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Factors other than fibrosis that increase measured shear wave velocity

World Journal of Gastroenterology 2022年第46期28卷 6512-6521页

作者： hiroko naganuma Hideaki Ishida Department of Gastroenterology Yokote Municipal HospitalYokote 013-8602Japan Department of Gastroenterology Akita Red Cross HospitalAkita 010-1495Japan

Shear wave elastography(SWE)is now becoming an indispensable diagnostic tool in the routine examination of liver diseases.In particular,accuracy is required for shear wave propagation velocity measurement,which is directly related to diagnostic accuracy.It is generally accepted that the liver shear wave propagation velocity reflects the degree of fibrosis,but there are still few reports on other factors that increase the shear wave propagation velocity.In this study,we reviewed such factors in the literature and examined their mechanisms.Current SWE measures propagation velocity based on the assumption that the medium has a homogeneous structure,uniform density,and is purely elastic.Otherwise,the measurement is subject to error.The other(confounding)factors that we routinely experience are primarily:(1)Conditions that appear to increase the viscous component;and(2)Conditions that appear to increase tissue density.Clinically,the former includes acute hepatitis,congested liver,biliary obstruction,etc,and the latter includes diffuse infiltration of malignant cells,various storage diseases,tissue necrosis,etc.In any case,it is important to evaluate SWE in the context of the entire clinical picture.

关键词： Liver Shear wave elastography Propagation velocity Viscoelasticity Artifact Ultrasound

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One-day seminar for residents for implementing abdominal pocketsized ultrasound

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World Journal of Methodology 2021年第4期11卷 208-221页

作者： hiroko naganuma Hideaki Ishida Department of Gastroenterology Yokote Municipal HospitalYokote 0138602AkitaJapan Department of Gastroenterology Akita Red Cross HospitalAkita-City 010-1495Japan

Despite its proven high utility,integration of pocked-sized portable ultrasound(US)into internal medicine residency training remains inconsistent.For 10 years,we have held a 1-d seminar biannually,consisting of lecture(half-day)and handson training(half-day)on pocket-sized US of the abdomen and lungs.The lecture consists of training on US physics and clinical applications of pocket-sized US,followed by a lecture covering the basic anatomy of the abdomen and lungs and introducing the systemic scanning method.Given the simple structure of pocketsized US devices,understanding the basic physics is sufficient yet necessary to operate the pocket-sized US device.It is important to understand the selection of probes,adjustment of B mode gain,adjustment of color gain,and acoustic impedance.Basic comprehension may have a significant positive impact on the overall utilization of pocket-sized US devices.The easiest and most reliable way to observe the whole abdomen and lungs is a combination of transverse,sagittal,and oblique scanning,pursuing the main vascular system from the center to the periphery of the organ in the abdomen and systemic scanning of the pleura.There is usually a marked change in knowledge and attitudes among the program participants,although skill gaps remain among them.We discuss the limitations and problems to this education system as well.

关键词： Pocket-sized ultrasound Abdomen Lung Medical education Resident Ultrasound physics

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

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World Journal of Radiology 2020年第5期12卷 76-86页

作者： hiroko naganuma Hideaki Ishida Atsushi Uno Hiroshi Nagai Hidekatsu Kuroda Masahiro Ogawa Department of Gastroenterology Yokote Municipal HospitalYokote 0138602AkitaJapan Department of Gastroenterology Akita Red Cross HospitalKamikitatesaruta 0101495AkitaJapan Department of Gastroenterology Oomori Municipal HospitalYokote 0130525AkitaJapan New Generation Imaging Laboratory Tokyo 1680065Japan Division of Gastroenterology and Hepatology Iwate Medical UniversityMorioka 0200023IwateJapan Department of Gastroenterology and Hepatology Nihon University HospitalChiyoda 1018309TokyoJapan

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.

关键词： Two-dimensional shear wave elastography Ultrasound Artifacts Liver cirrhosis Liver tumor Computer simulation model

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