The reproducibility of shear wave and strain elastography in epidermal cyst
Ji Na Kim , Hee Jin Park , Myung Sub Kim , So Yeon Won , Eunhee Song, Minchul Kim , Hyunchul Shin
Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea
Corresponding Author: Hee Jin Park ,Tel: 82-2-2001-1035 , Fax: 82-2-2001-1030 , Email:
Received: December 22, 2021;  Accepted: April 19, 2022.  Published online: April 19, 2022.
The aim of this study was to evaluate epidermal cyst elasticity for each parameter of strain elastography (SE) and shear wave elastography (SWE) and to assess the reproducibility of each parameter.
This retrospective study included 73 patients with epidermal cysts who underwent ultrasonography (US) including SE and SWE. SE scores were classified into four grades (1–4) according to elasticity. Strain ratio was evaluated using the elasticity ratio of lesions and adjacent subcutaneous fat tissue. For SWE, shear wave velocity (m/s), elasticity (kPa) by Young modulus, velocity ratio, and elasticity ratio were evaluated. All values were measured twice. Reproducibility of SE and SWE measurements were assessed. Relationships among SE and SWE measurements were evaluated.
Strain ratio on SE images showed good reproducibility (ICC value: 0.789), and SE scores showed substantial reproducibility (Kappa values: 0.753, 0.758, readers 1 and 2, respectively). Reproducibility of shear wave velocity and elasticity were moderate (ICC values: 0.750, 0.648, respectively). Reproducibility of shear wave velocity of reference tissue and velocity ratio were moderate (ICC value: 0.747, 0.713, respectively). All SE scores were positively correlated with strain ratio (p <0.001). The strain ratio on the second SE was significantly correlated with elasticity ratio and velocity ratio on the first SWE (R=0.245, p=0.037; R=0.243, p=0.038, respectively). Other variables were not correlated.
SE and SWE parameters of epidermal cysts showed moderate to good reproducibility. Particularly, the strain ratio on SE showed good reproducibility. To evaluate the elasticity of epidermal cyst, using strain ratio on SE images could provide a relatively objective and constant values.
Keywords: Strain elastography; Shear wave elastography; Ultrasound; Epidermal cyst
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