Araştırma Makalesi
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Evaluation of Spleen Stiffness Using Point Shear Wave Elastography in Healthy Individuals

Yıl 2022, Sayı: 18, 1006 - 1018, 31.12.2022
https://doi.org/10.38079/igusabder.1033907

Öz

Aim: Sonoelastography is a non-invasive imaging method used to evaluate the mechanical properties of any tissue. The clinical value of method, the usage of which is increasingly prevailing, is gradually increasing and on account of having newly entered the application field, it is becoming a potential in the research area. Shear wave (SW) propagates faster in stiffer and lower elastic tissues. Studies on liver fibrosis musculoskeletal, breast, prostate, testis, and thyroid nodules accept this principle. In this study, aimed to determine the average values using the point shear wave elastography (pSWE) technique in normal healthy individuals and to determine the relationship of these values with age, gender, body mass index (BMI), and the spleen dimensions.
Method: In 2019, patients who had visited the internal medicine service and those who have been directed to this clinics for grayscale ultrasound (US) for various reasons are voluntarily included in the study. The research was carried out consecutively on the same day by two specialist doctors who had 10 and 15 years of experience in ultrasonography and 3-year experience in elastography.
Results: 39 (39%) of the 100 patients who participated in the study were men, and 61 (61%) were women. And the ages varied between 32-75 years (y) (54,5±9,5). The average spleen stiffness was found to be 89,2±43,3 kilopascal (kPa) (14,2-152,3) by the first observer and 89,4±41,1 kPa (14,4-151,1) by the second observer.
Conclusion: To facilitate the common clinical usage and to evaluate the change in the stiffness of the spleen in different patients, first of all, it is required to determine the normal values of the stiffness of the spleen in healthy individuals using sonoelastography. In this study, the average spleen parenchyma stiffness was detected as higher than in previous studies. The values obtained in this study can be used to function as a comparison to determine the spleen stiffness. They can be used as referential to examine the different spleen pathologies in the clinical environments that use Esaote myLab device and pSWE method.

Kaynakça

  • Shiina T, Nightingale KR, Palmeri ML, et al. WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 1: Basic principles and terminology. Ultrasound Med Biol. 2015;41:126–47.
  • Süha Süreyya Özbek. Liver elastography. Trd Sem. 2019;7:13–24
  • Cosgrove D, Barr R, Bojunga J, et al. WFUMB guidelines and recommendations on the clinical use of ultrasound elastography: Part 4. Thyroid. Ultrasound Med Biol. 2017;43:4–26.
  • Leung VY, Shen J, Wong VW, et al. Quantitative elastography of liver fibrosis and spleen stiffness in chronic hepatitis B carriers: Comparison of shear-wave elastography and transient elastography with liver biopsy correlation. Radiology. 2013;269:910–918.
  • Zaleska-Dorobisz U, Pawluś A, Szymańska K, Łasecki M, Ziajkiewicz M. Ultrasound elastography: Review of techniques and its clinical applications in pediatrics. Part 2. Adv Clin Exp Med. 2015;24:725–730.
  • Paluch Ł, Nawrocka-Laskus E, Wieczorek J, Mruk B, Frel M, Walecki J. Use of ultrasound elastography in the assessment of the musculoskeletal system. Pol J Radiol. 2016;81:240–246.
  • Arda K, Ciledag N, Aktas E, Aribas BK, Köse K. Quantitative assessment of normal soft-tissue elasticity using shear-wave ultrasound elastography. AJR Am J Roentgenol. 2011;197:532–536.
  • Pawluś A, Inglot MS, Szymańska K, et al. Shear wave elastography of the spleen: Evaluation of spleen stiffness in healthy volunteers. Abdom Radiol (NY). 2016;41:2169–2174.
  • Rafał Mazur, Milena Celmer, Jurand Silicki, Daniel Hołownia, Patryk Pozowski, Krzysztof Międzybrodzki. Clinical applications of spleen ultrasound elastography – a review. J Ultrason. 2018;18:37–41.
  • Mauro Giuffrè, Daniele Macor, Flora Masutti, et al. Evaluation of spleen stiffness in healthy volunteers using point shear wave elastography. Annals of Hepatology. Sep-Oct 2019;18(5):736-741. doi: 10.1016/j.aohep.2019.03.004.
  • Giovanna Ferraioli, Carmine Tinelli, Raffaella Lissandrin, et al. Ultrasound point shear wave elastography assessment of liver and spleen stiffness: Effect of training on repeatability of measurements. Eur Radiol. 2014;24(6):1283-9. doi:10.1007/s00330-014-3140-y.
  • Cho YS, Lim S, Kim Y, et al. Spleen stiffness measurement using 2-dimensional shear wave elastography: The predictors of measurability and the normal spleen stiffness value. J Ultrasound Med. 2019;38(2):423–431.
  • Procopet B, Berzigotti A, Abraldes JG, et al. Real-time shear-wave elastography: Applicability, reliability and accuracy for clinically significant portal hypertension. J Hepatol. 2015;62(5):1068–1075.
  • Karlas T, Lindner F, Tröltzsch M, et al. Assessment of spleen stiffness using acoustic radiation force impulse imaging (ARFI): Definition of examination standards and impact of breathing maneuvers. Ultra-schall Med. 2014;35:38–43.
  • Kassym L, Nounou MA, Zhumadilova Z, et al. New combined parameter of liver and splenic stiffness as determined by elastography in healthy volunteers. Saudi J Gastroenterol. 2016;22:324-30.
  • Albayrak E, Server S. The relationship of spleen stifness value measured by shear wave elastography with age, gender, and spleen size in healthy volunteers. Journal of Medical Ultrasonic. 2019;46(2):195-199. doi: 10.1007/s10396-019-00929-3.

Sağlıklı Bireylerde Dalak Sertliğinin Point Shear Wave Elastografi ile Değerlendirilmesi

Yıl 2022, Sayı: 18, 1006 - 1018, 31.12.2022
https://doi.org/10.38079/igusabder.1033907

Öz

Amaç: Sonoelastografi, dokunun mekanik özelliklerini değerlendirmede kullanılan noninvaziv bir görüntüleme yöntemidir. Kullanımı giderek yaygınlaşan bu yöntemin klinik değeri giderek artmakta olup bazı cihazların uygulama alanına yeni girmiş olması nedeniyle araştırma alanında potansiyel oluşturmaktadır. Daha sert ve elastisitesi daha düşük dokularda kayma dalgası daha hızlı yayılmaktadır. Karaciğer fibrozu, kas-iskelet sistemi, meme, prostat, testis ve tiroid nodülleri üzerine yapılan çalışmalar bu prensibi kabul etmektedir. Bu çalışmada normal sağlıklı bireylerde dalak sertliğini pSWE tekniği kullanılarak kantitatif olarak değerlendirerek ortalama değerleri saptamayı ve bu değerlerin yaş, cinsiyet, vücut kitle indeksi ve dalak boyutları ile ilişkisini saptamayı amaçlanmıştır.
Yöntem: 2019 yılında Dahiliye kliniğine başvuran, farklı nedenlerle rutin gri skala US için Radyoloji kliniğine yönlendirilen hastalardan gönüllü olan bireyler çalışmaya dahil edilmiştir. Araştırma, US alanında 10 ve 15 yıllık, elastografi alanında ise 3 yıllık deneyime sahip iki uzman doktor tarafından aynı gün içinde ardışık olarak gerçekleştirilmiştir.
Bulgular: Çalışmaya dahil 100 hastanın 39’u (39%) erkek, 61’i (61%) kadın olup yaşları 32-75 (54,5±9,5) arasında değişmekte idi. Ortalama dalak sertliğini birinci araştırmacı 89,2±43,3 kPa (14,2-152,3), ikinci araştırmacı 89,4±41,1 kPa (14,4-151,1) olarak saptamıştır.
Sonuç: Yaygın klinik kullanımını kolaylaştırmak için ve farklı hastalıklarda dalak sertliği değişikliklerinin değerlendirilebilmesi için öncelikle sağlıklı bireylerde sonoelastografi ile dalak sertliğinin normal değerlerinin belirlenmesi gerekmektedir. Bu çalışmada sağlıklı bireylerde ortalama dalak parankim sertliği diğer çalışmalara göre yüksek olarak tespit edilmiştir. Bu çalışmada elde ettiğimiz değerlerin Esaote myLab9 cihazı ve pSWE yöntemi kullanan klinik ortamlarda dalak sertliğini belirlemek için bir karşılaştırma işlevi görebileceğine, farklı dalak patolojilerinin incelenmesinde referans değerler olarak kullanılabileceğini düşünülmektedir. 

Kaynakça

  • Shiina T, Nightingale KR, Palmeri ML, et al. WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 1: Basic principles and terminology. Ultrasound Med Biol. 2015;41:126–47.
  • Süha Süreyya Özbek. Liver elastography. Trd Sem. 2019;7:13–24
  • Cosgrove D, Barr R, Bojunga J, et al. WFUMB guidelines and recommendations on the clinical use of ultrasound elastography: Part 4. Thyroid. Ultrasound Med Biol. 2017;43:4–26.
  • Leung VY, Shen J, Wong VW, et al. Quantitative elastography of liver fibrosis and spleen stiffness in chronic hepatitis B carriers: Comparison of shear-wave elastography and transient elastography with liver biopsy correlation. Radiology. 2013;269:910–918.
  • Zaleska-Dorobisz U, Pawluś A, Szymańska K, Łasecki M, Ziajkiewicz M. Ultrasound elastography: Review of techniques and its clinical applications in pediatrics. Part 2. Adv Clin Exp Med. 2015;24:725–730.
  • Paluch Ł, Nawrocka-Laskus E, Wieczorek J, Mruk B, Frel M, Walecki J. Use of ultrasound elastography in the assessment of the musculoskeletal system. Pol J Radiol. 2016;81:240–246.
  • Arda K, Ciledag N, Aktas E, Aribas BK, Köse K. Quantitative assessment of normal soft-tissue elasticity using shear-wave ultrasound elastography. AJR Am J Roentgenol. 2011;197:532–536.
  • Pawluś A, Inglot MS, Szymańska K, et al. Shear wave elastography of the spleen: Evaluation of spleen stiffness in healthy volunteers. Abdom Radiol (NY). 2016;41:2169–2174.
  • Rafał Mazur, Milena Celmer, Jurand Silicki, Daniel Hołownia, Patryk Pozowski, Krzysztof Międzybrodzki. Clinical applications of spleen ultrasound elastography – a review. J Ultrason. 2018;18:37–41.
  • Mauro Giuffrè, Daniele Macor, Flora Masutti, et al. Evaluation of spleen stiffness in healthy volunteers using point shear wave elastography. Annals of Hepatology. Sep-Oct 2019;18(5):736-741. doi: 10.1016/j.aohep.2019.03.004.
  • Giovanna Ferraioli, Carmine Tinelli, Raffaella Lissandrin, et al. Ultrasound point shear wave elastography assessment of liver and spleen stiffness: Effect of training on repeatability of measurements. Eur Radiol. 2014;24(6):1283-9. doi:10.1007/s00330-014-3140-y.
  • Cho YS, Lim S, Kim Y, et al. Spleen stiffness measurement using 2-dimensional shear wave elastography: The predictors of measurability and the normal spleen stiffness value. J Ultrasound Med. 2019;38(2):423–431.
  • Procopet B, Berzigotti A, Abraldes JG, et al. Real-time shear-wave elastography: Applicability, reliability and accuracy for clinically significant portal hypertension. J Hepatol. 2015;62(5):1068–1075.
  • Karlas T, Lindner F, Tröltzsch M, et al. Assessment of spleen stiffness using acoustic radiation force impulse imaging (ARFI): Definition of examination standards and impact of breathing maneuvers. Ultra-schall Med. 2014;35:38–43.
  • Kassym L, Nounou MA, Zhumadilova Z, et al. New combined parameter of liver and splenic stiffness as determined by elastography in healthy volunteers. Saudi J Gastroenterol. 2016;22:324-30.
  • Albayrak E, Server S. The relationship of spleen stifness value measured by shear wave elastography with age, gender, and spleen size in healthy volunteers. Journal of Medical Ultrasonic. 2019;46(2):195-199. doi: 10.1007/s10396-019-00929-3.
Toplam 16 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Makaleler
Yazarlar

Sevim Özdemir 0000-0003-4270-6370

Tuba Selçuk Can 0000-0002-2388-1715

Behice Kaniye Yılmaz 0000-0001-6842-3323

Rüştü Turkay 0000-0002-7837-9861

Yayımlanma Tarihi 31 Aralık 2022
Kabul Tarihi 16 Aralık 2022
Yayımlandığı Sayı Yıl 2022 Sayı: 18

Kaynak Göster

JAMA Özdemir S, Can TS, Yılmaz BK, Turkay R. Evaluation of Spleen Stiffness Using Point Shear Wave Elastography in Healthy Individuals. IGUSABDER. 2022;:1006–1018.

 Alıntı-Gayriticari-Türetilemez 4.0 Uluslararası (CC BY-NC-ND 4.0)