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Breast cancer is a significant global health issue and is a leading cause of female deaths worldwide. Ultrasonography (US) is an adjunct technique for early diagnosis of breast cancer but has low specificity. So, researchers have suggested using US elastography to distinguish between benign and malignant breast lesions, which may lead to a decrease in unnecessary biopsy rates. We aimed to assess the diagnostic performance of strain elastography and if there was an increase in the diagnostic accuracy after adding it to conventional US results in BI-RADS 4 category breast lesions. This cross-sectional study was carried out from June 2022 to June 2024 on 240 patients with 240 breast lesions that were diagnosed as BI-RADS 4 category by conventional US. All the cases were examined using conventional US and strain elastography. Out of the 240 lesions, 107 were benign (44.6%) and 133 were malignant (55.4%). There was a significant statistical difference in the mean age of patients with benign breast lesions (37.89 ± 13.42 years) than those with malignant lesions (48.83 ± 13.65 years) (p < 0.001). Lesions' imaging characteristics detected by conventional US as shape, margin, aspect ratio, vascularity, and calcification all showed significant differences between benign and malignant breast lesions (p < 0.001). The diagnostic accuracy of conventional US alone was 73.3% and increased to 95.3% after combining it with strain elastography. The strain elastography score has a cutoff value of 4 in discriminating malignant from benign lesions (AUC = 0.9). Strain elastography provides an added diagnostic value in discriminating malignant breast lesions from benign lesions. The combination of strain elastography with US BI-RADS increases the diagnostic accuracy for the detection of malignant breast lesions which will decrease the need for unnecessary biopsy.

Background Intestinal changes in inflammatory bowel disease (IBD) are frequently observed on ultrasound. Invasive diagnostic procedures are often employed to differentiate between the main types of IBD and detect complications. Ultrasound Strain Elastography (SE) is a promising non-invasive technique for detecting intestinal changes and assessing inflammatory activity in pediatric IBD. Aim of the study This research aims to evaluate the diagnostic performance of conventional ultrasound, color Doppler, and SE in assessing inflammatory bowel disease in pediatric patients, both separately and in combination as additional tools. Patients and methods Forty patients (18 females and 22 males) initially diagnosed with IBD through clinical and endoscopic biopsy, along with 20 healthy controls, underwent conventional ultrasound, color Doppler, SE, and laboratory evaluations, including CBC, ESR, CRP, Fecal calprotectin, and assessment of IBD activity using PIBDAI. Results Conventional ultrasound, color Doppler, and SE significantly contributed to detecting disease activity and intestinal changes in IBD ( p  < 0.001; 95% CI 0.79–1.100), demonstrating better sensitivity in combination compared to each method individually. The combined approach showed 100% sensitivity, 84% specificity, 78.6% precision (Positive Predictive Value), 100% Negative Predictive Value, and an overall accuracy of 92%. Conclusion The addition of Color Doppler and SE parameters to grayscale ultrasound provides diagnostic value comparable to endoscopy, histopathology, and laboratory markers in detecting inflammatory activity and intestinal changes in IBD. This combined approach can help avoid unnecessary invasive techniques for follow-up.

Abstract Objective: The aim of the present study was to investigate the diagnostic value of strain elastography (SE) of testicular tissues in infertile population. We also evaluated the correlation between SE results with semen parameters and hormone profiles of the patients. Material and methods: A total of 61 patients and 122 testes were evaluated. Patients who were evaluated in an andrology outpatient clinic with the diagnosis of infertility and referred to radiology department for investigation of reproductive organs between June 2015 and January 2016 were included. Patients were divided into two groups according to semen analyses results as normal (Group 1) and abnormal (Group 2). Hormone profiles, semen analyses, B-mode, coloured Doppler ultrasonography and sonoelastography examinations were performed for each patient. Measurements of testicular volumes, resistive indices (RI) in intraparenchymal arteries, strain, strain ratio (SR) and presence of varicocele were recorded. Results: Mean age of participants was 33.7±6.3 years. Mean testicular volumes (Group 1, 19.41±4.8 mL, and Group 2, 17.64±3.62 mL) were significantly different between groups (p=0.023). Mean SRs were also different between Groups 1 and 2 (0.12±0.08 vs. 0.22±0.18, p<0.001). Testicular volumes were directly proportional with SRs in Group 1. Strain values had inverse relationship with sperm concentration and total motile sperm counts in Group 2 (p=0.01). SRs were found to be positively correlated with RI and sperm morphology in Group 2 (p<0.05). Although FSH values showed significant difference among groups, any correlation between FSH and elastographic parameters could not be displayed. Conclusion: Strain elastography results were found to be significantly different in patients with abnormal sperm counts. This technique may provide promising results, however, further large scale studies may help to clarify the value of this imaging modality in the assessment of male infertility. Cite this article as: Küçükdurmaz F, Sarıca MA, Emre Ö, Baykara M, Kızıldağ B, Resim S. Evaluation of the diagnostic efficacy of strain elastography in infertile population with normal and abnormal semen parameters. Turk J Urol 2017; 43: 261-7

Ultrasound (US) is the first-line investigation in patients with abdominal symptoms and it has a role in the diagnosis and monitoring of inflammatory bowel diseases. Strain elastography (SE) is a US method for estimating tissue elasticity. This method is still not routinely used in clinical practice, although it is suggested by the EFSUMB Guidelines for the characterization of intestinal stenosis in Crohn’s disease. The purpose of this Pictorial Essay is to confirm the feasibility of elastography in Crohn’s disease in clinical practice by comparing elastography images with corresponding endoscopic or radiological images. At present, diagnostic accuracy of SE is reported in the literature only in connection with detection of bowel wall fibrosis in advanced cases of Crohn’s disease. However, in our opinion, SE can add useful diagnostic information to grayscale and color Doppler US by providing a more accurate characterization of the bowel wall in the various manifestations of Crohn’s disease.

The objective of this study was to evaluate the reliability of four methods of assessing vastus lateralis (VL) stiffness, and to describe the influence of structural characteristics on them. The stiffness of the dominant lower-limb’s VL was evaluated in 53 healthy participants (28.4 ± 9.1 years) with shear wave elastography (SWE), strain elastography (SE), myotonometry and tensiomyography (TMG). The SWE, SE and myotonometry were performed at 50%, and TMG was assessed at 30%, of the length from the upper pole of the patella to the greater trochanter. The thickness of the VL, adipose tissue and superficial connective tissue was also measured with ultrasound. Three repeated measurements were acquired to assess reliability, using intraclass correlation coefficients (ICC). Pearson’s correlation coefficients were calculated to determine the relationships between methodologic assessments and between structural characteristics and stiffness assessments of the VL. Myotonometry (ICC = 0.93; 95%-CI = 0.89,0.96) and TMG (ICC = 0.89; 95%-CI = 0.82,0.94) showed excellent inter-day reliability whereas with SWE (ICC = 0.62; 95%-CI = 0.41,0.77) and SE (ICC = 0.71; 95%-CI = 0.57,0.81) reliability was moderate. Significant correlations were found between myotonometry and VL thickness (r = 0.361; p = 0.008), adipose tissue thickness (r = −0.459; p = 0.001) and superficial connective tissue thickness (r = 0.340; p = 0.013). Myotonometry and TMG showed the best reliability values, although myotonometry stiffness values were influenced by the structural variables of the supra-adjacent tissue.

BackgroundPost-stroke muscle stiffness is a major challenge in the rehabilitation of stroke survivors, with no gold standard in clinical assessment. Muscle stiffness is typically evaluated by the Modified Ashworth Scale or the Tardieu Scale; however, these can have low reliability and sensitivity. Ultrasound elastography is an advanced imaging technology that can quantitatively measure the stiffness of a tissue and has been shown to have good construct validity when compared to clinically assessed muscle stiffness and functional motor recovery.ObjectiveThe purpose of this article is to systematically review the literature regarding the change in muscle stiffness as measured by ultrasound elastography in stroke survivors.MethodsScopus, PubMed, Embase, CINAHL, MEDLINE and Cochrane Library were searched for relevant studies that assessed the change in stiffness of post-stroke muscle stiffness measured by ultrasound elastography following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.ResultsIn total, 29 articles were identified, using either strain elastography and shear wave elastography to measure the stiffness of muscles in stroke survivors, most frequently in the biceps and medial gastrocnemius muscles. The stiffness was typically higher in the paretic compared to the non-paretic or healthy control. Other variations that increased the stiffness include increasing the joint angle and introducing a passive stretch or muscle activation. The paretic muscle has also been assessed pre- and post-treatment demonstrating a decrease in stiffness.ConclusionUltrasound elastography is a promising imaging technology for determining the muscle stiffness in stroke survivors with need for a standardized imaging protocol.

Prolonged computer work and smartphone use can cause stiffness of the neck and shoulder muscles, including the trapezius muscle. Hence, muscle hardness quantification is clinically beneficial. The present study aimed to examine the reliability of trapezius muscle hardness measurement using a portable muscle hardness meter and ultrasound strain elastography. Overall, 20 healthy young men participated in this study. Prior to measurement, the participant’s subjective symptoms, particularly shoulder muscle stiffness, were rated using an 11-point verbal scale. Furthermore, hardness of the right and left upper trapezius muscles was assessed. In the strain elastography assessment, muscle hardness was evaluated using strain ratio. Results showed that, in quantifying upper trapezius muscle hardness, both portable muscle hardness meter and strain elastography had an excellent intra-tester reliability (>0.9). However, the correlation coefficients between muscle hardness values assessed using a muscle hardness meter and those evaluated with strain elastography did not significantly differ, and the scores for subjective shoulder stiffness did not correspond to muscle hardness values. Therefore, the hardness of the trapezius muscle does not directly reflect the subjective shoulder stiffness. Future studies should thoroughly examine the location of the shoulder stiffness, and check whether it is accompanied by local pain or tenderness.

Elastography assesses the biomechanical and structural properties of tissues by measuring their stiffness. Despite promising results, elastography has not yet earned its place in the daily practice of musculoskeletal radiologists. The purpose of this article is to present and examine the data available to date on ultrasound elastography of the tendons through a review of the literature to provide musculoskeletal radiologists with an overview that may help them better understand and use elastography routinely. The most common techniques in ultrasound elastography are described. Then, the aspects of the physiologic and pathologic tendon are presented and discussed. One must make this technique one’s own to better apprehend its contribution to the musculoskeletal imaging field, while bearing in mind that further research will be required before admitting elastography as a reliable and validated tool able to optimize our daily clinical practice.

ObjectivesTo correlate the cross-sectional area (CSA) and elasticity of the median nerve (MN) measured at carpal tunnel inlet between healthy controls and various degrees of carpal tunnel syndrome (CTS) graded as per nerve conduction studies (NCS).Materials and methodsA total of 53 patients (with 81 wrists) presenting with clinical symptoms characteristic of CTS, having their diagnosis confirmed and severity graded by NCS, and 48 healthy controls (with 96 wrists) were included in the study. All the study participants underwent wrist ultrasound which included initial Grey-scale USG followed by strain and shear wave elastography. The CSA and elasticity (in terms of strain ratio and shear modulus) of MN were measured at the carpal tunnel inlet. Statistical analysis was performed using the Mann–Whitney U test to compare between the two groups and for subgroup analysis of cases. The diagnostic performance of each variable was evaluated using the receiver operating characteristic curves.ResultsThe mean CSA was 9.20 ± 1.64, 11.48 ± 1.05, 14.83 ± 1.19 and 19.87 ± 2.68 mm2, the mean shear modulus was 17.93 ± 2.81, 23.59 ± 2.63, 32.99 ± 4.14 and 54.26 ± 9.24 kPa and the mean strain ratio was 5.26 ± 0.68, 5.56 ± 0.70, 7.03 ± 0.47 and 8.81 ± 0.94 in control, mild, moderate and severe grades of CTS, respectively (p < 0.001).ConclusionThe combined utility of Grey-scale USG and Elastography may serve as a painless and cost-effective alternative to NCS in grading the severity of CTS.

Infertility is a significant issue affecting approximately 8–12% of couples, with 10–30% of cases attributed to azoospermia. Elastography, a novel ultrasound technique, can assess testis elasticity and provide insight into the presence or absence of sperm. To evaluate the diagnostic utility of testicular elastography in infertile men and correlate elastography parameters with semen analysis and hormonal profiles. This prospective cross-sectional study was conducted on 51 infertile men with primary infertility diagnosed with azoospermia. The study was conducted between February 2022 and March 2023 at Sulaimaia Teaching Hospital, and the patients were recruited from a private fertility clinic in Sulaimani, Kurdistan Region, Iraq. Clinical history, physical examination, testicular ultrasound elastography, and hormonal assays were performed. pTESA was also carried out, and the histological type of testicular tissue was determined. The average age of patients was 34.41 years. Testicular strain elastography (Rt) can predict pTESA with 91.4% sensitivity and 93.8% specificity. Testicular strain elastography (Lt) can predict percutaneous TESA with 82.9% sensitivity and 93.8% specificity. The mean FSH level was 14.625 mlU/ml, and the mean volume for the 51 patients was 8.307 ml. Testicular elastography offers a non-invasive, quantitative assessment of testicular parenchymal integrity and correlates well with spermatogenic function. It may serve as a valuable adjunct to conventional infertility workup, particularly in differentiating functional impairment from obstructive causes.