Application of acoustic radiation force impulse imaging (ARFI) in quantitative evaluation of neonatal brain development

Su, Yun-Ai; Ma, J; Du, Lianfang; Xia, Jingjing; Wu, Yueh-Hsun; Jia, Xueqin; Cai, Yingjun; Li, Y; Zhao, Jing; Liu, Q

doi:10.12891/ceog1956.2015

Cited by 22 publications

(14 citation statements)

References 21 publications

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“…19 Su et al found acoustic radiation force imaging to be a "new quantitative index to evaluate neonatal brain development," as neonates with different gestational ages had different quantitative elastic values: the more the gestational ages were, the more the elastic numerical values. 20 Both studies address the complex process of prenatal and postnatal brain development and its possible delays and complications in preterm children, and both studies use brain tissue stiffness as a possible surrogate marker to display brain development.…”

Section: Discussionmentioning

confidence: 99%

“…18 However, to date, only a few studies are available on applying SWE in children's and neonate's brains, although noninvasive stiffness measurements could be of particular clinical interest, especially in this cohort. Studies by Albayrak and Kasap 19 and Su et al 20 firstly evaluated SWE and acoustic radiation force imaging as possible markers for neonatal brain development.…”

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confidence: 99%

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Transcranial Shear Wave Elastography of Neonatal and Infant Brains for Quantitative Evaluation of Increased Intracranial Pressure

et al. 2019

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Objectives: Increased intracranial pressure (ICP) in neonates and infants is a severe disease state that requires adequate diagnosis and, depending on the clinical situation and whether it is increasing, a rapid and efficient therapy. Clinical evaluation, B-mode ultrasound, and Doppler ultrasound give rise to a basic noninvasive diagnosis of increased ICP. The purpose of this prospective study was 2-fold: first, to analyze the technical feasibility of obtaining shear wave elastography (SWE) measurements of an infant's brain, and second, to compare the values of healthy neonates to those who have hydrocephalus and are either suspected of having or invasively shown to have increased ICP. Materials and Methods: This was a prospective, institutional review boardapproved study of 184 neonates and infants with a mean age of 12 weeks (ranging from 1 day to 12 months). The final, technical evaluable cohort consisted of 166 infants, of whom 110 were healthy asymptomatic infants and 56 were diagnosed with hydrocephalus. Of the latter, 38 showed clinically increased ICP and 18 did not. Invasive ICP measurements were available from 47 of the children. All infants underwent systematic examination using B-mode ultrasound, Doppler ultrasound, and SWE using a high-resolution linear 15-MHz probe (Aixplorer; Supersonic), by 1 of 2 radiologists, each of whom had at least 5 years' experience examining children's brains and applying SWE. Semiquantitative and quantitative SWE measurements were performed.We compared the SWE values to each participant's clinical symptoms and to their invasive ICP measurement results. Correlations were calculated using Pearson and Spearman correlation coefficients. We used Student t test to compare the mean SWE values in healthy children to those of children with increased ICP. Results: Shear wave elastography in the brain was technically feasible, giving reliable SWE measurements in 110 (88.7%) of 124 of healthy children and in 56 (93.3%) of 60 children with hydrocephalus. Shear wave elastography values and, thus, rigidity in the brain's parenchyma were significantly higher in children with hydrocephalus (n = 56) than in healthy children (n = 110; mean, 21.8 kPa vs 14.1 kPa; P = 0.0083). A thorough correlation between invasive ICP measurements and SWE values in a subgroup of patients with hydrocephalus revealed a direct correlation between increased ICP and increased SWE values (r = 0.69, P < 0.001). Mean SWE values were 30.8 kPa (range, 23.9-62.3 kPa) in patients with confirmed increased ICP (n = 35) versus 16.2 kPa (range, 10.2-41.9 kPa) in patients with nonincreased ICP (n = 12). Conclusions: Shear wave elastography is feasible in neonates with increased ICP and could be a useful additional diagnostic imaging and monitoring method for children verified or suspected to have increased ICP. However, more evidence is necessary to further evaluate the usefulness of SWE measurements in neonates with hydrocephalus. Clinical Relevance: Shear wave elastography can be used as a surrogate marker for ICP in neon...

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Transcranial Shear Wave Elastography of Neonatal and Infant Brains for Quantitative Evaluation of Increased Intracranial Pressure

et al. 2019

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“…132 Su et al quantitatively assessed the brain stiffness using ARFI and found significantly higher elasticity in full-term neonates compared with preterm neonates. 133 Both studies did not report adverse outcomes regarding the use of SWE/ARFI in premature neonates. Li et al further explored the immediate and long-term impacts of dynamic radiation force exposure (SWE) on neonatal mice's brain.…”

Section: Potential Riskmentioning

confidence: 97%

Elastogram: Physics, Clinical Applications, and Risks

Chen

et al. 2019

Maternal-Fetal Medicine

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The tissue stiffness is always an interesting issue to clinicians. Traditionally, it is assessed by the manual palpation, and this now can be measured by the ultrasound-based elastography. The basic physics is based on Young's modulus through the Hooke's law: E= S/e, where the Young's modulus (E) equals to the stress applied to the object (S) divided by the generated strain (e). With the rapid advancement of technology, the elastography has evolved from quasi-static elastography (ie, strain elastography) to dynamic elastography (i,e, shear wave elastography). The key differentiation of these two categories roots in the stimuli applied, namely mechanical or acoustic radiation force, and the response of the soft tissue. The strain elastography requires the operator to compress and decompress the tissue manually and the motion of the tissue during the stimuli is tracked to calculate the strain to reflect the tissue stiffness. While strain elastography is operator-dependent, shear wave elastography is not. Using shear wave elastography, the tissue is stimulated by the acoustic radiation force which can generate shear wave traveling through the tissue transversely. The shear wave propagation speed (V s ) is related to the shear modulus (m) of the medium: m = rV s 2 , where r is the density of the tissue and assumed to be a constant as 1000 kg/m 3 . In the incompressible biological tissue, the Young's modulus is approximately three times the shear modulus (E≈3 m). So the quantitative measurements of the tissue stiffness can be attained by shear wave elastography. The clinical application of elastography and its diagnostic capability has been extended. The knowledge of the basic physics of the various type of elastography facilitates the effective use of elastography. This review presented the clinical application and the risks of different types of elastography.

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“…The former would target the geographic region of interest (i.e., white matter versus cortical development), whereas the latter would target the brain region(s) most sensitive to early intracranial pressure changes. Prior studies have utilized coronal and sagittal planes to obtain brain elasticity values, but the methods and results remain heterogeneous [53][54][55][56]. Variations in methods include differences in scanner/transducer choice, scan settings, and protocol.…”

Section: Neonatal Brain Elastography Protocolmentioning

confidence: 99%

“…Several studies have documented the age-dependent evolution of brain stiffness in preterm and term infants [11,[54][55][56]. Su et al [56] used ARFI with VTQ to demonstrate higher brain stiffness in term than preterm infants in cortical, subcortical, and white matter structures.…”

Section: Brain Elasticity In Normal Developmentmentioning

confidence: 99%

Brain contrast-enhanced ultrasonography and elastography in infants

et al. 2022

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Advanced ultrasound techniques, including brain contrast-enhanced ultrasonography and elastography, are increasingly being explored to better understand infant brain health. While conventional brain ultrasonography provides a convenient, noninvasive means of assessing major intracranial pathologies, its value in revealing functional and physiologic insights into the brain lags behind advanced imaging techniques such as magnetic resonance imaging. In this regard, contrast-enhanced ultrasonography provides highly precise functional information on macrovascular and microvascular perfusion, while brain elastography offers information on brain stiffness that may be associated with relevant physiological factors of diagnostic, therapeutic, and/or prognostic utility. This review details the technical background, current understanding and utility, and future directions of these two emerging advanced ultrasound techniques for neonatal brain applications.

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Application of acoustic radiation force impulse imaging (ARFI) in quantitative evaluation of neonatal brain development

Cited by 22 publications

References 21 publications

Transcranial Shear Wave Elastography of Neonatal and Infant Brains for Quantitative Evaluation of Increased Intracranial Pressure

Transcranial Shear Wave Elastography of Neonatal and Infant Brains for Quantitative Evaluation of Increased Intracranial Pressure

Elastogram: Physics, Clinical Applications, and Risks

Brain contrast-enhanced ultrasonography and elastography in infants

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