Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
5-Year Impact Factor – 2.2
Scopus CiteScore – 3.4 (CiteScore Tracker 3.4)
Index Copernicus  – 161.11; MEiN – 140 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2015, vol. 24, nr 4, July-August, p. 725–730

doi: 10.17219/acem/34581

Publication type: review article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Ultrasound Elastography – Review of Techniques and Its Clinical Applications in Pediatrics – Part 2

Urszula Zaleska-Dorobisz1,A,B,C,D,E,F, Aleksander Pawluś1,A,B,C,D,E,F, Kinga Szymańska1,A,B,C,D,E,F, Mateusz Łasecki1,D,E,F, Marcin Ziajkiewicz2,B,C,D

1 Department of General and Pediatric Radiology, Independent Public Clinical Hospital No. 1, Wroclaw Medical University, Poland

2 J. Gromkowski Regional Specialist Hospital, Wrocław, Poland


Sonoelastography is a novel technique that uses ultrasound waves to assess the elasticity of tissues noninvasively. It provides an ultrasound-based method to detect and display the relative stiffness of tissue. The main principle of sonoelastography is the measurement of tissue distortion in response to external compression. Changes in elasticity and tissues deformation elicited by compression are measured, processed and then shown in real time presentation with color-coded elastograms. Most of the elastography applications are well known and have been described in detail in adults, e.g. evaluation of liver fibrosis or thyroid nodules. Similarly, most of sonoelastographic studies are based on groups of adults. The purpose of this review article is to bring this technology closer to pediatric clinicians and to summarize some of its current clinical applications that are being pursued. In this part we take into consideration utility of elastography in evaluation pathologies of musculoskeletal system, lymphatic nodes, thyroid, kidneys in pediatric patients and also elastography of placenta.

Key words

sonoelastography, muscles, thyroid.

References (28)

  1. Jid CB, Vasilescu D, Damian L, Dumitriu D, Ciurea A, Dudea SM: Musculoskeletal sonoelastography. Pictorial essay. Med Ultrason 2012, 14, 239–245.
  2. Berko NS, FitzGerald EF, Amaral TD, Payares M, Levin TL: Ultrasound elastography in children: Establishing the normal range of muscle elasticity. Pediatr Radiol 2014, 44, 158–163.
  3. Kwon DR, Park GY, Lee SU, Chung I: Spastic cerebral palsy in children: dynamic sonoelastographic findings of medial gastrocnemius. Radiology 2012, 263, 794–801.
  4. Kwon DR, Park GY: Diagnostic Value of Real-time Sonoelastography in Congenital Muscular Torticollis. J Ultrasound Med 2012, 31, 721–727.
  5. Lee SY, Park HJ, Choi YJ, Choi SH, Kook SH, Rho MH: Value of adding sonoelastography to conventional ultrasound in patients with congenital muscular torticollis. Pediatr Radiol 2013, 43, 1566–1572.
  6. Drakonaki EE, Allen GM: Magnetic resonance imaging, ultrasound and real-time ultrasound elastography of the thigh muscles in congenital muscle dystrophy. Skeletal Radiol 2010, 39, 391–396.
  7. Pawelec K, Wiechecka J, Boruczkowski D: Differential diagnosis enlarged lymph nodes in children. Nowa Pediatr 2012.
  8. Furukawa MK, Kubota A, Hanamura H, Furukawa M: Clinical application of real-time tissue elastography to head and neck cancer – evaluation of cervical lymph node metastasis with real-time tissue elastography. Nihon Jibiinkoka Gakkai Kaiho 2007, 110, 503.
  9. Zhang Y, Lv Q, Yin Y, Xie M, Xiang F, Lu C: The value of ultrasound elastography in differential diagnosis of superficial lymph nodes. Front Med China 2009, 3, 368–374.
  10. Bhatia KS, Cho C, Tong CS, Yuen EH, Ahuja AT: Shear wave elasticity imaging of cervical lymph nodes. Ultrasound Med Biol 2012, 38, 195–201.
  11. Choi YJ, Lee JH, Lim HK, Kim SY, Han MW, Cho KJ: Quantitative Shear Wave Elastography in the Evaluation of Metastatic Cervical Lymph Nodes. Ultrasound Med Biol 2013, 39, 935–940.
  12. Łasecki M, Olchowy C, Sokołowska-Dąbek D, Zaleska-Dorobisz U: Sonoelastography US in evaluation of lymph nodes in children and in young adults. Pol J Radiol 2013, 78, Suppl 1, 292–293.
  13. Niedziela M: Pathogenesis, diagnosis and management of thyroid nodules in children. Endocr Relat Cancer 2006, 13, 427–453.
  14. Aghini-Lombardi F, Antonangeli L, Martino E, Vitti P, Maccherini D, Leoli F: The spectrum of thyroid disorders in an iodine-deficient community: the Pescopagano survey. J Clin Endocrinol Metab 1999, 84, 561–566.
  15. Dinauer CA, Breuer C, Rivkees SA: Differentiated thyroid cancer in children: diagnosis and management. Curr Opin Oncol 2008, 20, 59–65.
  16. Cantisani V, Ulisse S, Guaitoli E, De Vito C, Caruso R, Mocini R: Q-elastography in the presurgical diagnosis of thyroid nodules with indeterminate cytology. PloS One 2012, 7, e50725.
  17. Gharib H, Goellner JR: Fine-needle aspiration biopsy of the thyroid: an appraisal. Ann Intern Med 1993, 118, 282–289.
  18. Guidelines for the management of thyroid cancer. Royal College of Physicians. British Thyroid Association 2007.
  19. Bojunga J, Herrmann E, Meyer G, Weber S, Zeuzem S, Friedrich-Rust M: Real-time elastography for the differentiation of benign and malignant thyroid nodules: a meta-analysis. Thyroid 2010, 20, 1145–1150.
  20. Lippolis PV, Tognini S, Materazzi G, Polini A, Mancini R, Ambrosini CE: Is elastography actually useful in the presurgical selection of thyroid nodules with indeterminate cytology? J Clin Endocrinol Metab 2011, 96, 1826–1830.
  21. Ünlütürk U, Erdoğan MF, Demir Ö, Güllü S, Başkal N: Ultrasound elastography is not superior to grayscale ultrasound in predicting malignancy in thyroid nodules. Thyroid 2012, 22, 1031–1038.
  22. Bhatia KS, Tong CS, Cho CC, Yuen EH, Lee YY, Ahuja AT: Shear wave elastography of thyroid nodules in routine clinical practice: preliminary observations and utility for detecting malignancy. Eur Radiol 2012, 22, 2397–2406.
  23. Corrias A, Mussa A: Thyroid nodules in pediatrics: which ones can be left alone, which ones must be investigated, when and how. J Clin Res Pediatr Endocrinol 2013, 5, Suppl 1, 57.
  24. Bruno C, Caliari G, Zaffanello M, Brugnara M, Zuffante M, Cecchetto M: Acoustic radiation force impulse (ARFI) in the evaluation of the renal parenchymal stiffness in paediatric patients with vesicoureteral reflux: preliminary results. Eur Radiol 2013, 23, 3477–3484.
  25. Lee MJ, Kim MJ, Han KH, Yoon CS: Age-related changes in liver, kidney, and spleen stiffness in healthy children measured with acoustic radiation force impulse imaging. Eur J Radiol 2013, 82, 290–294.
  26. Sugitani M, Fujita Y, Yumoto Y, Fukushima K, Takeuchi T, Shimokawa M: A new method for measurement of placental elasticity: Acoustic radiation force impulse imaging. Placenta 2013, 34, 1009–1013.
  27. Herman BA, Harris GR: Models and regulatory considerations for transient temperature rise during diagnostic ultrasound pulses. Ultrasound Med Biol 2002, 28, 1217–1224.
  28. Palmeri ML, Frinkley KD, Nightingale KR: Experimental studies of the thermal effects associated with radiation force imaging of soft tissue. Ultrason Imaging 2004, 26, 100–114.