Differential diagnosis of different types of solid focal liver lesions using two-dimensional shear wave elastography

BACKGROUND The clinical management and prognosis differ between benign and malignant solid focal liver lesions(FLLs),as well as among different pathological types of malignant FLLs.Accurate diagnosis of the possible types of solid FLLs is important.Our previous study confirmed the value of shear wave elastography(SWE)using maximal elasticity(Emax)as the parameter in the differential diagnosis between benign and malignant FLLs.However,the value of SWE in the differential diagnosis among different pathological types of malignant FLLs has not been proved.AIM To explore the value of two-dimensional SWE(2D-SWE)using Emax in the differential diagnosis of FLLs,especially among different pathological types of malignant FLLs.METHODS All the patients enrolled in this study were diagnosed as benign,malignant or undetermined FLLs by conventional ultrasound.Emax of FLLs and the periphery of FLLs was measured using 2D-SWE and compared between benign and malignant FLLs or among different pathological types of malignant FLLs.RESULTS The study included 32 benign FLLs in 31 patients and 100 malignant FLLs in 96 patients,including 16 cholangiocellular carcinomas(CCCs),72 hepatocellular carcinomas(HCCs)and 12 liver metastases.Thirty-five FLLs were diagnosed as undetermined by conventional ultrasound.There were significant differences between Emax of malignant(2.21±0.57 m/s)and benign(1.59±0.37 m/s)FLLs(P=0.000),and between Emax of the periphery of malignant(1.52±0.39 m/s)and benign(1.36±0.44 m/s)FLLs(P=0.040).Emax of liver metastases(2.73±0.99 m/s)was significantly higher than that of CCCs(2.14±0.34 m/s)and HCCs(2.14±0.46 m/s)(P=0.002).The sensitivity,specificity and accuracy were 71.00%,84.38%and 74.24%respectively,using Emax>1.905 m/s(AUC 0.843)to diagnose as malignant and 23 of 35(65.74%)FLLs with undetermined diagnosis by conventional ultrasound were diagnosed correctly.CONCLUSION Malignant FLLs were stiffer than benign ones and liver metastases were stiffer than primary liver carcinomas.2D-SWE with Emax was a useful complement to conventional ultrasound for the differential diagnosis of FLLs.

Diagnostic problems in two-dimensional shear wave elastography of the liver

Two-dimensional shear wave elastography(2D-SWE)is used in the clinical setting for observation of the liver.Unfortunately,a wide spectrum of artifactual images are frequently encountered in 2D-SWE,the precise mechanisms of which remain incompletely understood.This review was designed to present many of the artifactual images seen in 2D-SWE of the liver and to analyze them by computer simulation models that support clinical observations.Our computer simulations yielded the following suggestions:(1)When performing 2D-SWE in patients with chronic hepatic disease,especially liver cirrhosis,it is recommended to measure shear wave values through the least irregular hepatic surface;(2)The most useful 2D-SWE in patients with focal lesion will detect lesions that are poorly visible on B-mode ultrasound and will differentiate true tumors from pseudo-tumors(e.g.,irregular fatty change);and(3)Measurement of shear wave values in the area posterior to a focal lesion must be avoided.

Model for liver hardness using two-dimensional shear wave elastography,durometer,and preoperative biomarkers

BACKGROUND Post-hepatectomy liver failure(PHLF)increases morbidity and mortality after liver resection for patients with advanced liver fibrosis and cirrhosis.Preoperative liver stiffness using two-dimensional shear wave elastography(2D-SWE)is widely used to evaluate the degree of fibrosis.However,the 2D-SWE results were not accurate.A durometer measures hardness by quantifying the ability of a material to locally resist the intrusion of hard objects into its surface.However,the durometer score can only be obtained during surgery.To measure correlations among 2D-SWE,palpation by surgeons,and durometermeasured objective liver hardness and to construct a liver hardness regression model.METHODS We enrolled 74 hepatectomy patients with liver hardness in a derivation cohort.Tactile-based liver hardness scores(0-100)were determined through palpation of the liver tissue by surgeons.Additionally,liver hardness was measured using a durometer.Correlation coefficients for durometer-measured hardness and preoperative parameters were calculated.Multiple linear regression models were constructed to select the best predictive durometer scale.Receiver operating characteristic(ROC)curves and univariate and multivariate analyses were used to calculate the best model’s prediction of PHLF and risk factors for PHLF,respectively.A separate validation cohort(n=162)was used to evaluate the model.RESULTS The stiffness measured using 2D-SWE and palpation scale had good linear correlation with durometer-measured hardness(Pearson rank correlation coefficient 0.704 and 0.729,respectively,P<0.001).The best model for the durometer scale(hardness scale model)was based on stiffness,hepatitis B virus surface antigen,and albumin level and had an R2 value of 0.580.The area under the ROC for the durometer and hardness scale for PHLF prediction were 0.807(P=0.002)and 0.785(P=0.005),respectively.The optimal cutoff value of the durometer and hardness scale was 27.38(sensitivity=0.900,specificity=0.660)and 27.87(sensitivity=0.700,specificity=0.787),respectively.Patients with a hardness scale score of>27.87 were at a significantly higher risk of PHLF with hazard ratios of 7.835(P=0.015).The model’s PHLF predictive ability was confirmed in the validation cohort.CONCLUSION Liver stiffness assessed by 2D-SWE and palpation correlated well with durometer hardness values.The multiple linear regression model predicted durometer hardness values and PHLF.

Comparison of point and two-dimensional shear wave elastography of the spleen in healthy subjects

BACKGROUND Few systematic comparative studies of the different methods of physical elastography of the spleen are currently available.AIM To compare point shear wave and two-dimensional elastography of the spleen considering the anatomical location(upper,hilar,and lower pole).METHODS As part of a prospective clinical study,healthy volunteers were examined for splenic elasticity using four different ultrasound devices between May 2015 and April 2017.The devices used for point shear wave elastography were from Siemens(S 3000)and Philips(Epiq 7),and those used for two-dimensional shear wave elastography were from GE(Logiq E9)and Toshiba(Aplio 500).In addition,two different software versions(5.0 and 6.0)were evaluated for the Toshiba ultrasound device(Aplio 500).The study consisted of three arms:A,B,and C.RESULTS In study arm A,200 subjects were evaluated(78 males and 122 females,mean age 27.9±8.1 years).In study arm B,113 subjects were evaluated(38 men and 75 women,mean age 26.0±6.3 years).In study arm C,44 subjects were enrolled.A significant correlation of the shear wave velocities at the upper third of the spleen(r=0.33088,P<0.0001)was demonstrated only for the Philips Epiq 7 device compared to the Siemens Acuson S 3000.In comparisons of the other ultrasound devices(GE,Siemens,Toshiba),no comparable results could be obtained for any anatomical position of the spleen.The influencing factors age,gender,and body mass index did not show a clear correlation with the measured shear wave velocities.CONCLUSION The absolute values of the shear wave elastography measurements of the spleen and the two different elastography methods are not comparable between different manufacturers or models.

AN EXPLORATION TO THE MODELLING OF TWO-DIMENSIONAL COMPLEX TURBULENT SHEAR FLOWS

The regions with shear stress and mean velocity gradient of opposite sign often exist in complex turbulent shear flows.In these cases,the eddy viscosity hypothesis breaks down.Hinze regards the,departure from eddy viscosity hypothesis as a result from transportation of mean momentum over distance by the large structures and arrives at a shear stress expression including the second order derivatives of the mean velocity.However,his expression greatly overestimates the shear stress.This implies that the flow particles are unlikely to have enough memory of the mean momentum over distance.By assuming the departure from eddy viscosity hypothesis as a result from transportation of the shear stress contained in smaller eddies over distance by the large structures,the present author has arrived at a new shear stress expression.The shear stress estimated so far is in good agreement with the experiments.

Assessment of Calf Skeletal Muscle Stiffness in Diabetic Nephropathy Patients with Medial Tibial Stress Syndrome by Two-Dimensional Shear Wave Elastography

Objective:To explore the feasibility of two-dimensional shear wave elastography in evaluating calf skeletal muscle stiffness in diabetic nephropathy patients with medial tibial stress syndrome.Methods:A total of 48 diabetic nephropathy patients with medial tibial stress syndrome from January 2020 to December 2022 were included as the study group,and 48 patients with diabetic nephropathy during the same period were included as the control group.Both groups were detected by two-dimensional shear wave elastography with ultrasonic equipment,and Young‘s modulus of the tibialis anterior muscle,tibialis posterior muscle,and gastrocnemius muscle were observed and analyzed in the two groups.Results:The Young‘s modulus values of tibialis anterior muscle,tibialis posterior muscle,and gastrocnemius muscle in the study group were significantly lower than those in the control group(P<0.05).Conclusion:Two-dimensional shear wave elastography is feasible for the evaluation of calf skeletal muscle stiffness in diabetic nephropathy patients with medial tibial stress syndrome,and has high accuracy and repeatability.This technique can be used to diagnose,treat and monitor muscle lesions in patients with diabetic nephropathy,and can also be used to assess muscle fatigue and exercise capacity,which has broad application prospects.

Application of multi-channel two-dimensional transient Rayleigh wave exploration in goaf detection

The transient Rayleigh wave exploration has high detection accuracy in shallow exploration. The effect of detection array is comprehensive reflection of the velocity of rock and soil mass. Therefore, the roiling multi-channel transient acquisition system has been adopted in this study, which turns one dimensional transient Rayleigh wave exploration into two dimensions, consequently, the two-dimensional velocity distribution of rock and soil mass under the survey line has been achieved. Through comparing with the shallow seismic reflected wave exploration, the result indicates that the rolling multi-channel transient acquisition system has accurate resolution. Thus, in the process of the shallow reflected wave exploration, if the surface wave has developed, the coalition between the reflected wave exploration and the two-dimensional transient Rayleigh wave exploration should actualize the accuracy of exploration.

Diagnostic value of two dimensional shear wave elastography combined with texture analysis in early liver fibrosis

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.

Non-invasive assessment of liver fibrosis using twodimensional shear wave elastography in patients with autoimmune liver diseases

AIM To determine the diagnostic accuracy of two-dimensional shear wave elastography(2D-SWE) for the noninvasive assessment of liver fibrosis in patients with autoimmune liver diseases(AILD) using liver biopsy as the reference standard.METHODS Patients with AILD who underwent liver biopsy and 2D-SWE were consecutively enrolled. Receiver operating characteristic(ROC) curves were constructed to assess the overall accuracy and to identify optimal cut-off values.RESULTS The characteristics of the diagnostic performance were determined for 114 patients with AILD. The areas under the ROC curves for significant fibrosis, severe fibrosis, and cirrhosis were 0.85, 0.85, and 0.86, respectively, and the optimal cut-off values associated with significant fibrosis(≥ F2), severe fibrosis(≥ F3), and cirrhosis(F4) were 9.7 k Pa, 13.2 k Pa and 16.3 k Pa, respectively. 2D-SWE showed sensitivity values of 81.7% for significant fibrosis, 83.0% for severe fibrosis,and 87.0% for cirrhosis, and the respective specificity values were 81.3%, 74.6%, and 80.2%. The overall concordance rate of the liver stiffness measurements obtained using 2D-SWE vs fibrosis stages was 53.5%.CONCLUSION2D-SWE showed promising diagnostic performance for assessing liver fibrosis stages and exhibited high cut-off values in patients with AILD. Low overall concordance rate was observed in the liver stiffness measurements obtained using 2D-SWE vs fibrosis stages.

The Effect of Near-Wall Vortices on Wall Shear Stress in Turbulent Boundary Layers

The objective of the present study is to explore the relation between the near-wall vortices and the shear stress on the wall in two-dimensional channel flows. A direct numerical simulation of an incompressible two-dimensional turbulent channel flow is performed with spectral method and the results are used to examine the relation between wall shear stress and near-wall vortices. The two-point correlation results indicate that the wall shear stress is associated with the vortices near the wall and the maximum correlation-value location of the near-wall vortices is obtained. The analysis of the instantaneous diagrams of fluctuation velocity vectors provides a further expression for the above conclusions. The results of this research provide a useful supplement for the control of turbulent boundary layers.

西安市一次雷暴过程的闪电活动特征

利用陕西省闪电定位数据、多普勒天气雷达资料及逐小时降水资料,分析2018年8月9日西安市一次雷暴过程中闪电与降水、雷达回波和气流切变的关系特征,并进行特征对比分析。结果表明:15:00左右初始闪电发生后,闪电频次逐渐增加,17:54达到最大峰值后,闪电频次逐渐减少。整个雷暴过程中,正地闪占比较高,为23.8%;闪电频次出现了2次明显峰值,最大闪电频次为124次/6min,出现时段为17:48-17:54。闪电主要集中在强降水发生区域和时段,且先有闪电活动后有降水发生,正地闪活动与降水有密切关系。60 dBZ以上反射率面积与闪电频次随时间变化趋势一致,65 dBZ强反射率的出现和消失伴随着闪电频次的增加和减少。闪电频次与50 dBZ和40 dBZ的反射率等值线变化有较好的对应关系。正、负地闪在不同反射率范围集中程度不同,正地闪主要活动在强回波区前部和后部,且主要发生在雷暴云发展成熟后,负地闪则集中在强回波区中部和后部。地闪发生区域与上升气流和风切变区域有密切关系,但并不完全发生在上升气流区,负地闪在上升气流和下沉气流区的占比,对对流系统发展阶段有一定指示作用。经过特征对比分析,3次雷暴过程中降水量与正地闪的相关性、闪电与雷达反射率的关系均与西安市雷暴过程有相似特征。

1.55μm激光雷达高原机场下击暴流探测应用研究

为了探究激光雷达在湿下击暴流天气时的风场探测效果和低空风切变识别能力,采用多元资料结合具体事件进行理论分析和数据验证的方法,利用西宁曹家堡国际机场的测风激光雷达数据,结合地面观测记录,对2021-05-18的一次湿下击暴流过程进行了分析和研究。结果表明,下击暴流具有复杂的风场结构,主体到达机场前,首先造成了超过14 m/s的外流,并与环境风耦合形成逆风切变辐合线,且最强外流区位于辐合线后侧1 km~2 km;下击暴流抵达跑道上空时,造成了地面辐散风场,辐散中心风速远小于外流边缘且垂直气流存在着剧烈变化,下击暴流共持续约10 min;测风激光雷达对雷暴云内部垂直气流分布、跑道区域下击暴流辐散风场的水平和垂直结构以及地面风场辐合线的形成和演变均有良好的识别效果,交互使用雷达不同探测模式和数据产品有利于机场低空风切变的监测和预警。该研究为激光雷达在下击暴流风切变预报和研究中的应用提供了参考。

流固耦合作用下人体上呼吸道内气流运动特性数值仿真研究

分析人体上呼吸道内流固耦合现象,深入认识上呼吸道内气流运动特性,对于研究气溶胶在人体上呼吸道内的扩散、转捩及沉积模式具有重要作用。运用流固耦合力学数值仿真方法,在呼吸流量为30 L/min的状态下,对人体上呼吸道内稳态气流运动特性进行数值模拟,系统分析流固耦合作用下上呼吸道壁面的形变特点、壁面剪切应力分布以及呼吸道内的气流运动特点。结果表明:在低强度稳态呼吸模式下,人体上呼吸道整体向后运动,三级支气管位移最大为4.99 mm,气管前壁面受到拉伸,后壁面受到压缩;口喉模型中受到的壁面剪应力较大,最大处可达30.34 Pa,气管支气管受到的壁面剪切应力较小;气流速度在声门处达到最大值7.85 m/s,在咽部外壁、气管外壁发生分离现象,气流在气管内壁形成局部高速区,支气管内气流在分叉处分离,靠近支气管内壁速度较高。

过山气流低空风切变对野战火箭弹弹道特性影响分析

针对过山气流低空风切变的流动特点,基于位势流动理论,在地面坐标系上建立考虑地面摩擦及背风旋涡的过山气流三维风场分布模型。结合六自由度刚体弹道模型,以某122 mm尾翼火箭弹为例,仿真分析了野战火箭弹在主动段受过山气流风切变影响的弹道特性变化。结果表明,过山气流低空风切变对野战火箭弹的飞行时间、射程、侧偏,落速及角运动均产生较大影响,其中对弹箭横向运动的影响较为显著;风场强度与野战火箭弹受风场的影响程度正相关;野战火箭弹在迎风坡与背风坡发射时,弹道特性的变化规律相反,且背风坡处发射时弹道特性的变化更明显;中低射角范围内,增大野战火箭弹的射角能够降低过山气流低空风切变对射程的影响,但侧偏所受的影响会相应增大。

低空风切变对飞行的影响及应对措施

给出了低空风切变的定义,分析了风切变对航空器飞行影响的原理与原因,说明了在顺风切变、逆风切变、侧风切变和垂直风切变等各种低空风切变对飞机起飞与着陆阶段的影响,最后给出了对低空风切变的应对措施。

射流在不可压气流中破碎过程高精度数值仿真

研究液体射流在不可压气流中破碎过程的难点在于捕捉射流柱表面细节特征。采用基于Gerris开源代码的树形自适应加密算法和VOF方法对射流袋式破碎和剪切破碎的典型算例数值计算,实现了射流柱从变形、弯曲到破碎成液滴的全过程可视化,清晰的捕捉到了射流柱表面形成的表面波,计算得到的射流轨迹、破碎长度和液滴空间分布均与文献中实验结果很好的吻合。直观表明表面波导致射流柱不稳定,射流袋式破碎液滴较大,剪切破碎液滴平均直径约为60μm,基于Gerris的高精度数值算法有助于进一步认识射流破碎机理和高效评估破碎效果。

Assessment of diaphragmatic function by ultrasonography:Current approach and perspectives

This article reports the various methods used to assess diaphragmatic function by ultrasonography.The excursions of the two hemidiaphragms can be measured using two-dimensional or M-mode ultrasonography,during respiratory maneuvers such as quiet breathing,voluntary sniffing and deep inspiration.On the zone of apposition to the rib cage for both hemidiaphragms,it is possible to measure the thickness on expiration and during deep breathing to assess the percentage of thickening during inspiration.These two approaches make it possible to assess the quality of the diaphragmatic function and the diagnosis of diaphragmatic paralysis or dysfunction.These methods are particularly useful in circumstances where there is a high risk of phrenic nerve injury or in diseases affecting the contractility or the motion of the diaphragm such as neuro-muscular diseases.Recent methods such as speckle tracking imaging and ultrasound shear wave elastography should provide more detailed information for better assessment of diaphragmatic function.

Limit equilibrium method for slope stability based on assumed stress on slip surface

In the limit equilibrium framework, two- and three-dimensional slope stabilities can be solved according to the overall force and moment equilibrium conditions of a sliding body. In this work, based on Mohr-Coulomb(M-C) strength criterion and the initial normal stress without considering the inter-slice(or inter-column) forces, the normal and shear stresses on the slip surface are assumed using some dimensionless variables, and these variables have the same numbers with the force and moment equilibrium equations of a sliding body to establish easily the linear equation groups for solving them. After these variables are determined, the normal stresses, shear stresses, and slope safety factor are also obtained using the stresses assumptions and M-C strength criterion. In the case of a three-dimensional slope stability analysis, three calculation methods, namely, a non-strict method, quasi-strict method, and strict method, can be obtained by satisfying different force and moment equilibrium conditions. Results of the comparison in the classic two- and three-dimensional slope examples show that the slope safety factors calculated using the current method and the other limit equilibrium methods are approximately equal to each other, indicating the feasibility of the current method; further, the following conclusions are obtained: 1) The current method better amends the initial normal and shear stresses acting on the slip surface, and has the identical results with using simplified Bishop method, Spencer method, and Morgenstern-Price(M-P) method; however, the stress curve of the current method is smoother than that obtained using the three abovementioned methods. 2) The current method is suitable for analyzing the two- and three-dimensional slope stability. 3) In the three-dimensional asymmetric sliding body, the non-strict method yields safer solutions, and the results of the quasi-strict method are relatively reasonable and close to those of the strict method, indicating that the quasi-strict method can be used to obtain a reliable slope safety factor.

基于混合长度理论的巷道风速场规律研究

为研究巷道断面风流风速分布规律,准确测定风速大小,根据普朗特混合长度理论建立的粘性应力与速度梯度关系与湍流运动基本方程式相结合,运用量纲分析法,分析平均风速与巷道断面任一点风速的关系,并在实验巷道和井下进行现场实测,得出巷道风流风速分布规律。结果表明,巷道断面任一点风速与平均风速比和实测点位置存在一种线性关系。针对煤矿井下巷道断面风速分布进行研究可以为准确计算巷道风量及平均风速提供参考,并为风速传感器布置提出指导意见。

剪切气流中无黏液体横向射流破碎机理

航空发动机燃烧室中,液体燃料的雾化过程、特别是初始雾化过程非常复杂,至今无法建立准确的初始雾化模型。忽略液体射流黏性,采用线性不稳定性分析法对无黏液体(工质为水)在二维剪切横向气流中的破碎机理进行研究。通过建立射流的色散方程,根据其表面波的增长率及波数的发展情况对射流破碎进行预测。当气体韦伯数或液体韦伯数增大时,射流表面波增长率显著增加,最佳波长明显减小。液气动量比大于临界值时,Kelvin-Helmholtz(K-H)不稳定性占主导作用;反之,Rayleigh-Taylor(R-T)不稳定性占主导作用。二维剪切气流在射流方向上具有速度梯度,只改变横向气动力对射流表面波的作用。气体韦伯数与液体韦伯数对射流破碎的作用与均匀气流相似;保持气流流量相同时,负梯度剪切气流可以加速射流的破碎。