Diagnostic problems in two-dimensional shear wave elastography of the liver

Figure 9 Computer simulation model of deviated push-pulses. A: Surrounding tissue acoustic speed is 1540 m/s and that of tumor (blue) is 1480 m/s; B: Surrounding tissue acoustic speed is 1540 m/s and that of tumor (pink) is 1600 m/s [A and B — the push-pulses change direction twice at two interfaces (upper and lower) of the surface of the lesion]; C: Two-dimensional shear wave elastography shows the posterior zone behind the lesion (red circle) to have a greater shear wave velocity (1.67 ± 0.19 m/s) than the surrounding hepatic tissue (1.07 ± 0.08 m/s) (white circle); D: Hepatic ultrasound reveals a 2 cm × 2 cm echogenic mass (hemangioma) in segment 5.