions were obtained using a new linear transducer (SLH20-6, spatial resolution: 38 μm) and compared to those obtained using an SL10-2 probe (spatial resolution: 50 μm). The probe position was placed along the muscle fiber orientation. A semi-automatic method was developed to quantify the ZM muscle elasticity, and the repeatability was analyzed at one-week intervals. The mean elasticity for the two probes was about 15 kPa. The SLH20-6 probe yielded a higher mean elasticity (approximately 6 kPa) and less homogeneous echogenicity than the SL10-2 probe. Two distinct groups of texture profiles as a function of the transducer were obtained. This study will provide some guidance for clinical practices and will allow the construction of a reference database that could be used to evaluate treatments and develop numerical models of facial expression.
基金Supported by MEXT-Supported Program for the Strategic Research Foundation at Private Universities of the Japanese Governmentthe Ministry of Health,Labor,and Welfare of the Japanese Government
文摘AIM: To investigate the factors other than fibrosis stage correlating with acoustic radiation force impulse (ARFI) elastograpy in chronic hepatitis C.
文摘目的用剪切波弹性成像技术(SWE)定量测定乳腺良恶性肿瘤弹性模量值,评价对乳腺癌的诊断价值和临床意义。方法以中国医科大学附属第四医院415例女性乳腺肿瘤患者为研究对象,测定乳腺病变组织最大弹性模量值(Emax)和平均弹性模量值(Emean),分析与乳腺癌不同临床分期、分级及肿瘤大小的相关性,绘制ROC曲线,并计算其曲线下面积(AUC)。结果乳腺癌晚期(Ⅲ期+Ⅳ期)Emax和Emean高于早期(Ⅰ期、Ⅱ期),且Ⅱ期Emax和Emean高于Ⅰ期,组织学分级Ⅲ级(低分化)Emax和Emean高于Ⅱ级(中分化)、Ⅰ级(高分化),且Ⅱ级(中分化)高于Ⅰ级(高分化);肿瘤大小与Emax和Emean呈正相关。ROC曲线显示,良恶性肿瘤诊断Emax及Emean临界值分别为:60.5 k Pa、31.5 k Pa,其诊断灵敏度、特异度、准确性分别为:90.8%、96.2%、93.5%和89.9%、91.9%、90.8%。结论剪切波弹性成像定量技术对诊断乳腺良恶性肿瘤具有重要的价值和临床意义。
文摘目的:探讨剪切波弹性成像定量评估鼻咽癌放疗后颈部软组织纤维化的可行性和临床应用价值。方法:使用法国Supersonic公司的AixPlorer型实时定量剪切波弹性成像诊断仪,分别对30例鼻咽癌放疗后颈部软组织纤维化患者(观察组)和30例同时期体检健康者(对照组)颈部软组织进行检测,在相同条件下对比分析两组颈部皮下组织、肌肉、涎腺、甲状腺的杨氏模量值。结果:(1)鼻咽癌放疗后观察组双侧颈部皮下组织、胸锁乳突肌的杨氏模量平均值,与对照组比较各项数值有明显增高:L-Sub 71.74±60.71 vs 11.79±5.74、R-Sub 84.09±87.97 vs 13.54±6.46、L-SCM 85.63±56.32 vs 18.53±5.03、R-SCM 81.02±66.33 vs20.20±5.84,P值均小于0.05,表明鼻咽癌放疗后观察组双侧颈部皮下组织和胸锁乳突肌的质硬度即纤维化有了明显增高;(2)对照组和观察组双侧颈部颌下腺、腮腺、甲状腺的杨氏模量平均值比较:L-subman7.27±1.46 vs 7.73±3.38、R-subman 6.34±1.65 vs 6.18±2.60、L-partotid 5.77±1.25 vs 6.90±3.31、Rpartotid 6.01±1.03 vs 6.91±2.09、L-thy 8.12±2.46 vs 7.87±4.19、R-thy 7.47±2.13 vs 7.81±2.80,P值均大于0.05,提示放疗对涎腺、甲状腺的质硬度或纤维化没有明显的影响。结论:剪切波弹性成像技术具有足够的灵敏度,可客观地量化鼻咽癌放疗后的软组织纤维化,具有定量评价纤维化程度、分级的临床应用潜力。
