PURPOSE OF THE STUDY Decision-making in treatment of an acute compartment syndrome is based on clinical assessment, supported by invasive monitoring. Thus, evolving compartment syndrome may require repeated pressure measurements. In suspected cases of potential compartment syndromes clinical assessment alone seems to be unreliable. The objective of this study was to investigate the feasibility of a non-invasive application estimating whole compartmental elasticity by ultrasound, which may improve accuracy of diagnostics. MATERIAL AND METHODS In an in-vitro model, using an artificial container simulating dimensions of the human anterior tibial compartment, intracompartmental pressures (p) were raised subsequently up to 80 mm Hg by infusion of saline solution. The compartmental depth (mm) in the cross-section view was measured before and after manual probe compression (100 mm Hg) upon the surface resulting in a linear compartmental displacement (Δd). This was repeated at rising compartmental pressures. The resulting displacements were related to the corresponding intra-compartmental pressures simulated in our model. A hypothesized relationship between pressures related compartmental displacement and the elasticity at elevated compartment pressures was investigated. RESULTS With rising compartmental pressures, a non-linear, reciprocal proportional relation between the displacement (mm) and the intra-compartmental pressure (mm Hg) occurred. The Pearson's coefficient showed a high correlation (r2 = -0.960). The intraobserver reliability value kappa resulted in a statistically high reliability (κ = 0.840). The inter-observer value indicated a fair reliability (κ = 0.640). CONCLUSIONS Our model reveals that a strong correlation between compartmental strain displacements assessed by ultrasound and the intra-compartmental pressure changes occurs. Further studies are required to prove whether this assessment is transferable to human muscle tissue. Determining the complete compartmental elasticity by ultrasound enhancement, this application may improve detection of early signs of potential compartment syndrome. Key words: compartment syndrome, intra-compartmental pressure, non-invasive diagnostic, elasticity measurement, elastography.

• MeSH
• Models, Biological * MeSH
• Elasticity Imaging Techniques methods   MeSH
• Humans MeSH
• Elasticity MeSH
• Reproducibility of Results MeSH
• ROC Curve MeSH
• Anterior Compartment Syndrome physiopathology   ultrasonography   MeSH
• Pressure MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH

Úvod a ciele: Zistilo sa, že obehové časy pečene merané pomocou kontrastnej ultrasonografie a elasticita pečene dokázali predpovedať klinicky signifikantnú portálnu hypertenziu. Nie je však zatiaľ dostatočne preskúmané, či by obehové časy pečene dokázali predpovedať nepriaznivý priebeh aj u pacientov s klinicky diagnostikovanou cirhózou, ktorí vo väčšine prípadov majú klinicky signifikantnú portálnu hypertenziu. Cieľom našej štúdie bolo zhodnotiť význam obehových časov a elasticity pečene v predikcii nepriaznivého priebehu cirhózy a porovnať ich s MELD (model for end-stage liver disease). Metódy: Sledovaná skupina zahŕňala 48 po sebe idúcich ambulantných pacientov s cirhózou v 2.–4. štádiu podľa D´Amica. Pacienti v štádiu 4. mohli mať len ikterus, pacienti s ostatnými komplikáciami portálnej hypertenzie neboli zahrnutí. Meranie obehových časov bolo vykonané počas kontrolného ultrasonografie. Obehové časy boli merané od intravenóznej aplikácie kontrastnej látky (SonoVue) a jej príchodu do hepatálnej žily (venózny čas/hepatic vein arrival time – HVAT) alebo časového rozdielu medzi kontrastným signálom vo vetve a. hepatica a hepatálnej žily (obeh pečene/hepatic transit time – HTT) v sekundách. Elasticita pečene bola meraná pomocou tranzientnej elastografie (Fibroscan). Obehové časy a elasticita boli merané pri vstupe do sledovania. Pacienti boli následne sledovaní počas 1 roka. Nepriaznivý priebeh cirhózy bol definovaný ako objavenie sa klinicky zjavného ascitu alebo hospitalizácie pre chorobu pečene alebo úmrtia. Výsledky: Priemerný vek bol 61 rokov, pomer ženy/muži bol 23/25. Pri vstupe do štúdie bol medián Childova-Pughova skóre 5 (IQR 5,0–6,0), MELD 9,5 (IQR 7,6–12,1), medián HVAT bol 22 s (IQR 19–25) a HTT 6 (IQR 5–9). HTT aj HVAT negatívne korelovali s Childovom-Pughovom skóre (-0,351, resp. -0,441; p = 0,002) a MELD (-0,479, resp. -0,388; p = 0,006) skóre. Po dobu jedného roka bol nepriaznivý priebeh zaznamenaný v 11 prípadoch (22,9 %), vrátane 6 úmrtí a 5 hospitalizácií. Medián HVAT bol v prípadoch s nepriaznivým priebehom 20 s (IQR 19,3–23,5) porovnaní s 22 s (IQR 19 do 26, p = 0,32). Prípady s nepriaznivým priebehom mali signifikantne vyššie MELD (12,9 vs 8,5), Childovo-Pughovo skóre (7,0 vs 5,0) a elasticitu pečene (52,5 vs 21,05 kPa) (p <0,05). AUROC pre HVAT, elasticitu pečene a MELD v predikcii nepriaznivého priebehu bol 0,60 (95% CI 0,414–0,785), 0,767 (0,56–0,98) a 0,813 (0,66–0,97). Čas HVAT nebol schopný predpovedať nepriaznivý klinický výsledok, ale elasticita pečene > 35,3 kPa zvýšila toto riziko 10,3-násobne a MELD > 11 bodov 8,5-násobne. Záver: U pacientov s klinicky diagnostikovanou cirhózou s prítomnou klinicky signifikantnou portálnou hypertenziou obehové časy pečene nepreukázali schopnosť predpovedať nepriaznivý priebeh do jedného roka. Naopak, meranie elasticity pečene sa ukázalo ako klinicky prospešné s prognostickou hodnotou porovnateľnou s MELD. Kľúčové slová: elasticita pečene – klinicky diagnostikovaná cirhóza – MELD – obehové časy pečene – portálna hypertenzia

Introduction and objectives: Hepatic transit times measured by the contrast enhanced ultrasonography and liver elasticity were found to predict a clinically significant portal hypertension. However, these modalities we not yet sufficiently evaluated in predicting adverse clinical outcome in patients with clinically diagnosed cirrhosis (D´Amico stages > 1), having a clinically significant portal hypertension. The aim of our study was to assess the predictive power of the liver transit times and the liver elasticity on an adverse clinical outcome of clinically diagnosed cirrhosis compared with the MELD score. Methods: The study group included 48 consecutive outpatients with cirrhosis in the 2., 3. and 4. D’Amico stages. Patients with stage 4 could have jaundice, patients with other complications of portal hypertension were excluded. Transit times were measured from the time of intravenous administration of contrast agent (Sonovue) to a signal appearance in a hepatic vein (hepatic vein arrival time, HVAT) or time difference between the contrast signal in the hepatic artery and hepatic vein (hepatic transit time, HTT) in seconds. Elasticity was measured using the transient elastography (Fibroscan). The transit times and elasticity were measured at baseline and patients were followed for up for 1 year. Adverse outcome of cirrhosis was defined as the appearance of clinically apparent ascites and/or hospitalization for liver disease and/or death within 1 year. Results: The mean age was 61 years, with female/male ratio 23/25. At baseline, the median Child-Pugh score was 5 (IQR 5.0–6.0), MELD 9.5 (IQR 7.6 to 12.1), median HVAT was 22 s (IQR 19–25) and HTT 6 (IQR 5–9). HTT and HVAT negatively correlated with Child-Pugh (-0.351 and -0.441, p = 0.002) and MELD (-0.479 and -0.388, p = 0.006) scores. The adverse outcome at 1-year was observed in 11 cases (22.9 %), including 6 deaths and 5 hospitalizations. Median HVAT in those with/without the adverse outcome was 20 seconds (IQR 19.3–23.5) compared with 22 s (IQR 19–26, p = 0.32). Cases with adverse outcome had significantly higher MELD (12.9 vs 8.5), Child-Pugh score (7.0 vs 5.0) and the liver elasticity (52.5 vs 21.5 kPa) (p < 0.05). The AUROC of the HVAT, liver elasticity and MELD for the prediction of the adverse outcome was 0.60 (95% CI 0.414 to 0.785), 0.767 (0.56 to 0.98) and 0.813 (0.66 to 0.97). Unlike HVAT, the liver elasticity > 35.3 kPa increased the risk of the adverse outcome 10.3-times and MELD score > 11 points 8.5-times. Conclusion: In patients with clinically diagnosed cirrhosis having a clinically significant portal hypertension hepatic transit times do not predict the 1-year adverse clinical outcome. However, the liver elasticity > 35.3 kPa appears clinically useful with a prognostic value comparable with MELD. Key words: clinically diagnosed cirrhosis – hepatic transit times – liver elasticity – MELD – portal hypertension

• MeSH
• Elasticity Imaging Techniques * methods   MeSH
• Risk Assessment MeSH
• Data Interpretation, Statistical MeSH
• Liver Cirrhosis * physiopathology   MeSH
• Liver Circulation MeSH
• Contrast Media MeSH
• Middle Aged MeSH
• Humans MeSH
• Hypertension, Portal * physiopathology   MeSH
• Predictive Value of Tests MeSH
• Prognosis MeSH
• Blood Flow Velocity MeSH
• Aged MeSH
• Severity of Illness Index MeSH
• Ultrasonography methods   MeSH
• Hepatic Veins physiopathology   ultrasonography   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

Shear waves elastografie (SWE) je nová neinvazivní diagnostická zobrazovací metoda, která mapuje elastické vlastnosti tkání. V dnešní době se SWE v medicíně stále více rozvíjí napříč jejími obory a otevírá novou éru kvalitního ultrazvukového vyšetření proto, že zvyšuje jeho specificitu a tím zlepšuje diagnostickou jistotu. Metoda je obdobou palpačního vyšetření, zobrazuje elastické vlastnosti biologických tkání a poskytuje jakousi rekonstrukci vnitřní struktury měkkých tkání na základě měření odezvy komprese tkáně. Různé biologické tkáně mají odlišnou elasticitu a změny těchto elastických vlastností jsou často odrazem patologických procesů v tkáni a jejími abnormalitami. Metoda se již na některých zahraničních pracovištích používá při detekci a diagnostice karcinomů prsní a štítné žlázy, karcinomů prostaty, v hepatologii, kardiologii, zobrazení karotických cév, lymfatického řečiště a muskuloskeletálního systému. V neposlední řadě se zkoumá její nesporný přínos v oftalmologii. Výstupem elastografie je ultrazvukový obraz B-mode překrytý barevně kódovanou mapou. Shear waves elastografie nabízí tři hlavní inovace: kvantitativní aspekt, prostorové rozlišení a zobrazení v reálném čase.

Shear wave elastography (SWE) is a new non-invasive diagnostic imaging technique, that maps the elastic properties of tissues. Nowadays this modality develops increasingly in medicine across its disciplines and opens a new era of high-quality ultrasound examination because it increases the specificity and thus improves diagnostic assurance. This method is similar to manual palpation, shows elastic properties of biological tissues and provides a kind of reconstruction of the internal structure of soft tissues based on measurement of the response of tissue compression. Various biological tissues have different elasticity and changes of these elastic properties often reflect pathological processes in the tissue and its abnormalities. This method is already used routinely on some foreign institutions in the detection and diagnosis of breast cancer and thyroid cancer, prostate cancer, in hepatology, cardiology, view the carotid arteries and lymphatic nodules. Finally examines its unquestioned benefit in ophthalmology. The output of elastography is an ultrasound image B-mode superimposed color-coded map. Shear waves elastography provides three major innovations: the quantitative aspect, the spatial resolution and the ability to run in real time.

• Keywords
• Youngův modul pružnosti, UltrafastTM zobrazení, SonicTouchTM,
• MeSH
• Diagnostic Techniques, Ophthalmological MeSH
• Elasticity Imaging Techniques * methods   trends   MeSH
• Liver Cirrhosis ultrasonography   MeSH
• Humans MeSH
• Stress, Mechanical MeSH
• Prostatic Neoplasms ultrasonography   MeSH
• Breast Neoplasms ultrasonography   MeSH
• Orbital Diseases * ultrasonography   MeSH
• Image Processing, Computer-Assisted MeSH
• Signal Processing, Computer-Assisted MeSH
• Elasticity MeSH
• Ultrasonography history   MeSH
• Ultrasonic Waves MeSH
• Image Enhancement * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

The aim of this study was to examine the influence of hormonal changes during the menstrual cycle on deep fasciae. A total of 29 women, 17 users, and 12 nonusers of hormonal contraceptives were examined clinically and by ultrasound, including shear wave elastography, at two phases of the menstrual cycle. The thickness and elasticity of the fascia lata, thoracolumbar fascia, and plantar fascia were measured, compared between hormonal contraceptive users and nonusers, and correlated with clinical data. There were statistically significant differences between users and nonusers of hormonal contraceptives: the thoracolumbar fascia was thicker in nonusers (P = 0.011), and nonusers had higher maximal and mean stiffnesses of the fascia lata (P = 0.01 and 0.0095, respectively). Generally, nonusers had a higher body mass index (BMI). The elasticity of the thoracolumbar and the plantar fasciae did not differ significantly between the groups. We found no correlation between thickness and elasticity in the fasciae. There were no statistically significant differences in hypermobility, cephalgia, or dysmenorrhea between users and nonusers of hormonal contraceptives. The results of this pilot study suggest that deep fasciae can be evaluated by shear wave elastography. Nonusers of contraceptives had greater stiffness of the fascia lata and higher BMI. Clin. Anat. 32:941-947, 2019. © 2019 Wiley Periodicals, Inc.

• MeSH
• Adult MeSH
• Elasticity Imaging Techniques MeSH
• Fascia Lata anatomy & histology   drug effects   MeSH
• Contraceptives, Oral, Hormonal administration & dosage   pharmacology   MeSH
• Humans MeSH
• Menstrual Cycle physiology   MeSH
• Young Adult MeSH
• Prospective Studies MeSH
• Elasticity drug effects   MeSH
• Case-Control Studies MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

• MeSH
• Elasticity Imaging Techniques methods   instrumentation   utilization   MeSH
• Skin Physiological Phenomena MeSH
• Humans MeSH
• Suction methods   instrumentation   utilization   MeSH
• Elasticity MeSH
• Statistics as Topic methods   MeSH
• Models, Theoretical MeSH
• Viscosity MeSH
• Check Tag
• Humans MeSH

AIM: To compare the elasticity of the sternocleidomastoid and trapezius muscles in patients with cervicogenic headache and in healthy volunteers. METHODS: The medical history of 23 patients with cervicogenic headache was taken with a focus on pain characteristics. Elasticity of the sternocleidomastoid and trapezius muscles was measured by using shear wave elastography. Results were then compared with 23 healthy volunteers. RESULTS: The sternocleidomastoid muscle was significantly stiffer in patients with cervicogenic headache compared to healthy volunteers. The stiffness increased gradually from the parasternal area, where it was negligible, to the area near the mastoid process where it reached over 20 kPa. There was no difference in the stiffness of the trapezius muscle. The stiffness of the sternocleidomastoid muscle does show a significant dependence on headache characteristics (e.g., laterality, severity, or frequency). CONCLUSION: The results of this pilot study show that patients with cervicogenic headache have a higher stiffness of the sternocleidomastoid muscle than healthy volunteers. These findings suggest that elastography could be used as a diagnostic tool in cervicogenic headache.

• MeSH
• Elasticity Imaging Techniques * methods   MeSH
• Neck Muscles diagnostic imaging   physiology   MeSH
• Humans MeSH
• Pilot Projects MeSH
• Post-Traumatic Headache * diagnostic imaging   MeSH
• Elasticity MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH

INTRODUCTION AND HYPOTHESIS: Quantitative characterization of the birth canal and critical structures before delivery may provide risk assessment for maternal birth injury. The objective of this study was to explore imaging capability of an antepartum tactile imaging (ATI) probe. METHODS: Twenty randomly selected women older than 21 years with completed 35th week of pregnancy and a premise of vaginal delivery were enrolled in the feasibility study. The biomechanical data were acquired using the ATI probe with a double-curved surface, shaped according to the fetal skull and equipped with 168 tactile sensors and an electromagnetic motion tracking sensor. Software package COMSOL Multiphysics was used for finite element modeling. Subjects were asked for assessment of pain and comfort levels experienced during the ATI examination. RESULTS: All 20 nulliparous women were successfully examined with the ATI. Mean age was 27.8 ± 4.1 years, BMI 30.7 ± 5.8, and week of pregnancy 38.8 ± 1.4. Biomechanical mapping with the ATI allowed real-time observation of the probe location, applied load to the vaginal walls, and a 3D tactile image composition. The nonlinear finite element model describing the stress-strain relationship of the pelvic tissue was developed and used for calculation of Young's modulus (E). Average perineal elastic modulus was 11.1 ± 4.3 kPa, levator ani 4.8 ± 2.4 kPa, and symphysis-perineum distance was 30.1 ± 6.9 mm. The pain assessment level for the ATI examination was 2.1 ± 0.8 (scale 1-4); the comfort level was 2.05 ± 0.69 (scale 1-3). CONCLUSIONS: The antepartum examination with the ATI probe allowed measurement of the tissue elasticity and anatomical distances. The pain level was low and the comfort level was comparable with manual palpation.

• MeSH
• Adult MeSH
• Elasticity Imaging Techniques * MeSH
• Humans MeSH
• Young Adult MeSH
• Pelvic Floor * diagnostic imaging   MeSH
• Perineum diagnostic imaging   MeSH
• Parturition MeSH
• Feasibility Studies MeSH
• Pregnancy MeSH
• Imaging, Three-Dimensional MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

INTRODUCTION: A previous study has employed shear-wave ultrasound elastographic imaging to assess corneal rigidity in an ex-vivo porcine eye model. This study employs the same modality in vivo in a rabbit eye model in order to assess lens, ciliary body and total ocular rigidity changes following the instillation of atropine and pilocarpine. METHODS: Ten non-pigmented female rabbits were examined. Measurements of the lens, ciliary body and total ocular rigidity as well as lens thickness and anterior chamber depth were taken with the Aixplorer system (SuperSonic Imagine, Aix-en-Provence, France) with the SuperLinear™ SL 15-4 transducer in both eyes at baseline as well as after pilocarpine and atropine instillation. The IOP was also measured with the TonoPen tonometer. RESULTS: Changes in rigidity in the examined areas following atropine instillation were statistically not significant. Ciliary body rigidity was significantly increased whereas lens and total ocular rigidity were significantly reduced following pilocarpine instillation. The decrease in lens rigidity following pilocarpine was significantly associated with the respective increase in ciliary body rigidity. CONCLUSIONS: Shear-wave ultrasound elastography can detect in vivo rigidity changes in the anterior segment of the rabbit eye model and may potentially be applied in human eyes, providing useful clinical information on conditions in which rigidity changes play an important role, such as glaucoma, pseudoexfoliation syndrome or presbyopia.

• MeSH
• Atropine pharmacology   MeSH
• Ciliary Body drug effects   physiopathology   ultrasonography   MeSH
• Elasticity Imaging Techniques * MeSH
• Rabbits MeSH
• Miotics pharmacology   MeSH
• Mydriatics pharmacology   MeSH
• Lens, Crystalline drug effects   physiopathology   ultrasonography   MeSH
• Pilocarpine pharmacology   MeSH
• Elasticity drug effects   physiology   MeSH
• Animals MeSH
• Check Tag
• Rabbits MeSH
• Female MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH

Ultrazvuková elastografie (sonoelastografie, USE) je relativně nová, rychle se rozvíjející metoda zobrazování, která měří elasticitu tkání. Její vývoj započal v devadesátých letech 20. století a urychlil se poté, co se na trhu objevily přístroje zobrazující elasticitu v reálném čase a dále s nástupem elastografie střihové vlny (shear wave elastografie, SWE), která umožňuje kvantitativní měření tuhosti. První výsledky ukazují, že sonoelastografie v kombinaci se standardním ultrazvukovým vyšetřením dosahuje u onemocnění některých tkání přesnějších výsledků než ultrazvuk samotný. V zobrazování tkání hlavy a krku bylo zatím publikováno jen několik málo, většinou pilotních, studií s SWE. Tento přehledový článek shrnuje základní informace o sonoelastografii a jejím dosavadním využití v otorinolaryngologii. Klíčová slova: elastografie – lymfatické uzliny – slinné žlázy, štítná žláza – ultrazvuk

Ultrasound elastography (sonoelastography, USE) is a relatively new, rapidly evolving area of imaging that measures elasticity of tissues. Its development started in the last decade of the 20th century and was accelerated after devices allowing real-time imaging and quantification (shear wave elastography, SWE) became broadly available for clinical practise. First results suggest that combination of sonoelastography and conventional ultrasound gives more precise results than ultrasound alone in certain areas. In head and neck imaging, just a few mostly pilot studies have been published till January 2014. This article summarizes available information about sonoelastography and current view on USE imaging in otorhinolaryngology. Keywords: elastography – lymph nodes – salivary glands – shear wave – ultrasound

• Keywords
• elastografie střižné vlny, shear wave elastografie,
• MeSH
• Elasticity Imaging Techniques * methods   MeSH
• Humans MeSH
• Lymph Nodes ultrasonography   MeSH
• Head and Neck Neoplasms * ultrasonography   MeSH
• Salivary Gland Neoplasms ultrasonography   MeSH
• Thyroid Neoplasms ultrasonography   MeSH
• Thyroid Nodule ultrasonography   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

• Keywords
• Youngův modul pružnosti, UltrafastTM zobrazení, SonicTouchTM,
• MeSH
• Diagnostic Techniques, Ophthalmological MeSH
• Elasticity Imaging Techniques * methods   trends   MeSH
• Liver Cirrhosis ultrasonography   MeSH
• Humans MeSH
• Stress, Mechanical MeSH
• Prostatic Neoplasms ultrasonography   MeSH
• Breast Neoplasms ultrasonography   MeSH
• Orbital Diseases * ultrasonography   MeSH
• Image Processing, Computer-Assisted MeSH
• Signal Processing, Computer-Assisted MeSH
• Elasticity MeSH
• Ultrasonography history   MeSH
• Ultrasonic Waves MeSH
• Image Enhancement * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH