Zhijun Zhang

The purpose of the work is to measure placental elasticity in pregnant women with hypothyroidism by shear wave elastography (SWE), and to evaluate the clinical value of SWE on placental function in pregnant women with hypothyroidism. In total, 57 Hypothyroidism (Hypothyroidism group) and 74 normal control women (NC group) who received antenatal examination in our hospital from February 2024 to November 2024. Placental mean elasticity (E-mean), mean shear wave velocities (SWV-mean), uterine artery/umbilical arteries related parameters (UtA/UmbA-PI/RI/S/D) were measured. The pregnancy outcomes of pregnant women were followed up. The correlation between E-mean and preterm birth, uterine/umbilical artery parameters was analyzed. Meanwhile, the Receiver Operating Characteristic (ROC) curve was used to analyze the predictive power of E-mean on placental function. There were significant difference in E-mean, SWV-mean,UtA -PI,UtA -RI,UtA -S/D between the Hypothyroidism group and the NC group (PE-mean/PSMV-mean/PUtA-PI/PUtA-RI/PtA-S/D=0.023/0.013/0.047/0.038/0.025).The most effective parameter for evaluating placental function was the E-mean (AUC = 0.86). E-mean was positively correlated with the incidence of preterm birth and UtA-PI, UtA- RI, UtA-S/D, but not significantly correlated with low-birth-weight infants and fetal distress. Compared with the NC group, pregnant women with hypothyroidism had a higher incidence of premature birth. The hardness of the placenta could be quantitatively evaluated by SWE. E-mean was the most effective parameter for evaluating placental function in pregnant women with hypothyroidism during late pregnancy. Pregnant women with hypothyroidism had greater placental hardness and a higher incidence of premature birth.

Shear wave elastography (SWE) is a novel type of ultrasound elastography technology that has emerged in recent years. It quantitatively measures the elastic modulus of tissues (represented by Young's modulus values) by detecting the propagation speed of shear waves generated in tissues under the action of acoustic radiation force. SWE technology objectively reflects the hardness characteristics of tissues as an non-invasive and highly repeatable ultrasound examination method. It has significant advantages such as quantitative measurement, simple operation, and real-time dynamic imaging. As a result, it provides an important imaging evaluation tool for the early diagnosis of clinical diseases, pathological staging, and dynamic monitoring of treatment effects. With the continuous development of ultrasound technology and in-depth exploration of clinical applications, SWE technology has shown broad application prospects and important clinical value in multiple medical fields. This article systematically reviews the development history of ultrasound elastography technology, and focuses on elaborating the basic principles of SWE technology and its application status in clinical practice. Through a comprehensive analysis of the latest research progress at home and abroad, it elaborates on the research achievements and application value of SWE technology in multiple important clinical fields such as liver fibrosis assessment, thyroid nodule differential diagnosis, breast nodule benign and malignant discrimination, myocardial hardness detection, and kidney disease assessment. The aim is to provide comprehensive reference for clinical physicians and researchers, and to envision the future development direction of this technology.

Background: This study aimed to investigate the correlation between calcific aortic valve disease (CAVD) and carotid artery elasticity using ultra-fast pulse wave velocity (UFPWV) technology. Early detection of alterations in carotid artery elasticity, coupled with the prompt implementation of intervention strategies, can effectively decrease the incidence of cardiovascular diseases. Methods: Patients with CAVD were recruited from the University-Town Hospital of Chongqing Medical University and placed in the observation group. Meanwhile, an equivalent number of patients with non-calcified aortic valve disease were recruited as controls. All participants underwent comprehensive health assessments, including measurements of blood lipids, fasting blood sugar, and other biochemical indicators. Additionally, bilateral carotid intima-media thickness (CIMT) was measured, as well as pulse wave velocity (PWV) at the beginning of systole (PWV-BS) and the end of systole (PWV-ES). Differences in various indicators between the two groups were analyzed, and the factors associated with CAVD and carotid artery elasticity were investigated. The correlation between CAVD and carotid artery elasticity was also evaluated. Results: Patients with CAVD exhibited significantly higher CIMT, PWV-BS, and PWV-ES levels than those with non-calcified aortic valve disease (p < 0.01). PWV-BS and PWV-ES showed progressive increases according to the severity of calcification. Coronary atherosclerotic heart disease and PWV-BS were all identified as independent risk factors for CAVD. The risk factors associated with PWV-BS include hypertension, coronary atherosclerotic heart disease, total cholesterol, and homocysteine (p < 0.05 for all). The risk factors related to PWV-ES include hypertension, coronary atherosclerotic heart disease, total cholesterol, and glycated hemoglobin (p < 0.05 for all). Conclusions: UFPWV technology is a novel method for the early diagnosis of carotid elasticity. Evaluating carotid artery atherosclerosis in patients with CAVD may lead to earlier detection and intervention and reduce the incidence of cardiovascular events.

To investigate the correlation between idiopathic neonatal hyperbilirubinemia and ductus venosus closure time and to examine prenatal factors influencing DV closure in neonates. A total of 103 full-term hyperbilirubinemic neonates born between September 2022 and September 2023 were selected as the hyperbilirubinemia group, while 169 full-term healthy neonates were chosen as the control group. Neonates with other perinatal or maternal abnormalities were excluded. Ultrasonographic examinations monitored ductus venosus closure time. ductus venosus blood flow, umbilical vein blood flow, ductus venosus shunt fraction, middle cerebral artery pulsitility index, and estimated fetal weight at term were retrospectively analyzed to compare differences between the two groups. The correlation between neonatal serum total bilirubin and ductus venosus closure time, as well as prenatal influences on ductus venosus closure time in neonates, were evaluated. The hyperbilirubinemia group had significantly longer ductus venosus closure time than the control group (p < 0.05). A positive association was found between ductus venosus closure and elevated neonatal serum total bilirubin. Prenatal factors influencing ductus venosus closure time included ductus venosus shunt fraction and fetal weight, where lower fetal weight and higher ductus venosus shunt fraction were associated with a delayed ductus venosus closure in neonates. Ductus venosus closure time is positively correlated with idiopathic neonatal hyperbilirubinemia, suggesting a potential role in its development. Fetal weight and the ductus venosus shunt fraction during the fetal period appear to influence the timing of ductus venosus closure in neonates.

This study aimed to compare the repeatability and diagnostic efficiency of shear wave elastography (SWE) while using coupling gel and gel pads in the diagnosis of superficial breast lesions. Two experienced sonographers, trained in SWE, used different methods to perform the maximum Young's modulus (Emax) measurement of the lesion while using coupling gel SWE and gel pad SWE at different time points. All 80 lesions were in the superficial layer of the breast. The interclass correlation coefficient (ICC) was calculated to evaluate the intraobserver and interobserver repeatability. Meanwhile, the receiver operating characteristic curve (ROC curve) was used to calculate the sensitivity, specificity and area under the curve of the two methods. In the 80 breast lesions, the intraobserver and interobserver reproducibility of SWE measurements using coupling gel were considered good, and the ICCs were 0.728 (95% CI: 0.509-0.813) and 0.702 (95% CI: 0.492-0.795), respectively. The intraobserver and interobserver reproducibility of the SWE measured by the gel pad were also considered good, and the ICCs were 0.745 (95% CI: 0.501-0.801) and 0.713 (95% CI: 0.498-0.802), respectively. The sensitivity, specificity and area under the curve were 0.711 and 0.737, 0.929 and 0.905, and 0.873 and 0.878, respectively. In the SWE measurement of superficial breast lesions, the use of a gel pad does not affect the repeatability and diagnostic efficiency of the measurement.

Objective In comparing the repeatability of the internal diameter and hemodynamic parameters of the dorsalis pedis artery measured by immersion ultrasound and contact ultrasound, the factors affecting the accuracy and repeatability of measurement were analyzed. This study aimed to provide a better method for ultrasound evaluation of the dorsalis pedis artery before flap transplantation. Methods Two senior sonographers measured the diameter of the dorsalis pedis artery (D) of 56 healthy volunteers, measuring at the same location and at different time points using water immersion and contact ultrasound. Color Doppler ultrasound was used to measure the hemodynamics of the dorsalis pedis artery, including peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI). The interclass correlation coefficient (ICC) was used to evaluate the intraobserver and interobserver repeatability for each group’s measurements. Results The intraobserver and interobserver reproducibility of D, PSV, EDV, and RI measurements by water immersion ultrasound was very good. The intraobserver and interobserver reproducibility of the contact ultrasound measurements of D, PSV, EDV, and RI was good. Conclusion The repeatability of water immersion ultrasound is better than that of contact ultrasound in the measurement of the dorsalis pedis artery. Water immersion ultrasound can improve the near-field resolution of superficial tissues and increase the display of the lengths of blood vessels in images, thereby suggesting its superiority in ultrasound examination of dorsalis pedis arteries.

Objective: To study the factors that influence the measurement of median nerve elasticity, to provide a more reproducible test for the assessment of median nerve elasticity using shear wave elasticity (SWE), and to reduce operator empirical dependence. To compare the repeatability of the median nerve elasticity measurement using immersion SWE with that using contact SWE, analyze the factors affecting SWE measurement, and provide a more repeatable method for doctors without SWE operation experience. Methods: Two doctors without SWE operation experience measured the median nerve mean elastic modulus (Emean) at the same position and at different time points on the right wrist of 58 healthy volunteers using immersion and contact ultrasound methods. The intraobserver and interobserver repeatability of measurements was assessed using the interclass correlation coefficient (ICC), while the repeatability was assessed using the Bland–Altman diagram. Results: The intraobserver and interobserver repeatability of the median nerve elasticity measured via contact SWE by inexperienced operators were classified as good, with ICCs of 0.633 (95% CI 0.380–0.783) and 0.552 (95% CI 0.243–0.735), respectively. The intraobserver and interobserver repeatability of the median nerve elasticity measured by immersion SWE were very good, with ICCs of 0.975 (95% CI 0.958–0.985) and 0.942 (95% CI 0.902–0.966), respectively. The intraobserver and interobserver Bland–Altman diagram of median nerve elasticity measured by immersion SWE showed that 98% of the points fell within the 95% limits of agreement. The intraobserver and interobserver Bland–Altman diagram of median nerve elasticity measured by contact SWE showed that 94% of the points fell within the 95% limits of agreement. Conclusion: Immersion ultrasound can improve the repeatability of median nerve elasticity measurements by inexperienced operators.

To reduce the empirical dependence of ultrasound measurement of the cephalic vein diameter, improve the repeatability of measurements for inexperienced operators, and provide a new method for inexp...