BACKGROUND Few systematic comparative studies of the different methods of physical elastography of the spleen are currently available. AIM To compare point shear wave and two-dimensional elastography of the spleen considering the anatomical location (upper, hilar, and lower pole). METHODS As part of a prospective clinical study, healthy volunteers were examined for splenic elasticity using four different ultrasound devices between May 2015 and April 2017. The devices used for point shear wave elastography were from Siemens (S 3000) and Philips (Epiq 7), and those used for two-dimensional shear wave elastography were from GE (Logiq E9) and Toshiba (Aplio 500). In addition, two different software versions (5.0 and 6.0) were evaluated for the Toshiba ultrasound device (Aplio 500). The study consisted of three arms: A, B, and C. RESULTS In study arm A, 200 subjects were evaluated (78 males and 122 females, mean age 27.9 ± 8.1 years). In study arm B, 113 subjects were evaluated (38 men and 75 women, mean age 26.0 ± 6.3 years). In study arm C, 44 subjects were enrolled. A significant correlation of the shear wave velocities at the upper third of the spleen ( r = 0.33088, P < 0.0001) was demonstrated only for the Philips Epiq 7 device compared to the Siemens Acuson S 3000. In comparisons of the other ultrasound devices (GE, Siemens, Toshiba), no comparable results could be obtained for any anatomical position of the spleen. The influencing factors age, gender, and body mass index did not show a clear correlation with the measured shear wave velocities. CONCLUSION The absolute values of the shear wave elastography measurements of the spleen and the two different elastography methods are not comparable between different manufacturers or models.
Die sonoelastografischen (ARFI-)Verfahren bieten die Möglichkeit, eine relevante Fibrose der Leber nichtinvasiv zu diagnostizieren, und können ggf. helfen, eine Leberbiopsie zu vermeiden. Des Weiteren kann die Messung der Lebersteifigkeit mittels ARFI im Therapie-Monitoring diffuser Lebererkrankungen eingesetzt werden. Die nachfolgende SOP beschreibt die Einflussfaktoren und Prozeduren zur Gewinnung optimaler 2-D-Elastografie-Messwerte der Leber. Einleitung Chronische Lebererkrankungen können zu einem narbigen Umbau des Lebergewebes führen. Symptome des fibrotischen Umbaus der Leber treten meist erst sehr spät auf. Daher bleibt eine Erkrankung häufig lange unbemerkt oder wird zufällig im Rahmen der Abklärung anderer Beschwerden entdeckt. Des Weiteren ist eine Leberfibrose bzw. -zirrhose eine der häufigsten Ursachen für die Entwicklung einer portalen Hypertonie sowie von Komplikationen wie Ösophagusvarizen, Aszites oder Leberversagen [1]. Die B-Bild-Sonografie ist für eine frühe sichere Diagnostik nicht sensitiv genug und zeigt erst in fortgeschrittenen Stadien typische Veränderungen in der Leber.
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