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MECHANISM OF ACTION:
It consists of the generation of a remote radiation force by focused
ultrasonic beams, the so-called “pushing beams,” a patented
technology called “Sonic Touch.”
Several pushing beams at increasing depths are transmitted to
generate a quasi-plane shear wave frame that propagates
throughout the whole imaging area.
After generation of this shear wave, an ultrafast echographic
imaging sequence, the Ulmtraast Imaging System, is performed to
acquire successive raw radiofrequency dots at a very high frame
rate (up to 20,000 frames per second).
Based on Young’s modulus formula, the assessment of tissue
elasticity can be derived from shear wave propagation speed.
A color-coded image is displayed, which shows softer tissue in
blue and stiffer tissue in red. Quantitative information is delivered;
elasticity index (EI) is expressed in kilo-Pascal (kPa).
Both steps of SWE are achieved using a linear US probe without
requiring any intervention (as pressure) by the operator.
ADVANTAGES:
SWE is operator-independent and more reproducible than static
elastography. First, it is quantitative.
DISADVANTAGES:
CONCLUSION:
The place of SWE in the evaluation of thyroid nodules for potential
malignancy needs to be established. Actually, this evaluation is
based upon clinical examination, conventional US characteristics,
and FNA above all.
Cut off point is taken between 3 & 4 for the malignant lesion, it
showed 86.5 % sensitivity, 89.8% specificity & 88.3% accuracy in
one study.
RHEUMATOL;OGICAL DISORDER:
SOFT TISSUE NODULES: HELPS IN DIFFERNTIATION OF
RHEUMATIC NODULES FROM TOPHI( NODULES ARE LESS
ELASTIC THAN TOPHI)
SYNOVITIS: INLAMMATORY SYNOVITIS-INTERMEDIATE
STIFFNESS
INFECTIOUS SYNOVITIS-SOFTER
LIPOMA ABRORESENCE AND PIGMENTED VILLONODULAR
SYNOVITIS-SOFT
SOFT TISSUE MASSES: LIPOMA, LOW FLOW VASCULAR
MALFORMATIONS AND THYROGLOSSAL CYST- SOFT
NEUROGENIC TUMOES, DERMOID OR SEBACEOUS CYSTS-
STIFFER
INFLAMMATORY/DYSROPHIC CONDITION
INFLAMMATORY MYOSITIS- INCREASES STIFFNESS DUE TO
FIBROSIS.
CEREBRAL PALSY-ELASTOGRAPHY HELPS TO ESTABLIS SITE
OF BOTULINUM TOXIN INJECTION.
HYALINE CARTILAGE-EVALUATION OF ELASTICITY OF HYLINE
CARTILAGE BEFORE ARTHROSCOPY AND IN MONITORING OF
TREATMENT.