Valsalva Maneuver Decreases Liver and Spleen Stiffness Measured by Time-Harmonic Ultrasound Elastography
Ultrasound elastography quantitatively measures tissue stiffness and is widely used in clinical practice to diagnose various diseases including liver fibrosis and portal hypertension. The stiffness of soft organs has been shown to be sensitive to blood flow and pressure-related diseases such as port...
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Bioengineering and Biotechnology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fbioe.2022.886363/full |
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| author | Tom Meyer Heiko Tzschätzsch Brunhilde Wellge Ingolf Sack Thomas Kröncke Alma Martl |
| author_facet | Tom Meyer Heiko Tzschätzsch Brunhilde Wellge Ingolf Sack Thomas Kröncke Alma Martl |
| author_sort | Tom Meyer |
| collection | DOAJ |
| description | Ultrasound elastography quantitatively measures tissue stiffness and is widely used in clinical practice to diagnose various diseases including liver fibrosis and portal hypertension. The stiffness of soft organs has been shown to be sensitive to blood flow and pressure-related diseases such as portal hypertension. Because of the intricate coupling between tissue stiffness of abdominal organs and perfusion-related factors such as vascular stiffness or blood volume, simple breathing maneuvers have altered the results of liver elastography, while other organs such as the spleen are understudied. Therefore, we investigated the effect of a standardized Valsalva maneuver on liver stiffness and, for the first time, on spleen stiffness using time-harmonic elastography (THE). THE acquires full-field-of-view stiffness maps based on shear wave speed (SWS), covers deep tissues, and is potentially sensitive to SWS changes induced by altered abdominal pressure in the hepatosplenic system. SWS of the liver and the spleen was measured in 17 healthy volunteers under baseline conditions and during the Valsalva maneuver. With the Valsalva maneuver, SWS in the liver decreased by 2.2% (from a median of 1.36 m/s to 1.32 m/s; p = 0.021), while SWS in the spleen decreased by 5.2% (from a median of 1.63 m/s to 1.51 m/s; p = 0.00059). Furthermore, we observed that the decrease was more pronounced the higher the baseline SWS values were. In conclusion, the results confirm our hypothesis that the Valsalva maneuver decreases liver and spleen stiffness, showing that THE is sensitive to perfusion pressure-related changes in tissue stiffness. With its extensive organ coverage and high penetration depth, THE may facilitate translation of pressure-sensitive ultrasound elastography into clinical routine. |
| first_indexed | 2024-12-12T13:12:27Z |
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| language | English |
| last_indexed | 2024-12-12T13:12:27Z |
| publishDate | 2022-05-01 |
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| series | Frontiers in Bioengineering and Biotechnology |
| spelling | doaj.art-d7e9c77823e147ba920b194362568c102022-12-22T00:23:29ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852022-05-011010.3389/fbioe.2022.886363886363Valsalva Maneuver Decreases Liver and Spleen Stiffness Measured by Time-Harmonic Ultrasound ElastographyTom Meyer0Heiko Tzschätzsch1Brunhilde Wellge2Ingolf Sack3Thomas Kröncke4Alma Martl5Department of Radiology, Charité—Universitätsmedizin Berlin, Berlin, GermanyDepartment of Radiology, Charité—Universitätsmedizin Berlin, Berlin, GermanyDepartment of Radiology, Charité—Universitätsmedizin Berlin, Berlin, GermanyDepartment of Radiology, Charité—Universitätsmedizin Berlin, Berlin, GermanyDepartment of Diagnostic and Interventional Radiology and Neuroradiology, Universitätsklinikum Augsburg, Augsburg, GermanyDepartment of Diagnostic and Interventional Radiology and Neuroradiology, Universitätsklinikum Augsburg, Augsburg, GermanyUltrasound elastography quantitatively measures tissue stiffness and is widely used in clinical practice to diagnose various diseases including liver fibrosis and portal hypertension. The stiffness of soft organs has been shown to be sensitive to blood flow and pressure-related diseases such as portal hypertension. Because of the intricate coupling between tissue stiffness of abdominal organs and perfusion-related factors such as vascular stiffness or blood volume, simple breathing maneuvers have altered the results of liver elastography, while other organs such as the spleen are understudied. Therefore, we investigated the effect of a standardized Valsalva maneuver on liver stiffness and, for the first time, on spleen stiffness using time-harmonic elastography (THE). THE acquires full-field-of-view stiffness maps based on shear wave speed (SWS), covers deep tissues, and is potentially sensitive to SWS changes induced by altered abdominal pressure in the hepatosplenic system. SWS of the liver and the spleen was measured in 17 healthy volunteers under baseline conditions and during the Valsalva maneuver. With the Valsalva maneuver, SWS in the liver decreased by 2.2% (from a median of 1.36 m/s to 1.32 m/s; p = 0.021), while SWS in the spleen decreased by 5.2% (from a median of 1.63 m/s to 1.51 m/s; p = 0.00059). Furthermore, we observed that the decrease was more pronounced the higher the baseline SWS values were. In conclusion, the results confirm our hypothesis that the Valsalva maneuver decreases liver and spleen stiffness, showing that THE is sensitive to perfusion pressure-related changes in tissue stiffness. With its extensive organ coverage and high penetration depth, THE may facilitate translation of pressure-sensitive ultrasound elastography into clinical routine.https://www.frontiersin.org/articles/10.3389/fbioe.2022.886363/fullultrasound elastographytime-harmonic elastographyValsalva maneuverliver stiffnessspleen stiffness |
| spellingShingle | Tom Meyer Heiko Tzschätzsch Brunhilde Wellge Ingolf Sack Thomas Kröncke Alma Martl Valsalva Maneuver Decreases Liver and Spleen Stiffness Measured by Time-Harmonic Ultrasound Elastography Frontiers in Bioengineering and Biotechnology ultrasound elastography time-harmonic elastography Valsalva maneuver liver stiffness spleen stiffness |
| title | Valsalva Maneuver Decreases Liver and Spleen Stiffness Measured by Time-Harmonic Ultrasound Elastography |
| title_full | Valsalva Maneuver Decreases Liver and Spleen Stiffness Measured by Time-Harmonic Ultrasound Elastography |
| title_fullStr | Valsalva Maneuver Decreases Liver and Spleen Stiffness Measured by Time-Harmonic Ultrasound Elastography |
| title_full_unstemmed | Valsalva Maneuver Decreases Liver and Spleen Stiffness Measured by Time-Harmonic Ultrasound Elastography |
| title_short | Valsalva Maneuver Decreases Liver and Spleen Stiffness Measured by Time-Harmonic Ultrasound Elastography |
| title_sort | valsalva maneuver decreases liver and spleen stiffness measured by time harmonic ultrasound elastography |
| topic | ultrasound elastography time-harmonic elastography Valsalva maneuver liver stiffness spleen stiffness |
| url | https://www.frontiersin.org/articles/10.3389/fbioe.2022.886363/full |
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