BMC Medical Imaging最新文献

Objectives: Atherosclerosis is influenced by hemodynamic forces and arterial stiffness. Vector flow imaging (VFI) provides assessment of wall shear stress (WSS) and turbulence, while radiofrequency-based quantitative analysis (RVQS) measures hardness coefficient (HC) and pulse wave velocity (PWV). To date, these techniques have not been applied together in a well-characterised healthy cohort. This study aimed to evaluate segmental age and sex-related differences in the carotid artery using VFI and RVQS.

Methods: Sixty healthy volunteers (30 women, 30 men; aged 20-59 years) underwent carotid ultrasonography. The common carotid artery (CCA), the bifurcation (BIF), and the internal carotid artery (ICA) segments were examined. WSS, turbulence, HC, PWV, and distension parameters were measured in each segment. Non-parametric tests were used.

Results: Significant segmental variation was found (p < 0.001). The BIF showed the lowest mean WSS (median = 0.84 Pa, < 0.001), the highest turbulence 3.87 (< 0.001), and the highest stiffness (HC: 3.22 < 0.001, PWV: 6.04, < 0.001). ICA had greatest distension (866 μm, < 0.001) and lowest stiffness (HC = 1.25, < 0.001, PWV: 3,83 < 0.001). Older participants had markedly stiffer arteries. PWV was higher in the older vs. younger group at both CCA (6.1 m/s vs. 4.6 m/s, p < 0.001) and BIF (7.2 vs. 4.96 m/s, p < 0.001). HC was also significantly higher in CCA and BIF (3.3 vs. 1.8, p < 0.001, 1.3 vs. 2.3, p < 0.001). Distension decreased with age in CCA and BIF (CCA: 364 vs. 560 μm, p < 0.001, BIF: 547 vs. 355 μm, p < 0.001). In contrast, WSS and turbulence did not differ significantly by age. Women exhibited higher mean WSS in the ICA (1.3 vs. 1.1 Pa, p = 0.018) and BIF (0.94 vs. 0.74 Pa, p = 0.045). Men showed slightly higher turbulence in the ICA (TAT = 1.1 vs. 0.5, p = 0.020).

Conclusion: The study revealed marked segmental and demographic differences in atherosclerosis parameters. RVQS parameters showed significant age-related differences, whereas WSS did not vary with age in this healthy group (20-59 years), suggesting RVQS may be more sensitive for detecting subclinical early vascular change. The combined application of VFI and RVQS may provide a physiologic reference framework for assessing the carotid arteries.

Background: Diabetic peripheral neuropathy (DPN) is a prevalent complication of diabetes mellitus, and is often underdiagnosed because of its variable clinical presentation and operator-dependent diagnostic tools. Shear wave elastography (SWE), which quantitatively evaluates tissue stiffness, has the potential to enhance conventional ultrasound by improving diagnostic accuracy and consistency. Nevertheless, a comprehensive analysis examining the extent to which the integration of SWE with conventional ultrasound can enhance the diagnostic performance of radiologists across varying levels of expertise has yet to be performed.

Methods: In this study, a total of 458 lower extremities from patients with type 2 diabetes were examined via ultrasound and SWE. Four radiologists (two seniors and two juniors) independently assessed the grayscale ultrasound, SWE, and combined images. Diagnostic performance was compared via receiver operating characteristic (ROC) curves and sensitivity and specificity metrics.

Results: SWE measurements revealed significantly greater stiffness of the tibial nerve in the DPN group than in the non-DPN group, with values of 37.30 kPa versus 25.40 kPa (P < 0.001) and corresponding shear wave velocities of 3.54 m/s versus 2.90 m/s (P < 0.001). The combined images improved diagnostic accuracy across all readers. Notably, junior radiologists exhibited a substantial improvement in terms of sensitivity (ΔSensitivity = 25.565, 95% CI: 18.477-32.653, P = 0.004). In contrast, for the senior radiologists, neither the sensitivity nor the specificity significantly increased with increasing integration SWE.

Conclusion: Combining SWE with conventional ultrasound improves the diagnostic accuracy for DPN and helps reduce performance gaps between junior and senior radiologists. SWE may serve as an effective adjunct to support early detection and consistent evaluation of DPN in clinical practice.