Reinhard I. Kubale MD, Presenter: Nothing to Disclose

Jonas Stroeder MD, Abstract Co-Author: Nothing to Disclose

Heinrike Wilkens, Abstract Co-Author: Nothing to Disclose

Arno Buecker MD, Abstract Co-Author: Consultant, Covidien AG Speaker, Covidien AG Co-founder, Aachen Resonance GmbH Research Grant, Siemens AG

Elastography can provide information about tissue’s mechanical property. The new variant of shear wave imaging (SVI) enables a quick examination not only of breast tumours but also of tendons and liver stiffness. Purpose of this study is to evaluate its feasibility for depicting subpleural parenchymal lung disease and to evaluate influencing physical factors.

In a group of 30 normal patients proved by HRCT shear wave images, ARFI measurements and displacement maps are analyzed for reproducibility and variation of displacement of lung structures in the subpleural space (Siemens S3000). The effect of frequency, depth of pleural structures and aperture of the scan heads were analyzed. In 25 patients with subpleural fibrotic changes proved by CT and in one sided lung transplant patients with fibrosis the displacement maps are are scored and compared with HRCT.

A good quality of the displacement map was seen in 28/30 of patients with normal lungs. 25/30 patients had a clear delineation between normal lung and pleura. Problems are seen in the basal area due to muscles and depth. 21/25 patients with fibrotic changes had a focal or general reduced displacement in the subpleural space correlating with CT (fig. 1). False positive results are caused by sub pleural metastasis and pneumonia in 2 cases.

Although quantitative measurements of the shear wave velocity in the subpleural space showed a great variation, semiquatitative analysis of the displacement map of subpleural lung parenchyma could be a useful tool for diagnosis and noninvasive follow-up controls of early stages of lung fibrosis. Factors that should be standardized are - Frequency and aperture size of the scan head and its elements - compression and amount of inspiration

Elastography of the subpleural space can be a useful tool for early depiction of sub pleural fibrosis.

Kubale, R, Stroeder, J, Wilkens, H, Buecker, A, Shear Wave Imaging and ARFI Technique: Potential Tools for Analyzing Early Fibrotic Changes in the Sub Pleural Space - Experimental Data and First Clinical Results.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14018870.html