Effectiveness of two-dimensional shear-wave sonoelastography in the diagnosis and follow-up of infantile hypertrophic pyloric stenosis
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In brief
In brief
This study demonstrates that two-dimensional shear-wave sonoelastography can effectively diagnose infantile hypertrophic pyloric stenosis by measuring pyloric tissue stiffness, which is four times higher in affected infants. The technique also enables postoperative monitoring, with tissue stiffness normalizing by three months after Ramstedt pyloromyotomy.
- 2D shear-wave sonoelastography shows pyloric tissue is 4× stiffer in IHPS vs controls (27.4 kPa vs 7.66 kPa), aiding diagnosis.
- Shear-wave speed is significantly elevated in IHPS pylorus (2.69 m/s vs 1.34 m/s), providing quantitative diagnostic criteria.
- Pyloric stiffness normalizes by 3 months post-pyloromyotomy, offering objective marker for surgical adequacy.
- 2D-SW-SE complements B-mode ultrasound for IHPS diagnosis and can detect incomplete myotomy at follow-up.
- Elastography provides quantitative tissue characterization beyond traditional pyloric wall thickness measurements.
Written by the GCMD Library team from the article.
Abstract
Introduction
We sought to determine the effectiveness and utility of two-dimensional shear-wave sonoelastography (2D-SW-SE) in the diagnosis and postoperative follow-up of infantile hypertrophic pyloric stenosis (IHPS).
Materials and Methods
Twenty-three infants were included in the study, 13 in the IHPS group and 10 in the control group (CG). Preoperative B-mode ultrasonography measurements (longitudinal length and single-wall thickness of the pylorus) and 2D-SW-SE measurements (pylorus tissue stiffness and shear-wave propagation speed) were compared between the groups. The infants with IHPS then underwent Ramstedt pyloromyotomy and were invited for follow-ups on the tenth day and the first, third, and sixth months postoperatively. Measurements taken at the follow-ups were compared with the preoperative values.
Results
No differences were found between the groups regarding age, gender, body weight, or week of birth. The pyloric lengths in the IHPS group were longer than in the CG (p < 0.001), and the single-wall thicknesses were thicker (p < 0.001). The pylorus in the IHPS group was four times stiffer than in the CG (27.4 kPa versus 7.66 kPa), and the shear-wave propagation speed in the tissue was higher (1.34 m/s versus 2.69 m/s; p < 0.001). Both values decreased over time in the IHPS group and were normal by the third postoperative month.
Conclusions
2D-SW-SE can be used as an assistive imaging tool alongside B-mode ultrasound for diagnosing IHPS. It can also be used to identify inadequate surgery by detecting whether the pyloric tissue has softened at follow-up.