Today, more and more often, the method of ultrasound elastography is used to diagnose liver pathologies. It allows you to «probe» the organ, determining its density in different areas. In addition to the liver, this technique allows you to examine various soft tissues and organs, identify diseases of the subcutaneous tissue, and problems in the structure of the thyroid gland. In women, when performing elastography, benign adenomas can be distinguished from cancerous nodes in the breast. What information can elastography give a doctor, what is its value and uniqueness?
What information does elastography give a doctor?
Ultrasound elastography has been used in scientific research for about 20 years, but in practical medicine, as one of the diagnostic methods, doctors use it relatively recently. Using the apparatus for elastography, it is possible to qualitatively and quantitatively determine the mechanical properties of the glands, soft tissues, including fiber, and internal organs. The basis of the technique lies in the following fact: all body tissues, including those in the area of pathological foci, have a certain level of rigidity (elasticity). During the study, ultrasound beams, sent and perceived by the sensor, like a doctor, “probe” a certain organ. The program evaluates the elasticity of the sections. This allows you to distinguish an inflammatory seal, an adenoma from a cancerous lesion.
With a conventional ultrasound scan, the doctor cannot distinguish between benign and malignant seals in the area of parenchymal organs, various glands or soft tissues. Ultrasound elastography complements the picture, helping to identify and differentiate the neoplasm earlier, and subsequently helps in monitoring treatment, reducing the number of biopsies.
Where the technique is applied: detection of adenoma, cancer, fibrosis
Today, doctors prescribe ultrasound elastrography (aka elastosonography) in the differential diagnosis of neoplasms in soft tissues, glandular organs, and fiber, which provides new opportunities for making a diagnosis with minimal invasive interventions. Evaluation of the elasticity of tissue structures is useful, for example, when a seal is detected in the mammary gland. Scanning allows you to determine whether it is an adenoma, a fibrous focus or a cancerous one. Elastography of soft tissues, lymph nodes, and thyroid gland is also performed. In addition to adenoma, it is possible to determine inflammatory foci, cysts, and other lesions.
Elastography helps in detecting tissue fibrosis (proliferation of connective tissue areas, formation of cicatricial deformities). This eliminates the need for a diagnostic biopsy.
If we talk about endocrinology, with the help of elastography, the thyroid gland is often examined. The technique helps to clarify the nature of the formations found when probing the organ or during a conventional ultrasound. So, elastosonography of the thyroid gland allows you to determine whether it is a colloidal cyst of the gland, an adenoma or a cancerous node, eliminating the need for an invasive biopsy procedure. No less important is the definition of such a pathology as thyroiditis, since the density of the tissue against the background of inflammatory changes increases significantly, the thyroid gland changes its structure. By conducting this clarifying method of ultrasound diagnostics, the doctor can select the category of patients who really need a biopsy, separating them from those patients who need only dynamic observation.
Detection of liver pathology according to ultrasound elastography
Such pathology of the liver as fibrosis or cirrhosis often requires a needle biopsy to establish the final diagnosis. This is an invasive procedure that is carried out through the skin with a special needle, taking a small area of the affected organ tissue. This is an expensive, extremely unpleasant procedure, which is also fraught with complications with side effects. Analysis of the obtained tissues and determination of the nature of liver pathology requires time and the availability of a special laboratory. Elastosonography allows the doctor to obtain reliable information much faster, saving the patient from invasive intervention and tedious waiting. Moreover, a specific liver lesion is determined with a certainty of 88 to 99% within 20 minutes of scanning. This makes elastography one of the most accessible and sensitive non-invasive diagnostic methods. It is indicated for suspected fibrous transformation of the liver tissue, as well as to determine the specific stage of organ fibrosis. Elastrography provides significant assistance in the separation of such pathological formations of the liver as hemangioma and cancer. In addition to the liver itself, the state of the lymph nodes of intra-abdominal localization can also be assessed.
Oncological diseases, tissue neoplasms
Elastography allows, without additional intervention, to determine the fibrous transformation of tissues or organs, breast cancer, lesions of the lymph nodes or the thyroid gland. In addition, it allows you to identify many liver diseases, including cirrhosis, fibrosis and cancer, hemangiomas and cysts. It is also used in monitoring benign neoplasms in the area of soft tissues, or lesions of the subcutaneous tissue, and also allows you to assess the presence of abnormalities in the structure of tissues against the background of wound healing (detection of keloid scars), with scleroderma, psoriasis. It also allows you to determine skin edema in some systemic diseases and metabolic disorders.
The use of ultrasound elastography helps in the detection of melanoma, skin carcinomas. Among the indications for scanning, the presence of a palpable infiltrate under the skin is distinguished in order to clarify its nature. Elastosonography allows you to determine tissue inflammation, lipomas and primary skin cancer, as well as the presence of metastases. Using this technique, the state of regional lymph nodes is also assessed with their increase.
The only problem with the technique today is the lack of devices in the field in clinics. Not all diagnostic centers are equipped with powerful ultrasound scanners capable of performing elastography.
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