Pediatric cardiac shear wave elastography for quantitative assessment of myocardial stiffness: A pilot study in healthy controls

Pengfei Song, Xiaojun Bi, Daniel C. Mellema, Armando Manduca, Matthew W. Urban, Patricia A. Pellikka, Shigao Chen, James F. Greenleaf

Research output: Contribution to journalArticlepeer-review


The long-term goal of this study is to assess chemotherapy-induced cardiotoxicity for pediatric cancer patients using cardiac ultrasound shear wave (SW) elastography. This pilot study aimed to systematically investigate the feasibility of using cardiac SW elastography in children and provide myocardial stiffness control data for cancer patients. Twenty healthy volunteers (ages 5-18) were recruited. A novel cardiac SW elastography sequence with pulse-inversion harmonic imaging and time-aligned sequential tracking was developed for this study. Cardiac SW elastography produces and detects transient SWs propagating in the myocardium in late-diastole, which can be used to quantify myocardial stiffness. The parasternal long-axis (L-A) and short-axis (S-A) views of the interventricular septum (IVS) were feasible for pediatric cardiac SW elastography. The L-A and S-A views of the basal and mid IVS provided better success rates than those of the apical IVS. Success rates decreased with increased body mass index (BMI), but did not differ with age or gender. Two-dimensional SW speed measurements were 1.26, 1.22, 1.71 and 1.67 m/s for L-A base, L-A mid, S-A base and S-A mid IVS, respectively. All S-A SW speed values were significantly higher (p < 0.01) than L-A values due to myocardial anisotropy. No SW speed difference was observed for different ages and genders. This pilot study demonstrated, for the first time, the feasibility of using cardiac SW elastography to measure quantitative myocardial stiffness in children, and established control SW speed values for using SW elastography to assess chemo-induced cardiotoxicity for pediatric cancer patients. The results showed that the myocardial anisotropy needs to be accounted for when comparing SW speed from different imaging axes.

Original languageEnglish (US)
Pages (from-to)1719-1729
Number of pages11
JournalUltrasound in Medicine and Biology
Issue number8
StatePublished - Aug 1 2016
Externally publishedYes


  • Cardiac shear wave elastography
  • Myocardial anisotropy
  • Myocardial stiffness
  • Pediatric

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Biophysics
  • Acoustics and Ultrasonics


Dive into the research topics of 'Pediatric cardiac shear wave elastography for quantitative assessment of myocardial stiffness: A pilot study in healthy controls'. Together they form a unique fingerprint.

Cite this