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13 pages, 1684 KiB

Open AccessArticle

Evaluating Carotid Plaque Stiffness with Ultrasound 2D Shear-Wave Elastography in Patients Undergoing Coronary Artery Bypass Grafting

by Adel Alzahrani, Amjad Ali Alharbi, Amjad Khalid Alharbi, Asma Alkhaldi, Asseel Z. Filimban, Abrar Alfatni, Reham Kaifi, Ahmad Albngali, Mohammed Alkharaiji, Omar Alserihy and Salahaden R. Sultan

Diagnostics 2025, 15(3), 338; https://doi.org/10.3390/diagnostics15030338 - 31 Jan 2025

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Abstract

Background: Coronary and carotid artery diseases are manifestations of a systemic atherosclerotic process, often coexisting in patients affected by both conditions. This association emphasizes the importance of evaluating both coronary and carotid atherosclerosis in high-risk individuals. Ultrasound 2D shear-wave elastography (2D-SWE) has shown [...] Read more.

Background: Coronary and carotid artery diseases are manifestations of a systemic atherosclerotic process, often coexisting in patients affected by both conditions. This association emphasizes the importance of evaluating both coronary and carotid atherosclerosis in high-risk individuals. Ultrasound 2D shear-wave elastography (2D-SWE) has shown promise as a noninvasive technique for assessing carotid plaque stiffness. This prospective pilot study aimed to assess carotid plaque stiffness in patients undergoing coronary artery bypass grafting (CABG) and those not scheduled for the procedure as a control group. Methods: 32 patients (17 CABG and 15 controls) were recruited, collectively presenting 43 carotid plaques. Bilateral carotid ultrasound was performed using a high-resolution linear transducer. Plaque stiffness was quantified via 2D-SWE, expressed in shear-wave velocity (SWV, m/s) and Young’s modulus (YM, kPa). Plaque characteristics, including GSM, were quantified. Intra-observer reproducibility was evaluated with intraclass correlation coefficients (ICCs) and Bland–Altman plots. Statistical differences and correlations were assessed using Mann–Whitney U and Spearman’s correlation tests. Results: Carotid plaques in the CABG group exhibited significantly lower stiffness compared to controls (median stiffness SWV: 3.64 m/s vs. 4.91 m/s, p < 0.0001; YM: 20.96 kPa vs. 72.54 kPa, p < 0.0001). ICCs demonstrated excellent reproducibility for stiffness measurements (SWV: ICC = 0.992; YM: ICC = 0.992), with minimal bias in measurements. A positive correlation was observed between 2D-SWE and GSM values (SWV: r = 0.343, p = 0.024; YM: r = 0.340, p = 0.026). Conclusions: Ultrasound 2D-SWE has shown promise as a reliable tool for quantifying carotid plaque stiffness, demonstrating high reproducibility and a significant correlation with GSM. The observed reduction in plaque stiffness among CABG patients highlights its potential as a valuable parameter for identifying high-risk plaques and assessing cerebrovascular risk in patients undergoing CABG. Full article

(This article belongs to the Special Issue Current Perspectives and Advances in Ultrasound Imaging)

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12 pages, 2165 KiB

Open AccessArticle

The Effectiveness of Ultrasound-Guided Infiltrations Combined with Early Rehabilitation in the Management of Low Back Pain: A Retrospective Observational Study

by Danilo Donati, Fabio Vita, Vincenza Amoruso, Flavio Origlio, Roberto Tedeschi, Francesco Castagnini, Salvatore Massimo Stella, Marco Miceli, Cesare Faldini and Stefano Galletti

Diagnostics 2024, 14(18), 2087; https://doi.org/10.3390/diagnostics14182087 - 20 Sep 2024

Cited by 1 | Viewed by 838

Abstract

Background and Aims: Low back pain is a prevalent condition affecting 60–85% of individuals during their lifetime. Despite various proposed mechanisms, the etiology of low back pain remains unclear. This study aims to evaluate the effectiveness of combining ultrasound-guided infiltrations with early rehabilitation [...] Read more.

Background and Aims: Low back pain is a prevalent condition affecting 60–85% of individuals during their lifetime. Despite various proposed mechanisms, the etiology of low back pain remains unclear. This study aims to evaluate the effectiveness of combining ultrasound-guided infiltrations with early rehabilitation in reducing pain and improving functional limitations in patients with chronic nonspecific low back pain. Methods: A retrospective observational study was conducted, reviewing data from January to April 2024 involving 40 patients with chronic nonspecific low back pain. Each patient received two cycles of ultrasound-guided lidocaine and corticosteroid infiltrations at the level of the posterior lower iliac spine, followed by 10 rehabilitation sessions. Patients were assessed at baseline (T0), after the first treatment cycle (T1), and after the second cycle (T2) using the Oswestry Disability Index, Quebec Back Pain Disability Scale, Roland Disability Questionnaire, and Numeric Rating Scale. Results: Significant improvements were observed across all assessment scales. The ODI scores decreased from 33.5 at baseline to 3.5 after treatment (p < 0.001). Similar reductions were noted in the QBPDS (from 61.5 to 10.3), RDQ (from 18 to 3.4), and NRS (from 7.4 to 1.3). The combination of ultrasound-guided infiltrations and early rehabilitation resulted in a significant reduction in pain and disability, with the most notable improvements occurring after the second treatment cycle. Conclusions: The integration of ultrasound-guided infiltrations with early rehabilitation is highly effective in managing chronic nonspecific low back pain, significantly reducing both pain and functional limitations. Full article

(This article belongs to the Special Issue Current Perspectives and Advances in Ultrasound Imaging)

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7 pages, 1635 KiB

Open AccessArticle

Machine Learning on Ultrasound Texture Analysis Data for Characterizing of Salivary Glandular Tumors: A Feasibility Study

by Li-Jen Liao, Ping-Chia Cheng and Feng-Tsan Chan

Diagnostics 2024, 14(16), 1761; https://doi.org/10.3390/diagnostics14161761 - 13 Aug 2024

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Abstract

Background: Objective quantitative texture characteristics may be helpful in salivary glandular tumor differential diagnosis. This study uses machine learning (ML) to explore and validate the performance of ultrasound (US) texture features in diagnosing salivary glandular tumors. Material and methods: 122 patients with salivary [...] Read more.

Background: Objective quantitative texture characteristics may be helpful in salivary glandular tumor differential diagnosis. This study uses machine learning (ML) to explore and validate the performance of ultrasound (US) texture features in diagnosing salivary glandular tumors. Material and methods: 122 patients with salivary glandular tumors, including 71 benign and 51 malignant tumors, are enrolled. Representative brightness mode US pictures are selected for further Gray Level Co-occurrence Matrix (GLCM) texture analysis. We use a t-test to test the significance and use the receiver operating characteristic curve method to find the optimal cut-point for these significant features. After splitting 80% of the data into a training set and 20% data into a testing set, we use five machine learning models, k-nearest Neighbors (kNN), Naïve Bayes, Logistic regression, Artificial Neural Networks (ANNs) and supportive vector machine (SVM), to explore and validate the performance of US GLCM texture features in diagnosing salivary glandular tumors. Results: This study includes 49 female and 73 male patients, with a mean age of 53 years old, ranging from 21 to 93. We find that six GLCM texture features (contrast, inverse difference movement, entropy, dissimilarity, inverse difference and difference entropy) are significantly different between benign and malignant tumors (p < 0.05). In ML, the overall accuracy rates are 74.3% (95%CI: 59.8–88.8%), 94.3% (86.6–100%), 72% (54–89%), 84% (69.5–97.3%) and 73.5% (58.7–88.4%) for kNN, Naïve Bayes, Logistic regression, a one-node ANN and SVM, respectively. Conclusions: US texture analysis with ML has potential as an objective and valuable tool to make a differential diagnosis between benign and malignant salivary gland tumors. Full article

(This article belongs to the Special Issue Current Perspectives and Advances in Ultrasound Imaging)

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10 pages, 873 KiB

Open AccessArticle

Handheld Ultrasound Parameters of Lower Limb Muscles versus Bioelectrical Impedance Analysis Parameters for Skeletal Muscle Assessments in Arabic Female Adults

by Nada H. Alamoudi, Dara Aldisi, Mohamed S. El-Sharkawy and Mahmoud M. A. Abulmeaty

Diagnostics 2024, 14(15), 1582; https://doi.org/10.3390/diagnostics14151582 - 23 Jul 2024

Viewed by 1522

Abstract

Ultrasound (US) is a promising tool for skeletal muscle assessment; however, US studies have scarcely focused on Arabic populations. This study examined the association of handheld US indicators and bioelectrical impedance analysis (BIA) parameters in healthy Arabic females. A cross-sectional study was conducted [...] Read more.

Ultrasound (US) is a promising tool for skeletal muscle assessment; however, US studies have scarcely focused on Arabic populations. This study examined the association of handheld US indicators and bioelectrical impedance analysis (BIA) parameters in healthy Arabic females. A cross-sectional study was conducted on 60 healthy Arabic females whose muscle thickness (MT) and cross-sectional area (CSA) of the rectus femoris (RF) were measured alongside their MT and pennation angle (PA) of the medial gastrocnemius (MG) muscle (both muscles on the dominant side). Anthropometric and body composition analyses quantified fat-free mass (FFM) and appendicular skeletal muscle mass (ASMM). Muscle strength was assessed using a handgrip dynamometer, and physical activity levels were recorded with the Global Physical Activity Questionnaire (GPAQ). The CSA of the RF and the MT of both the RF and MG correlated significantly with FFM and ASMM. The PA of MG showed no significant correlations with ASMM, FFM, or handgrip strength. The CSA of RF was significantly correlated with handgrip strength (r = 0.313, p = 0.015), while the PA of MG correlated positively with GPAQ score (r = 0.346, p = 0.007). The CSA of RF significantly predicted both ASMM (β = 0.883, p = 0.0002) and FFM (β = 1.935, p = 0.0001). In conclusion, handheld US parameters, especially the RF’s CSA, correlate with and can predict BIA-based FFM and ASMM in healthy females. Full article

(This article belongs to the Special Issue Current Perspectives and Advances in Ultrasound Imaging)

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10 pages, 1787 KiB

Open AccessArticle

Ultrasound-Guided Sciatic Nerve Hydrodissection Can Improve the Clinical Outcomes of Patients with Deep Gluteal Syndrome: A Case-Series Study

by Yun-Shan Yen, Chang-Hao Lin, Chen-Hao Chiang and Cheng-Yi Wu

Diagnostics 2024, 14(7), 757; https://doi.org/10.3390/diagnostics14070757 - 2 Apr 2024

Cited by 1 | Viewed by 2560

Abstract

Deep gluteal syndrome (DGS) is caused by sciatic nerve entrapment. Because fascial entrapment neuropathies may occur in multiple locations, ultrasound-guided nerve hydrodissection is a key component of DGS treatment. In this study, we examined the clinical outcomes of patients with DGS undergoing ultrasound-guided [...] Read more.

Deep gluteal syndrome (DGS) is caused by sciatic nerve entrapment. Because fascial entrapment neuropathies may occur in multiple locations, ultrasound-guided nerve hydrodissection is a key component of DGS treatment. In this study, we examined the clinical outcomes of patients with DGS undergoing ultrasound-guided sciatic nerve hydrodissection. A 10 mL mixture consisting of 5% dextrose, 0.2% lidocaine (Xylocaine), and 4 mg betamethasone (Rinderon) was used for nerve hydrodissection. Clinical outcomes were evaluated using Numeric Rating Scale (NRS) scores of pain, the proportion of patients with favorable outcomes (reduction of ≥50% in pain), the duration for which patients exhibited favorable outcomes (percentage of follow-up duration), and the occurrence of major complications and minor side effects. A total of 53 patients were consecutively included and followed up for 3 to 19 months. After the initial injection, the NRS scores significantly improved at 1 week, 1 month, 3 months, and the final follow-up. Specifically, 73.6%, 71.7%, 64.2%, and 62.3% of the patients exhibited favorable outcomes at 1 week, 1 month, 3 months, and the final follow-up, respectively. The median duration for which the patients exhibited favorable outcomes was 84.7% of the follow-up period. Three patients (5.7%) experienced transient dizziness and vomiting, which resolved without further treatment. No vessel or nerve puncture was observed. Overall, ultrasound-guided sciatic nerve hydrodissection is a safe procedure that mitigates the pain associated with DGS. To achieve favorable outcomes, three consecutive injections 3 weeks apart are required. Full article

(This article belongs to the Special Issue Current Perspectives and Advances in Ultrasound Imaging)

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Review

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15 pages, 5447 KiB

Open AccessReview

Shear Wave Elastography for Carotid Artery Stiffness: Ready for Prime Time?

by Dimitrios Kavvadas, Vasileios Rafailidis, Sasan Partovi, Thomas Tegos, Zoi Kallia, Panagiotis Savvoulidis, Theodora Papamitsou and Panos Prassopoulos

Diagnostics 2025, 15(3), 303; https://doi.org/10.3390/diagnostics15030303 - 27 Jan 2025

Viewed by 789

Abstract

Carotid artery stiffness is associated with aging and atherosclerotic disease, leading to cerebrovascular events. Shear Wave Elastography (SWE) is a novel ultrasound technique offering a direct, quantitative assessment of the arterial wall elasticity. The aim of this study is to validate the technical [...] Read more.

Carotid artery stiffness is associated with aging and atherosclerotic disease, leading to cerebrovascular events. Shear Wave Elastography (SWE) is a novel ultrasound technique offering a direct, quantitative assessment of the arterial wall elasticity. The aim of this study is to validate the technical feasibility of SWE in measuring carotid stiffness (CS). A literature search was performed across the PubMed and Scopus databases, with keywords including “carotid stiffness”, “Shear Wave Elastography”, “atherosclerosis”, and “vascular elasticity”. The findings reveal the potential of SWE in quantifying carotid Intima–Media Complex (IMC) stiffness, with implications for the early diagnosis of vascular disease, aiding in clinical decision making and prognostic assessment. Based on the findings of the literature search, a small pilot study was conducted involving 10 participants, using the Philips EPIQ Elite system for the SWE measurements. The technical analysis revealed optimizing the region of interest (ROI) size, probe positioning, and cine-loop analysis as crucial factors for obtaining accurate results. The results of the literature review and small pilot study demonstrate the potential of SWE as a non-invasive method for assessing carotid stiffness. Certain technical adjustments, such as smaller ROIs and careful probe placement, improved the accuracy and repeatability of carotid SWE measurements. Further studies are needed to assess and standardize carotid SWE across larger patient populations. Full article

(This article belongs to the Special Issue Current Perspectives and Advances in Ultrasound Imaging)

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13 pages, 1173 KiB

Open AccessReview

Imaging of Carotid Stenosis: Where Are We Standing? Comparison of Multiparametric Ultrasound, CT Angiography, and MRI Angiography, with Recent Developments

by Emanuele David, Hektor Grazhdani, Lorenzo Aliotta, Livio Maria Gavazzi, Pietro Valerio Foti, Stefano Palmucci, Corrado Inì, Francesco Tiralongo, Davide Castiglione, Maurizio Renda, Patrizia Pacini, Chiara Di Bella, Carmen Solito, Silvia Gigli, Alessandro Fazio, Rita Bella, Antonio Basile and Vito Cantisani

Diagnostics 2024, 14(16), 1708; https://doi.org/10.3390/diagnostics14161708 - 6 Aug 2024

Cited by 5 | Viewed by 2307

Abstract

Atherosclerotic disease of the carotid arteries is a crucial risk factor in predicting the likelihood of future stroke events. In addition, emerging studies suggest that carotid stenosis may also be an indicator of plaque load on coronary arteries and thus have a correlation [...] Read more.

Atherosclerotic disease of the carotid arteries is a crucial risk factor in predicting the likelihood of future stroke events. In addition, emerging studies suggest that carotid stenosis may also be an indicator of plaque load on coronary arteries and thus have a correlation with the risk of acute cardiovascular events. Furthermore, although in symptomatic patients the degree of stenosis is the main morphological parameter studied, recent evidence suggests, especially in asymptomatic patients, that plaque vulnerability should also be evaluated as an emerging and significant imaging parameter. The reference diagnostic methods for the evaluation of carotid stenosis are currently ultrasonography, magnetic resonance imaging (MRI), and computed tomography angiography (CTA). In addition, other more invasive methods such as 123I-metaiodobenzylguanidine (MIBG) scintigraphy and PET-CT, as well as digital subtraction angiography, can be used. Each method has advantages and disadvantages, and there is often some confusion in their use. For example, the usefulness of MRI is often underestimated. In addition, implementations for each method have been developed over the years and are already enabling a significant increase in diagnostic accuracy. The purpose of our study is to make an in-depth analysis of all the methods in use and in particular their role in the diagnostic procedure of carotid stenosis, also discussing new technologies. Full article

(This article belongs to the Special Issue Current Perspectives and Advances in Ultrasound Imaging)

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18 pages, 10501 KiB

Open AccessReview

Elastography of the Male Pelvic Region—Perspectives on Malignant Lesions

by Rute Santos, Martina Kastrup Loft and Malene Roland Vils Pedersen

Diagnostics 2024, 14(12), 1218; https://doi.org/10.3390/diagnostics14121218 - 8 Jun 2024

Cited by 1 | Viewed by 941

Abstract

Ultrasound elastography is widely used to assess tissue stiffness for lesion characterization, including differentiation between benign and malignant lesions. This study focuses on the use of elastography in the male pelvis, including the prostate, testicles, and rectum, by comparing elastography types (shear wave [...] Read more.

Ultrasound elastography is widely used to assess tissue stiffness for lesion characterization, including differentiation between benign and malignant lesions. This study focuses on the use of elastography in the male pelvis, including the prostate, testicles, and rectum, by comparing elastography types (shear wave and strain). This article provides a summary of the existing literature on the use of elastography in the male pelvic region and outlines the clinical perspective. Ultrasound elastography is a good technique for evaluating and monitoring lesions in the male pelvic region. Full article

(This article belongs to the Special Issue Current Perspectives and Advances in Ultrasound Imaging)

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