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Objective@#To explore the application value of virtual touch tissue imaging quantification(VTIQ) technology in initial polymyositis(PM).@*Methods@#Sixteen PM patients collected from February 2016 to March 2019 in Wenzhou People′s Hospital were selected as PM group, and 33 healthy subjects as healthy control group. After gray and color Doppler ultrasound, the shear wave velocity(SWV) values of target muscle and control muscle in the same side of affected limb were measured by VTIQ technique. Maximum velocity(Vmax) and minimum velocity(Vmin) were measured, average velocity(Vmean) and standard deviation(SD) were calculated, and compared between the two groups. SWV difference and ratio between target muscle and control muscle were calculated, and creatine kinase(CK) was detected in the same day.@*Results@#Part of PM patients had abnormal ultrasonographic manifestations of full muscle shape (31.25%), increased or decreased echo of muscle bundles (56.25%), blurred muscle texture (25.00%) and increased blood flow signals (37.50%). There were significant differences in Vmin, SD, and Vmax difference, Vmin difference, Vmean difference, and Vmax ratio, Vmin ratio, and Vmean ratio between PM group and healthy control group (all P<0.01). The ROC curve analysis showed that the diagnostic efficiency of Vmin was lower than those of Vmin difference and Vmean difference, Vmin ratio and Vmean ratio with very close diagnostic efficiencies of the latter four parameters. The correlation analysis showed that Vmin difference and Vmean difference were moderately correlated with CK value(r=0.512, 0.601; all P<0.05).@*Conclusions@#Reduced VTIQ values or relative reduction of VTIQ values compared with other non-involved muscles are the manifestations of initial PM, VTIQ have certain diagnostic efficacy for initial PM.
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Objective: To explore the value of virtual touch tissue imaging quantification (VTIQ) combined with contrast-enhanced ultrasound (CEUS) in differential diagnosis of benign and malignant TI-RADS 4 thyroid nodules. Methods: Totally 86 patients underwent surgical operation and were pathologically diagnosed were selected, including 45 benign(benign group) and 53 malignant ( malignant group) TI-RADS 4 thyroid nodules. VTIQ and CEUS were performed before operation, and the maximal shear wave velocity (SWVmax), minimum shear wave velocity (SWVmin), mean shear wave velocity (SWVmean) as well as the ratio of lesion SWVmax to the surrounding normal tissue shear wave velocity (SWVratio) and CEUS characteristics were obtained and recorded. Then Logistic regression model of VTIQ combined with CEUS was established, the diagnostic effectiveness of VTIQ, CEUS and the combination of VTIQ and CEUS regression models of benign and malignant TI-RADS 4 thyroid nodules were compared using area under the curve (AUC). Results: SWVmax, SWVmin, SWVmean and SWVratio in malignant group were all higher than those in benign group (all P2.96 m/s and low enhancement were important indexes for malignant nodules (P<0.05). AUC of SWVmean, CEUS and Logistic regression model were 0.862, 0.835 and 0.933, respectively. Conclusion: VTIQ and CEUS have good differential diagnostic ability for benign and malignant TI-RADS 4 thyroid nodules. Combination of VTIQ and CEUS can significantly improve the diagnostic effectiveness.
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Objective: To observe elastic features of breast cancer with different molecular subtype using virtual touch tissue imaging quantification (VTIQ) technique. Methods: Totally 101 patients with pathologically proven breast cancers were collected. All patients underwent preoperative routine ultrasound and VTIQ examination. The elastic features and the maximum shear wave velocity (SWVmax) were obtained with VTIQ technique, and the molecular subtypes of breast cancers were recorded according to pathological findings after surgical resection. The elastic features and SWVmax of different molecular subtype breast cancer were analyzed. Results: The predominant elastic model of Luminal tumor was edge advantage, of human epidermal growth factor receptor-2epidermal growth factor 2 (HER-2) expression type tumor was center advantage, while of triple-negative type tumor was homogeneity (PLuminal B type>HER-2 expression type>triple-negative type. No significant difference of SWVmax in central region of breast cancer was observed among different molecular subtypes (P>0.05), nor of SWVmax in tumor surrounding tissue (P>0.05). Conclusion: The elastic features and SWVmax, especially in the marginal regions of breast cancers are related with molecular subtype,which may reflect the biological characteristics of breast cancer on certain degree. VTIQ may be helpful to treatment planning and evaluation on prognosis of breast cancer.
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Objective To explore the value of virtual touch tissue imaging quantification(VTIQ) and contrast-enhanced ultrasonography(CEUS) in the differential diagnosis of benign and malignant breast lesions with non-mass type. Methods A retrospective analysis of 85 cases by conventional ultrasound examination for the type of breast lesions in patients of image data,with pathologic results as the gold standard,analysis of US,VTIQ,CEUS and VTIQ joint CEUS for the breast type value in the differential diagnosis of benign and malignant lesions. Results There were 46 benign cases and 39 malignant cases in 85 cases of breast non-mass lesions. The internal shear wave velocity (SWV) and SWV ratio of breast non-mass benign lesions were significantly lower than that of malignant lesions(3. 43 ± 0. 59 m/s vs 4. 76 ± 0. 95 m/s,1. 73 ± 0. 43 vs 2. 67 ± 0. 77). The sensitivity,specificity and accuracy of VTIQ in the diagnosis of breast non-mass-like lesions were 76. 9％,80. 4％ and 78. 8％ respectively. Type of breast malignant lesions CEUS was high-enhanced enhancement compared with glandular tissue around the contrast agent into early enhancement and immediately wash-out and more for the nonuniformity,around the lesions or internal contrast enhancement of blood vessels,the sensitivity of CEUS in the diagnosis of mammary gland non tumor lesions, specific degrees and accuracy were 79. 5％,80. 4％ and 80. 0％ respectively. VTIQ type combined with CEUS in the diagnosis of breast mass lesions sensitivity and accuracy of the specific degree were 89. 7％,93. 5％ and 91. 8％ respectively,the joint diagnosis efficiency was significantly higher than single use of CEUS or VTIQ (P< 0. 05),CEUS and VTIQ diagnostic value were significantly higher than the US (P < 0. 05). Conclusion CEUS,VTIQ type in breast tumors in the differential diagnosis of benign and malignant lesions has good diagnostic value,VTIQ joint CEUS complementary advantages,more comprehensive diagnostic information available pathological changes,the type of breast disease diagnosis accuracy is improved.
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Objective To measure the shear wave velocity (SWV) of normal adult testis using virtual touch tissue imaging quantification(VTIQ), and to analyze the main impact factors of testicular stiffness and the value of VTIQ in evaluation of testicular spermatogenesis. Methods Totally 200 normal adult male volunteers were recruited and underwent routine testicular ultrasonography for the measurement of bilateral testicular volume. VTIQ technique was used to measure SWV of the upper, middle and lower poles of the bilateral testis. The differences of SWV in bilateral testis and testis of different age groups were compared. The correlation of SWV with age, testicular volume and sperm motility and density was analyzed. Results SWV of both the left and right lateral testis of 200 normal adult males were (1.23±0.18)m/s, and no statistically significant difference was found (t=-0.376, P=0.710). There were significant differences of SWV among the 21-30 years old group, 31-40 years old group, 41-50 years old and 51-60 years old group (all P<0.001). Testicular SWV was positively correlated with age (r=0.454, P<0.001) and negatively correlated with testicular volume, sperm motility and density (r=-0.649, -0.668, -0.675, all P<0.001). Conclusion VTIQ technique can quantitatively measure testicular tissue hardness, which may be used to initially evaluate testicular spermatogenesis.
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Objective: To explore the value of virtual touch tissue imaging quantification (VTIQ) in evaluation on skeletal muscle hardness after injection of botulinum toxin type A for treatment of forearm pronation muscle spasm after stroke. Methods A total of 31 patients with forearm pronation muscle spasm after stroke were collected. VTIQ examinations were performed on bilateral pronator teres and pronator quadratus before and 1 month after ultrasound-guided injection of botulinum toxin type A. Shear wave velocity (SWV) was measured, and the differences between the affected side and the healthy side were compared before and after the treatment. The modified Ashworth scale (MAS) was used to evaluate the muscle tension of upper limb on the affected side before and after treatment, and the differences were compared, and the correlation with SWV was evaluated. Results: SWV of pronator teres of the affected side was higher than that of the healthy side before treatment (P=0.005). One month after treatment, there was no significant difference in SWV of the pronator teres and pronator quadratus between the affected side and healthy side (both P>0.05). SWV of the pronator teres and pronator quadratus on the affected side were lower after treatment than those before treatment (both P<0.05). The difference of MAS score of the affected upper limb before and after treatment were statistically significant (Z=-2.252, P=0.024). MAS score of upper limb on the affected side was positively correlated with SWV of the pronator teres on the affected side before and after treatment (rs=0.629, 0.653, both P<0.001). Conclusion: VTIQ can be used to dynamically observe muscle hardness of pronator teres and pronator quadratus in patients with spasm of forearm pronator after stroke, and quantitatively evaluate the curative effect of injection of botulinum toxin type A for treatment of forearm pronator muscle spasm after stroke.
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Objective: To investigate the value of single and combination of virtual touch tissue imaging quantification (VTIQ) technique and mammography in diagnosis of benign and malignant breast lesions. Methods: VTIQ and mammography were performed on 99 patients (110 breast lesions).The mean value of shear wave velocity (SWVmean) of breast lesions were obtained. Mammographic classification of breast lesions was obtained with breast imaging reporting and data system (BI-RADS). Taken pathology as gold standard, the ROC curve was used to evaluate the diagnostic efficacy of SWVmean, mammography and the combination of these two methods. The differences of AUC among single and combined VTIQ technique and mammography in diagnosis of benign and malignant breast lesions were compared. Results: SWVmean of benign breast lesions was (3.03±0.78) m/s, of malignant ones was (5.61±2.11) m/s (P<0.001). The cutoff value of SWVmean in diagnosis of benign and malignant breast lesions was 3.93 m/s, and of mammography was BI-RADS 4B. AUC of VTIQ, mammography and combination was 0.870, 0.749 and 0.873, respectively. The differences of AUC between VTIQ technique and mammography, combination and mammography were statistically significant (P=0.036, 0.015), while of AUC between the combination and VTIQ technique was not statistically significant (P=0.908). Conclusion: Combination of VTIQ technique and mammography has high efficacy in diagnosis of benign and malignant breast lesions.
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Objective: To explore the value of virtual touch tissue imaging quantification (VTIQ) in evaluation of rehabilitation effect of children with spastic cerebral palsy. Methods: Forty spastic children were randomly divided into 2 groups (each n=20). Children treated with rehabilitation training and botulinum toxin A (BTA) injection were assigned into BTA group, while those treated with rehabilitation training, BTA injection and extracorporeal shock wave therapy (ESWT) were assigned into BTA+ESWT group. The modified Ashworth scale (MAS) and shear wave velocity (SWV) using VTIQ were assessed before treatment and 1 week, 4 weeks, 12 weeks and 16 weeks after treatment. Results: There were total significant differences in MAS scores and SWV before and after treatment in both 2 groups (all P<0.01). Compared with those before treatment, MAS score and SWV in BTA group decreased to the lowest 4 weeks after treatment (both P<0.05), while MAS score and SWV in BTA+ESWT group significantly decreased 1 week after treatment (both P<0.05). With time going after treatment, MAS scores and SWV in both groups increased gradually, but the differences were still statistically significant compared with those before treatment (all P<0.05). Conclusion: VTIQ can objectively and quantitatively evaluate the hardness of spastic muscles, therefore can be used as an effective method for evaluation rehabilitation treatment of children with spastic cerebral palsy.
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Objective: To explore the value of virtual touch tissue imaging quantification (VTIQ) in evaluation of pre-and post-operative elasticity of incomplete acute closed ruptured Achilles tendon in young and middle-age men. Methods: A total of 32 patients with unilateral incomplete acute closed ruptured Achilles tendon were enrolled. VTIQ examination was performed on bilateral Achilles tendon for speed mode. Achilles tendon was divided into distal segment (5 cm above insertion at the attachment of Achilles tendon), middle segment (>5-10 cm above insertion at the attachment of Achilles tendon ) and proximal segment (from >10 cm above insertion at the attachment of Achilles tendon to musculotendinous junction). SWV was obtained, and then statistical analysis was performed in a neutral position 1 week before, 12 weeks and 24 weeks after operation. Results: SWV of ruptured Achilles tendon was lower than that of healthy side (all P<0.001), of distal segment was higher than of middle and proximal segment for bilateral Achilles tendon (all P<0.01). Twelve weeks after operation, SWV of the middle and distal segment of the healing Achilles tendon were both lower than the healthy side (both P<0.001), while 24 weeks after operation, SWV of distal segment of the healing Achilles tendon was lower than the healthy side (P<0.001). SWV of healing Achilles tendon gradually increased with time going, the difference between the two time points is statistically significant (all P<0.01). Conclusion: VTIQ can be used to quantitatively observe the elasticity of incomplete acute closed ruptured Achilles tendon pre-and post-operation, and provide objective evaluation indicators of Achilles tendon.
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Objective: To compare the diagnostic value of virtual touch tissue quantification (VTQ) technique and virtual touch tissue imaging quantification (VTIQ) technique in benign and malignant breast masses with different sizes. Methods: Totally 219 breast masses were selected and confirmed by pathology. According to the largest diameter, all masses were divided into three groups: 5-10 mm (S1 group), 11-20 mm (S2 group) and 21-39 mm (S3 group). The shear wave velocity (SWV) value (SWVVTQ) was obtained by VTQ examination, the SWV maximum value (SWVmax) and SWVmax to the SWV of the surrounding gland in the same depth (SWVratio) were obtained by VTIQ examination before surgery. The pathological results were used as the criteria to compare the diagnostic value of two virtual touch tissue quantification techniques for benign and malignant breast masses of different sizes. Results: There were significant differences in SWVVTQ, SWVmax, SWVratio between the benign and malignant breast masses in 3 groups (all P0.90. The difference of AUC between SWVVTQ and SWVmax, SWVratio was statistically significant in S1 group (P0.05). Conclusion: For breast masses with the largest diameter >10 mm, the diagnostic value of VTQ and VTIQ techniques are equivalent. For breast masses with the largest diameter ≤10 mm, VTIQ technology has higher diagnostic value than VTQ technology in the diagnosis of benign and malignant breast masses.
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Objective To investigate the value of the automated breast volume scanning (ABVS) combined with virtual touch tissue imaging quantification (VTIQ) in the differential diagnosis of benign and malignant breast lesion.Methods Five hundred and seven patients with a total of 675 breast nodules were detected using ABVS and VTIQ technique.Of them,coronal plane imaging,SWVmax,SWVmin,and SWVmean (in m/s) for each nodule was acquired three days before operation or core needle biopsy.According to pathological results,the receiver operating characteristic (ROC) curve analysis was performed to evaluate the utility of the ABVS alone (retraction phenomenon on coronal plane),VTIQ alone and their combination in the diagnosis of breast lesions.Results Among all nodules,504 lesions were benign,and 171 were malignant.The rate of retraction phenomenon on coronal plane in malignant lesions was significantly higher than that in benign lesions (x2=279.89,P ＜ 0.001).The value of SWVmax,SWVmin,SWVmean (6.79± 1.71 m/s,5.03 ± 1.24 m/s,5.74± 1.36 m/s) in malignant nodules were higher than that of benign nodules [(3.41 ±1.51) m/s,(2.46± 0.87) m/s,(2.65 ± 1.23) m/s],the differences were statistically significant (t=32.43,33.85,26.77,all P ＜ 0.001).The AUC of malignant nodules for SWV (maximum,minimum,and average) were 0.922,0.934 and 0.937,respectively.With cut-off value of 4.045 m/s,SWVmean showed the best diagnostic performance.The sensitivity,specificity and accuracy of the retraction phenomenon on coronal plane,SWVmean and their combination in diagnosing malignant breast lesion were (39.65％,94.39％,95.78％),(97.50％,94.39％,95.53％) and (82.84％,93.51％,94.25％),respectively.And the SWVmean showed significant higher sensitivity than that of retraction phenomenon.The diagnostic capacity significantly improved when the two approaches were combined.Conclusion Both the retraction phenomenon on coronal plane and VTIQ had high diagnostic value,combining the two methods can improve the differential diagnosis ability for breast lesions.
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Objective To assess the correlation between the shear wave velocity(SWV) and the ratio of type Ⅰ /type Ⅲ collagen fibers in plaques using virtual touch tissue imaging quantification(VTIQ).Methods Fifty four patients (54 plaques) who scheduled to carotid endarterectomy(CEA) were enrolled in this study.Their carotid plaques were preoperatively examined using VTIQ.The value of SWE of each plaque was obtained.The SWV of the plaque was evaluated by VTIQ.The endarterectomy specimens were transferred to the pathological department immediately after surgery to evaluate the plaque types and the distribution of collagen fibers in plaques.According to HE staining,the 54 plaques were divided into stable and unstable group.Results Among 54 plaques,14 were stable plaque and 40 were unstable plaques.The thickness and stenosis rate had no significant difference between stable group and unstable group (both P ＞ 0.05).The mean value of SWV and the ratio of type Ⅰ/typeⅢ collagen fiber in stable plaques were higher than those in the unstable plaques (both P ＜0.05).Based on ROC analysis,a cut-off value of SWE of 3.725 m/s (AUC=0.936) showed a sensitivity of 92.9％,a specificity of 80.0％ and an accuracy of 83.3％ for predicting stable plaques (95％ CI 0.818-0.982,P ＜0.05).The value of SWVs was closely correlated to the ratio of type Ⅰ/typeⅢ collagen fiber in plaques(r =0.882,P ＜0.05).Conclusions SWV of the carotid atherosclerotic plaque can be used to reflect the ratio of the type Ⅰ/typeⅢ collagen fiber in the plaques,and to evaluate the stability of plaque.