{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T20:00:31Z","timestamp":1790625631736,"version":"4.1.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T00:00:00Z","timestamp":1734912000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clinical Hemorheology and Microcirculation"],"published-print":{"date-parts":[[2024,12,23]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND AND OBJECTIVE:<\/jats:title>\n                    <jats:p>Modern ultrasound technology enables detailed tissue morphology analysis. A novel approach involves measuring viscoelasticity or viscosity. This pilot study investigates the potential of a novel high-end ultrasound system with dynamic quality indicators and the M-Ref tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Using a novel premium high-end ultrasound system (Resona A20\/Mindray), comparative investigations were conducted on 52 patients, evaluating B-mode morphology, shear wave tissue elastography (STE), and viscosity (STVi) of the liver parenchyma. The study utilized a cohort of 25 healthy volunteers as a control group. The examinations were performed intercostally using a multifrequency convex probe SC7-1U (1\u20137\u200aMHz) and breath-hold technique, ensuring that at least the highest or second-highest score in the dynamic quality control (5 stars) was achieved. Measurements were made in a color-coded region with a maximum 2\u200acm diameter and a depth of no more than 2\u200acm, avoiding bile ducts or blood vessels, at a depth up 2\u200acm from the liver capsule.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>A minimum of 10 measurements were taken for each parameter: liver steatosis (based on acoustic attenuation coefficient, USAT), viscosity (STVi), and shear wave elastography (STE) with correlation to fibrosis grade. Reference values for the control group were &lt;1.4\u200am\/s and &lt;5\u200akPa for STE, with cirrhosis criteria defined as values &gt;2.6\u200am\/s and &gt;15\u200akPa. For steatosis, values up to 0.5\u200adB\/cm\/MHz were considered normal, while values &gt;0.8\u200adB\/cm\/MHz indicated fatty liver. Viscosity values &lt;1.7\u200aPa.s were deemed normal, with &gt;3.6\u200aPa.s indicating significant abnormality. Major causes of increased viscosity included severe steatosis, active hepatitis, hepatic tumors, or post-ablative states. In all cases, a high-quality indicator score (&gt;93%) was achieved with at least 4\/5 top reference markers in green.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>This pilot study confirms the comprehensive capabilities of multimodal imaging for tissue characterization using B-mode, elastography, and new techniques for assessing viscoelasticity. However, extensive multicenter evaluations will be needed to definitively establish reference values specific to the type of transducer and equipment used.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3233\/ch-248111","type":"journal-article","created":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T14:10:05Z","timestamp":1741097405000},"page":"419-427","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Initial experiences with dynamic, quality indicator-based multimodal tissue analysis (M-Ref) with parallel assessment of viscosity and shear wave elastography in liver parenchyma alterations"],"prefix":"10.1177","volume":"88","author":[{"given":"Ernst Michael","family":"Jung","sequence":"first","affiliation":[{"name":"Institute of Diagnostic Radiology and Interdisciplinary Ultrasound Department, University Hospital Regensburg, Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Wiesinger","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Medbo District Hospital Regensburg, Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Kaiser","sequence":"additional","affiliation":[{"name":"Clinic and Polyclinic for Internal Medicine III, University Hospital Regensburg, Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedrich","family":"Jung","sequence":"additional","affiliation":[{"name":"Institute of Biotechnology, Molecular Cell Biology, Brandenburg University of Technology Cott-bus-Senftenberg, Senftenberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,3,3]]},"reference":[{"key":"ref001","doi-asserted-by":"publisher","DOI":"10.3233\/ch-239102"},{"key":"ref002","doi-asserted-by":"publisher","DOI":"10.3233\/ch-221681"},{"key":"ref003","doi-asserted-by":"publisher","DOI":"10.3390\/life14030342"},{"key":"ref004","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-021-07872-3"},{"key":"ref005","doi-asserted-by":"publisher","DOI":"10.3233\/ch-249103"},{"key":"ref006","doi-asserted-by":"publisher","DOI":"10.1109\/tuffc.2024.3381529"},{"key":"ref007","doi-asserted-by":"publisher","DOI":"10.1002\/he28431"},{"key":"ref008","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics11050783"},{"key":"ref009","doi-asserted-by":"publisher","DOI":"10.1016\/j.nic.2018.01.009"},{"key":"ref010","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v27.i7.609"},{"key":"ref011","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhe2016.12.022"},{"key":"ref012","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2893.2011.01534.x"},{"key":"ref013","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.01.042"},{"key":"ref014","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2018.07.008"},{"key":"ref015","doi-asserted-by":"publisher","DOI":"10.1002\/he29367"},{"key":"ref016","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.13856"},{"key":"ref017","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhe2013.12.018"},{"key":"ref018","doi-asserted-by":"publisher","DOI":"10.15403\/jgld.2014.1121.mlp"},{"key":"ref019","doi-asserted-by":"publisher","DOI":"10.1016\/s2468-1253(20)30367-8"},{"key":"ref020","doi-asserted-by":"publisher","DOI":"10.11152\/mu-4327"}],"container-title":["Clinical Hemorheology and Microcirculation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3233\/CH-248111","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.3233\/CH-248111","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3233\/CH-248111","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:06:59Z","timestamp":1777388819000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.3233\/CH-248111"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,23]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,12,23]]}},"alternative-id":["10.3233\/CH-248111"],"URL":"https:\/\/doi.org\/10.3233\/ch-248111","relation":{},"ISSN":["1386-0291","1875-8622"],"issn-type":[{"value":"1386-0291","type":"print"},{"value":"1875-8622","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,23]]}}}