Affiliations: [a] Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
| [b] Department of Radiology, Klinikum Schwabing, Städtisches Klinikum München, Munich, Germany
| [c]
Bioscientia Institute for Medical Diagnostics GmbH, Karlsfeld, Germany
| [d] Department of Plastic, Hand and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
Correspondence:
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Corresponding author: Veronika I. Teusch, Department of Radiology, University Medical Center Regensburg, 93042 Regensburg, Germany. Tel.: +49 941 9447431; Fax: +49 941 9447481; E-mail: veronika.teusch@gmx.de.
Abstract: AIM: Comparison of different ultrasound elastography techniques for detection of changes after sclerotherapy within venous malformations. MATERIAL AND METHODS: In patients with venous malformations sonography was executed at exactly the same position prior to and after ethanol-gel sclerotherapy. Both examinations included B-Mode, vascular sonography with Color-Coded Duplex Sonography, and additional sonography with different elastography techniques (strain, qualitative and quantitative Acoustic Radiation Force Impulse (ARFI) elastography) with a linear transducer (6–9 MHz). Qualitative elastograms were read in consensus and scored. Differences of elasticity scores were statistically analyzed, p-values <0.05 were regarded significant. RESULTS: Elasticity scores of strain and qualitative ARFI elastography in 25 patients (21 females, averagely 24.4 years old) were comparable before treatment (p = 0.69). After therapy qualitative ARFI scores changed significantly compared to pre-treatment scores (p = 0.0017), whereas strain elastography scores revealed no significant changes (p = 0.13). Quantitative ARFI values obtained after sclerotherapy within the venous malformations were significantly higher compared to pre-treatment values (p = 0.049), and significantly higher to values obtained in surrounding tissue (p = 0.030). Comparison of pre- and post-treatment ARFI values of the surrounding tissue was not significant (p = 0.67). CONCLUSION: Elasticity scores of qualitative ARFI elastography reliably detect ethanol-gel induced changes in venous malformations. Quantitative ARFI may be a tool for therapy planning, and for monitoring sclerotherapy outcome as well as the effect of sclerosing agents on malformation and surrounding tissue in patients with venous malformations.
Keywords: Venous malformation, elastography, elasticity score, Acoustic Radiation Force Impulse (ARFI) imaging, therapy control
