Diagnostic value of ultrasonic shear wave elastography in neonatal hypoxic ischemic injury
Objective To explore the diagnostic value of ultrasonic shear wave elastography(SWE)in neonatal hypoxic ischemic injury(HII).Methods 64 neonates were used as study subjects,and the ultrasound SWE technique was applied to measure the elasticity of their intracranial regions of interest(ROIs),which were the right and left lateral ventricles and the brain parenchyma in the basal ganglia region,respectively,and the shear-wave velocity of elastography was converted into Young's modulus to indicate the stiffness of the tissues.The basic information of the neonates was analyzed;the elasticity of bilateral ventricles and basal ganglia were compared between normal neonates and HII neonates;the diagnostic efficacy of HII for elasticity of bilateral ventricle and basal ganglia in neonates was analyzed.Results There were 30 cases of normal neonates and 34 cases of HII neonates among the 64 neonates.The mean,maximum(max),minimum(min),and standard deviation(sd)of the right and left lateral ventricles as well as the basal ganglia region of HII neonates were smaller than those of the normal neonates,and the difference was statistically significant(P<0.05).Based on the mean elasticity,the area under the curve(AUC)[confidence interval(95%CI)],threshold,sensitivity and specificity of the right lateral ventricle were 1.00(1.00,1.00),5.34 kPa,100.00%and 100.00%,those of left lateral ventricle were 0.99(0.98,1.00),5.20 kPa,97.06%,and 96.67%,and those of basal ganglia were 0.92(0.85,0.99),6.32 kPa,88.24%,and 86,67%.Based on the maximum elasticity,the AUC(95%CI),threshold,sensitivity and specificity of the right lateral ventricle were 1.00(0.99,1.00),11.37 kPa,97.06%,and 100.000%,those of left lateral ventricle were 0.98(0.95,1.00),8.98 kPa,94.12%,and 100.00%,and those of basal ganglia were 0.69(0.55,0.83),13.10 kPa,58.82%,and 96.67%.Based on the minimum elasticity,the AUC(95%CI),threshold,sensitivity and specificity of the right lateral ventricle were 0.91(0.82,0.99),3.22 kPa,100.00%,and 76.67%,those of left lateral ventricle were 0.73(0.60,0.86),3.12 kPa,82.35%,and 66.67%,and those of basal ganglia were 0.76(0.63,0.88),2.32 kPa,79.41%,and 76.67%.Based on the standard deviation of elasticity,the AUC(95%CI),threshold,sensitivity and specificity of the right lateral ventricle were 0.98(0.96,1.00),1.62 kPa,91.18%and 96.67%,those of left lateral ventricle were 0.97(0.93,1.00),1.62 kPa,94.12%and 93.33%,and those of basal ganglia were 0.70(0.57,0.83),2.19 kPa,58.82%and 86.67%.The diagnostic efficacy of the left and right lateral ventricles was better than that of the basal ganglia,and the diagnostic efficacy of the mean and maximum values was higher than that of the minimum and standard deviation.Conclusion Ultrasonic SWE measurement of brain parenchymal elasticity can well distinguish HII and normal neonates,with the best location being the left and right lateral ventricle of the brain parenchyma,the best elastic parameters being the mean and maximum values,which is worthy of clinical promotion.
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