LIVER VISCOSITY and US Elastography

 

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FURTHER READINGS:

Review of Clinical Examination in Identifying Dislocated Hip in Infant

 

CRITICAL CARE POCUS: RUSH PROTOCOL

 

LEMP Score

 

LEMPS - Liver Elastography Malignancy Prediction Score

Due to copyright issues we are not in position to present detailed science behind LEMPS, so we are presenting an abstract of the original publication with the link to paper itself:

BACKGROUND&AIMS:
To analyse elastographic characteristics of focal liver lesions (FLL)s and diagnostic performance of real-time two-dimensional shear-wave elastography (RT-2D-SWE) in order to differentiate benign and malignant FLLs.
METHODS:
Consecutive patients diagnosed with FLL by abdominal ultrasound (US) underwent RT-2D-SWE of FLL and non-infiltrated liver by intercostal approach over the right liver lobe. The nature of FLL was determined by diagnostic work-up, including at least one contrast-enhanced imaging modality (MDCT/MRI), check-up of target organs when metastatic disease was suspected and FLL biopsy in inconclusive cases.
RESULTS:
We analysed 196 patients (median age 60 [range 50-68], 50.5% males) with 259 FLLs (57 hepatocellular carcinomas, 17 cholangiocarcinomas, 94 metastases, 71 haemangiomas, 20 focal nodular hyperplasia) of which 70 (27%) were in cirrhotic liver. Malignant lesions were stiffer (P < .001) with higher variability in intralesional stiffness (P = .001). The best performing cut-off of lesion stiffness was 22.3 kPa (sensitivity 83%; specificity 86%; positive predictive value [PPV] 91.5%; negative predictive value [NPV] 73%) for malignancy. Lesion stiffness <14 kPa had NPV of 96%, while values >32.5 kPa had PPV of 96% for malignancy. Lesion stiffness, lesion/liver stiffness ratio and lesion stiffness variability significantly predicted malignancy in stepwise logistic regression (P < .05), and were used to construct a new Liver Elastography Malignancy Prediction (LEMP) score with accuracy of 96.1% in validation cohort (online calculator available at http://bit.do/lemps).
CONCLUSION:
The comprehensive approach demonstrated in this study enables correct differentiation of benign and malignant FLL in 96% of patients by using RT-2D-SWE.


Original publication describing the methodology and accuracy of LEMPS can be found here:

Grgurević I et al. Liver Int. 2018 Jun;38(6):1055-1063.

SWE for diagnosing and grading Carpal Tunnel Syndrome

 

Abstract

Objective

To quantify the shear velocity and stiffness of the median nerve (MN) with shear wave elastography (SWE) at the carpal tunnel entrance and determine whether SWE is useful for diagnosing and staging carpal tunnel syndrome (CTS).

Materials and methods

The study included 58 patients (79 wrists) with clinical and electroneuromyographic diagnoses of CTS and 55 healthy controls (63 wrists). MN shear velocity and stiffness were measured by SWE on the axial plane in both groups. The differences between CTS patients and controls and between different grades of CTS based on electrodiagnostic tests were studied using Student’s t test and ANOVA with ROC analysis.

Results

The mean MN shear velocity and stiffness were significantly greater in CTS patients (2.5 ± 0.37 m/s and 19.4 ± 5.8 kPa) than in controls (1.91 ± 0.24 m/s and 11.1 ± 3.0 kPa) (p < 0.001) and greater in the severe CTS group (2.69 ± 0.39 m/s and 22.4 ± 7.1 kPa) than in the mild CTS group (2.37 ± 0.35 m/s and 17.3 ± 4,8 kPa). The cutoff value for the shear velocity was 2.13 m/s, with 86% and 82% sensitivity and specificity, respectively, and the cutoff value for stiffness was 13.6 kPa, with 87% and 82% sensitivity and specificity.

Conclusion

MN shear velocity and stiffness are significantly higher in CTS patients. SWE can be used to diagnose CTS and distinguish between patients with mild and severe disease.

Siêu âm cơ Hoành và thần kinh Hoành _COVID19

 

LIVER ULTRASOUND and PUSH Protocol

 

CHÚC MỪNG NĂM MỚI

TONGUE ULTRASOUND IMAGING

 

The Cyst of the Canal of Nuck

 CONCLUSION:

The cyst of the canal of Nuck in adult women is an extremely rare disease. If one is aware of its existence, it can be easily diagnosed using modern diagnostic methods and treated by adequate surgical approaches. 

A cyst of the canal of Nuck should always be considered as a possible cause in suspect inguinal and genital swellings in females.

Vaccination into Dermal Compartment by Ultrasound

 

SWE and Sciatic Nerve Stiffness

 

MRI and TVS in Uterine Adenomyosis

 

The Nerve/Tendon Ratio in Carpal Tunnel Syndrome

 

Ultrasound platform effective evaluating hepatic steatosis

Amerigo Allegretto
Nov 14, 2023


Attendees will hear about the potential for ultrasound-derived fat fraction to be an alternative tool for MRI in assessing hepatic steatosis.

Yi Dong, MD, from Fudan University in Shanghai, China, will present findings that show how ultrasound-derived fat fraction can detect hepatic steatosis using MRI-derived proton density fat fraction as the reference standard.

Several ultrasound platforms now provide quantitative measures of hepatic steatosis. One of these is ultrasound-derived fat fraction, which combines attenuation and backscatter quantification. In their study, Dong and colleagues wanted to explore the role of this platform in detecting and assessing hepatic steatosis, with MRI-derived proton density fat fraction being used as the reference standard.

They included 113 participants in their prospective study. Of these, 39 had type 2 diabetes mellitus while 76 had nonalcoholic fatty liver disease. The team reported that the median ultrasound-derived fat fraction in the patients was 9.2%.


It also found good correlation between ultrasound-derived fat fraction and MRI-derived proton density fat fraction (p = 0.764, p < 0.001).

The researchers additionally reported that ultrasound-derived fat fraction had good accuracy in diagnosing nonalcoholic fatty liver disease, with an area under the curve (AUC) of 0.865, a sensitivity of 67.1%, and a specificity of 89.2%.

Finally, the team found that the inter- and intraobserver agreement of ultrasound-derived fat fraction were excellent and 0.948 and 0.904-0.969, respectively (p < 0.001 for both).

See what else the team had to say about this ultrasonic method in this session.

Ultrasound Elastography-free download