Strain elastography

Last revised by Dr Mostafa El-Feky on 11 Nov 2022

Strain elastography (also known as tissue strain elastography/static elastography/compression elastography) is a developing form of ultrasound that assesses tissues' macroscopic structure through the strain modulus. This is different from normal B-mode grayscale ultrasound which characterizes a tissue's elasticity but at a microscopic level.

Strain elastography relies on Young's modulus to detect strain in the axial dimension. The characteristics of an ultrasound beam through tissue before and after compression are compared. In some systems, the strain of tissues is measured in a semi-quantitative way, relying on Young's modulus, but not directly calculating it.

Applications of strain elastography are currently being developed for:

  • breast ultrasound
  • liver ultrasound
    • detection of small lesions
    • evaluation of diffuse liver disease
  • prostate ultrasound
  • thyroid nodule ultrasound
  • musculoskeletal ultrasound
  • obstetric ultrasound for preterm labor 2

There may also be some applications in echocardiography.

The technique is still being developed for clinical use. Currently, there are a number of different ways to perform strain elastography and continued improvement in differentiation between the lesion and background tissue is necessary for reliable clinical diagnosis.

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Cases and figures

  • Case 1: fibroadenoma
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  • Case 2: invasive micropapillary carcinoma of the breast
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  • Case 3: infiltrating pleiomorphic lobar carcinoma
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  • Case 4: tubular adenoma - breast
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