Value of Real‐Time Shear Wave Elastography Versus Acoustic Radiation Force Impulse Imaging in the Diagnosis of Female Bladder Neck Obstruction

Abstract

Objective-To investigate the application value of shear wave elastography (SWE) and acoustic radiation force impulse imaging (ARFI) in the diagnosis of female bladder neck obstruction (FBNO), we compared the advantages of these 2 methods to provide a more accurate reference for clinical work.Methods-From April 2016 to February 2018, 27 patients who were diagnosed with FBNO by cystoscopy and/or urine dynamics testing were selected for the study, together with 24 healthy adults in a case-control study at Liaoning Province People's Hospital. We collected general information from 27 patients with FBNO, and using transperineal 2-dimensional ultrasound detection, shear wave elastography (SWE) and ARFI were used, respectively, to detect the Young's modulus and shear wave velocity (SWV) of the bladder necks. Cystoscopy results were considered to be the gold standard, and receiver operating characteristic (ROC) curves were drawn for ARFI, SWE, and the combined diagnosis of the two. The efficacy of the diagnosis was determined by comparing the areas under the ROC curves and calculating the sensitivity, specificity, and accuracy.Results-The areas under the ROC curve for the Q-box mean and max value detected by SWE for FBNO patients were 88.4% and 89.9%, respectively, and the sensitivity, specificity, and accuracy were 81.5%, 79.2%, and 80.4%, respectively. The area under the ROC curve detected by ARFI for FBNO patients was 93.7%, and the sensitivity, specificity, and accuracy were 88.9%, 79.2%, and 84.3%, respectively. The sensitivity, specificity, and accuracy of the combined detection of ARFI and SWE were 92.5%, 87.5%, and 90.2%, respectively. The best diagnostic cutoff point of the SWV or the Q-box mean and max value of SWE in FBNO obtained with the ROC curve was SWV = 2.38 m/s (sensitivity, 71.4%; specificity, 82.5%), Q-box mean = 20.2 kPa, Q-box max = 39.8 kPa (sensitivity, 67.5%; specificity, 76.2%). The average shear wave velocity of ARFI, Q-box mean, and Q-box max value of SWE in the control group were 1.89 AE 0.35 m/s, 15.3 AE 3.6 kPa, and 29.2 AE 8.7 kPa, respectively. In the FBNO group, these values were 2.81 AE 0.63) m/s, 27.2 AE 8.6 kPa, and 51.2 AE 12.3 kPa, respectively. The differences were statistically significant (P < .05).Conclusion-The value of the ARFI in the diagnosis of FBNO is a little greater than that of SWE in terms of sensitivity and accuracy, and the combined detection of ARFI and SWE performs better than ARFI or SWE employed separately.Abbreviations 2D, 2-dimensional; ARFI, acoustic radiation force impulse imaging; FBNO, female bladder neck obstruction; P det , detrusor pressure; Q max , maximum urine flow rate; ROC, receiver operating characteristic; ROI, region of interest; SWE, shear wave elastography; SWV, shear wave velocity.

Can shear wave elastography be utilized as an additional tool for the assessment of non-mass breast lesions?

“…13 In addition, some believe that for isotropic tissues, such as breast, liver, and thyroid, the diagnostic value of SWE is superior to that of acoustic radiation force impulse. 16 SWE improves the specificity of conventional US in differentiating malignant from benign breast masses. 17,18 Few studies have described SWE characteristics of NMLs; therefore, we conducted this study to define SWE characteristics of NMLs and to assess the measures of diagnostic accuracy of grayscale US and US þ SWE for differentiation of benign and malignant NMLs, using histopathologic results as a gold standard.…”

Elastography in the Urological Practice: Urinary and Male Genital Tract, Prostate Excluded—Review

“…The sensitivity and accuracy of pSWE were better than SWE in diagnosing female bladder neck obstruction. The combined use of pSWE and 2D SWE outperformed their separate use [ 94 ].…”