Shear wave elastography in elastofibroma dorsi: lesion-based associations with pain severity and anatomical localization.

OBJECTIVES

The objective of this study is to evaluate lesion-based associations between pain severity and intrinsic tissue stiffness measured by shear wave elastography in elastofibroma dorsi.

METHODS

This single-center study included 58 patients, in whom 110 elastofibroma dorsi lesions were incidentally detected on thoracic computed tomography. All underwent shear wave elastography. Pain was graded per lesion using the Chronic Pain Grade scale. Lesion volume, computed tomography attenuation, inferior ectopy, and concomitant superior elastofibroma dorsi were recorded. Painful vs. painless lesions were compared using correlation and multivariable regression.

RESULTS

Mean age was 62.1 ± 9.4 years; 91.4% were female. Stiffness was higher in painful lesions than in painless lesions (3.12 vs. 2.59 m/s; p < 0.001) and correlated with pain severity (ρ = 0.45, p < 0.001). Shear wave elastography independently predicted pain (odds ratio = 1.80 per 1 m/s; 95% confidence interval 1.21-2.68; p < 0.01). Inferior ectopy (84.6% vs. 72.2%, p = 0.041) and concomitant superior elastofibroma dorsi (91.7% vs. 68.6%, p = 0.048) were associated with higher pain prevalence but did not influence stiffness. In multivariable analysis, shear wave elastography and concomitant superior elastofibroma dorsi remained independently associated with pain (odds ratio = 5.08; p = 0.037), while inferior ectopy did not. Lesion volume and computed tomography attenuation were not associated with pain.

CONCLUSIONS

Increased stiffness independently predicts pain in elastofibroma dorsi. Inferior ectopy may contribute through extrinsic factors; superior lesions independently predict pain. Shear wave elastography may aid identification of symptomatic lesions.