Background. Shear wave elastography is a relatively new method of quantitative measurement of tissue elasticity. Assuming that malignant lesions are stiffer than benign ones, elastography may provide supplementary information for their discrimination. However, potential confounding factors impacting tissue stiffness should be investigated first. Aims. The objective of this study was to measure the stiffness of selected tissues of the head and neck in a normal population and to evaluate its relationship to age, sex, and body mass index. Methods. Stiffness of the thyroid, submandibular and parotid glands, masseter and sternocleidomastoid muscles, and cervical lymph nodes was measured bilaterally in 128 healthy volunteers (83 female and 45 male). At least 20 subjects in each decade of life (20-29, 30-39…, 70+) were enrolled. Shear wave elastography was performed by a single radiologist in all the subjects. The stiffnesses obtained were correlated with age, sex, and body mass index. Results. The mean stiffness was 9.5 ± 3.6 kPa for the thyroid, 9.5 ± 4.6 kPa for the lymph node, 11.0 ± 3.4 kPa for the submandibular gland, 9.0 ± 3.5 kPa for the parotid gland, 9.9 ± 4.1 kPa for the sternocleidomastoid, and 10.0 ± 4.3 kPa for the masseter muscle. A slight general decrease in stiffness with increasing age was found. BMI and weight had a small impact on the minimum and maximum stiffness values. The sex of the subject did not affect elasticity. Conclusion. The mean stiffness of healthy head and neck organs has a relatively narrow distribution around 11 kPa. The changes of stiffness with age, BMI, and weight that were identified are too small to have clinical impact.
OBJECTIVES: The most promising strategy for managing COVID-19 pandemic is achieving suffi cient vaccination rate worldwide. The question is how many people will be willing to get vaccinated. STUDY DESIGN: We systematically reviewed peer-reviewed manuscripts monitoring people´s intention to receive a vaccine against COVID-19. METHODS: Up to December 28, 2020 we identifi ed 62 relevant peer-reviewed articles in PubMed, Web of Science, Scopus and GoogleScholar. RESULTS: Total sample size was 118 855 respondents with overall average COVID-19 vaccine acceptance rate of 72.5% which is "just" the level estimated to be suffi cient for reaching herd immunity threshold. Surprisingly, healthcare workers showed smaller interest in receiving the vaccine when compared to general adult population and university students. On the other hand, their attitude to vaccination did not change over time. In case of general adult population, the longer the pandemic lasts, the smaller proportion of population wants to get vaccinated. Vaccination intentions were independent of gross domestic product and human development index. CONCLUSION: Willingness of population to receive COVID-19 is just at the herd immunity threshold and it is decreasing over time (Tab. 2, Fig. 3, Ref. 110).
Aim To create a predictive score for the discrimination between benign and malignant parotid tumors using elastographic parameters and to compare its sensitivity and specificity with standard ultrasound. Methods A total of 124 patients with parotid gland lesions for whom surgery was planned were examined using conventional ultrasound, Doppler examination, and shear wave elastography. Results of the examinations were compared with those ones of histology. Results There were 96 benign and 28 malignant lesions in our cohort. Blurred tumor margin alone proved to be an excellent predictor of malignancy with the sensitivity of 79% and specificity of 97%. Enlarged cervical lymph nodes, tumor vascularisation, microcalcifications presence, homogeneous echogenicity, and bilateral occurrence also discriminated between benign and malignant tumors. However, their inclusion in a predictive model did not improve its performance. Elastographic parameters (the stiffness maxima and minima ratio being the best) also exhibited significant differences between benign and malignant tumors, but again, their inclusion did not significantly improve the predictive power of the blurred margin classifier. Conclusion Even though elastography satisfactorily distinguishes benign from malignant lesions on its own, it hardly provides any additional value in evaluation of biological character of parotid gland tumors when used as an adjunct to regular ultrasound examination.
The objective of this study is to investigate the effect of multiple dead elements in an ultrasound probe on the accuracy of Doppler ultrasound measurements. For this work, we used a specially designed ultrasound imaging system, the Ultrasonix Sonix RP, that provides the user with the ability to disable selected elements in the probe. Using fully functional convex, linear, and phased array probes, we established a performance baseline by measuring the parameters of a laminar parabolic flow profile. These same parameters were then measured using probes with 1 to 10 disabled elements. The acquired velocity spectra from the functional probes and the probes with disabled elements were then analyzed to determine the overall Doppler power, maximum flow velocity, and average flow velocity. Color Flow Doppler images were also evaluated in a similar manner. The analysis of the Doppler spectra indicates that the overall Doppler power as well as the detected maximum and average velocities decrease with the increasing number of disabled elements. With multiple disabled elements, decreases in the detected maximum and average velocities greater than 20% were recorded. Similar results were also observed with Color Flow Doppler measurements. Our results confirmed that the degradation of the ultrasound probe through the loss of viable elements will negatively affect the quality of the Doppler-derived diagnostic information. We conclude that the results of Doppler measurements cannot be considered accurate or reliable if there are four or more contiguous dead elements in any given probe.
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