The Use of Shear Wave Elastography in the Diagnosis of Prestenotic Phase of Takayasu's Aortoarteritis.

We report the use of shear wave elastography with dispersion imaging in diagnosing a case of prestenotic Takayasu's arteritis which presented with symptoms of fever of unknown origin with persistently raised C-reactive protein levels. Vessel wall inflammation was detected in the carotid arteries on dispersion and shear wave imaging along with increased wall stiffness which was characteristic of vasculitis seen in a prestenotic phase of Takayasu's disease. These findings preceded the sonographic finding of vessel wall thickening described as the earliest sign of the disease on routine ultrasonography and not only helped to make an early diagnosis in a patient with a fever of unknown origin but also in the posttreatment follow-up.

Adhesions Detection and Staging Classification for Preoperative Assessment of Difficult Laparoscopic Cholecystectomies: A Prospective Case-Control Study.

Background: Laparoscopic cholecystectomy (LC) is the treatment of choice for cholelithiasis; however, there are procedural difficulties in determining preoperative detection of a difficult LC. The current methods using clinical and sonographic variables to identify difficult LCs have limitations to identify gallbladder adhesions which form the most common cause. We present a new method of evaluation using acoustic radiation force impulse (ARFI)-based virtual touch imaging (VTI) for the detection and classification of these patients.