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Measurement of Liver Stiffness Using Shear Wave Elastography in a Rat Model: Factors Impacting Stiffness Measurement with Multiple and Single Tracking Location Techniques

机译：使用剪切波弹性成像在大鼠模型中测量肝脏僵硬度：影响使用单次跟踪定位技术进行多次僵硬度测量的因素

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The clinical use of elastography for monitoring fibrosis progression is challenged by the subtle changes in liver stiffness associated with early stage fibrosis, and the comparatively large variance of stiffness estimates provided by elastography. Single Tracking Location Shear Wave Elasticity Imaging (STL-SWEI) is an ultrasound elastography technique that was previously demonstrated to provide improved estimate precision compared to Multiple Tracking Location (MTL) SWEI. As a result of improved precision, it is reasonable to expect that STL-SWEI would provide improved ability to differentiate liver fibrosis stage compared to MTL-SWEI. However, this expectation has not been previously challenged rigorously. In this work, the performance of STL- and MTL-SWEI in the setting of a rat model of liver fibrosis is characterized and the advantages of STL-SWEI in staging fibrosis are explored. The purpose of this study is to determine what advantages, if any, arise from utilizing STL-SWEI instead of MTL-SWEI in the characterization of fibrotic liver. Thus, the ability of STL-SWEI to differentiate livers at various METAVIR fibrosis scores, for ex vivo, post-mortem measurements, is explored. In addition, we examine the effect of the common confounding factor of fluid versus solid boundary conditions in SWEI experiments. Sprague-Dawley rats are treated with carbon tetrachloride over several weeks to produce liver disease of varying severity. STL and MTL stiffness measurements were performed ex vivo and compared to the METAVIR score from histological analysis and the duration of treatment. A strong association was observed between liver stiffness and weeks of treatment with the liver toxin carbon tetrachloride. Direct comparison of STL- and MTL-SWEI measurements show no significant difference in ability to differentiate fibrosis stages based on SWEI image mean values. However, image interquartile range is greatly improved in the case of STL-SWEI imaging compared to MTL-SWEI at small beam spacings.
机译：弹性成像技术在监测纤维化进程中的临床应用受到了与早期纤维化相关的肝脏硬度的细微变化以及弹性成像技术提供的相对较大的硬度估计值的挑战。单跟踪位置剪切波弹性成像（STL-SWEI）是超声弹性成像技术，先前已证明与多跟踪位置（MTL）SWEI相比可提供更高的估计精度。由于提高了精确度，因此可以合理预期STL-SWEI与MTL-SWEI相比将提供更好的区分肝纤维化分期的能力。但是，这种期望先前并未受到严格的挑战。在这项工作中，表征了STL-和MTL-SWEI在建立肝纤维化大鼠模型中的性能，并探讨了STL-SWEI在分期纤维化中的优势。这项研究的目的是确定利用STL-SWEI代替MTL-SWEI在纤维化肝的表征中有什么优势（如果有）。因此，探索了STL-SWEI区分各种METAVIR纤维化评分的肝脏的能力，以便进行离体，死后测量。此外，我们在SWEI实验中检查了流体与固相边界条件共同混杂因素的影响。用四氯化碳处理Sprague-Dawley大鼠数周，以产生严重程度不同的肝病。离体进行STL和MTL硬度测量，并与组织学分析和治疗持续时间与METAVIR得分进行比较。观察到肝脏僵硬与肝毒素四氯化碳治疗数周之间有很强的联系。对STL和MTL-SWEI测量值的直接比较显示，根据SWEI图像平均值区分纤维化阶段的能力没有显着差异。但是，与小光束间距下的MTL-SWEI相比，在STL-SWEI成像的情况下，图像四分位间距得到了极大的改善。

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