Elastography

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Medical imaging technique to map tissue stiffness


Elastography is a medical imaging modality that maps the elastic properties and stiffness of soft tissue. It is used to detect and characterize various diseases, particularly those that alter the mechanical properties of tissues, such as cancer and fibrosis.

Principles of Elastography[edit | edit source]

Elastography is based on the principle that pathological tissues often have different mechanical properties compared to normal tissues. By applying a mechanical force to the tissue and measuring the resulting displacement, elastography can provide a visual map of tissue stiffness.

Types of Elastography[edit | edit source]

There are several types of elastography, each utilizing different techniques to measure tissue stiffness:

  • Strain Elastography: This method involves applying a manual or mechanical compression to the tissue and measuring the resulting strain. It is often used in breast and thyroid imaging.
  • Shear Wave Elastography: This technique uses focused ultrasound to generate shear waves within the tissue. The speed of these waves is measured to determine tissue stiffness. It is commonly used in liver and musculoskeletal imaging.
  • Magnetic Resonance Elastography (MRE): MRE uses magnetic resonance imaging to visualize the propagation of mechanical waves through tissues, providing a quantitative measure of tissue stiffness.

Applications of Elastography[edit | edit source]

Elastography is used in various clinical applications, including:

Breast Imaging[edit | edit source]

Breast self-exam illustration

Elastography is used to differentiate between benign and malignant breast lesions. Malignant tumors tend to be stiffer than benign ones, making elastography a valuable tool in breast cancer diagnosis.

Thyroid Imaging[edit | edit source]

Thyroid elastography showing papillary thyroid carcinoma

In thyroid imaging, elastography helps in assessing thyroid nodules. Stiffer nodules are more likely to be malignant, aiding in the decision-making process for biopsy.

Liver Imaging[edit | edit source]

VCTE showing normal and cirrhotic livers

Elastography is widely used to assess liver fibrosis. It provides a non-invasive alternative to liver biopsy for evaluating the degree of fibrosis in patients with chronic liver disease.

Prostate Imaging[edit | edit source]

Prostate elastography with histology

Elastography can be used to detect prostate cancer by identifying areas of increased stiffness within the prostate gland.

Musculoskeletal Imaging[edit | edit source]

Supersonic shear imaging of hand muscle stiffness

In musculoskeletal applications, elastography assesses muscle stiffness and can help diagnose conditions such as tendinopathy and muscle tears.

Brain Imaging[edit | edit source]

Brain MRE showing mechanical properties

MRE is used to study the mechanical properties of brain tissue, which can be altered in conditions such as Alzheimer's disease and multiple sclerosis.

Advantages and Limitations[edit | edit source]

Elastography offers several advantages, including being non-invasive, providing real-time results, and enhancing the diagnostic accuracy of conventional imaging techniques. However, it also has limitations, such as operator dependency and variability in results depending on the technique used.

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Contributors: Prab R. Tumpati, MD