scholarly journals Achilles and patellar tendinopathy display opposite changes in elastic properties: A shear wave elastography study

2017 ◽  
Vol 28 (3) ◽  
pp. 1201-1208 ◽  
Author(s):  
B. K. Coombes ◽  
K. Tucker ◽  
B. Vicenzino ◽  
V. Vuvan ◽  
R. Mellor ◽  
...  
2018 ◽  
Vol 1 (1) ◽  
pp. 14-22
Author(s):  
Marketa Zemanova

Shear Wave Elastography (SWE) is a non-invasive diagnostic imaging technique, that maps the elastic properties of tissues. Nowadays this modality develops increasingly in medicine across its disciplines and opens a new era of high-quality ultrasound examination because it increases the specificity and thus improves diagnostic assurance. This method is similar to manual palpation, shows elastic properties of biological tissues and provides a kind of reconstruction of the internal structure of soft tissues based on measurement of the response of tissue compression. Results: This method is already used routinely in the detection and diagnosis of breast cancer and thyroid cancer, prostate cancer, in hepatology, cardiology, view of the carotid arteries and lymphatic nodules. Standards of elasticity values for human tissues such as the mammary gland, liver, prostate or thyroid gland are progressively being created across the medical fields. Finally, the article examines its unquestioned benefit in ophthalmology. In ophthalmology, it already appears as an up-and-coming method in diagnostics and in evaluating the changes in oculomotor muscles and orbital tissues in patients with endocrine orbitopathy. Conclusion: Shear wave elastography offers three main innovations: the quantitative aspect, dimensional resolution, and real-time imaging ability. Determination of the utilization rate of this method and its inclusion into the diagnostics of endocrine orbitopathy is still a question and the subject of presently conducted clinical studies.


2017 ◽  
Vol 19 (4) ◽  
pp. 357 ◽  
Author(s):  
Gregor Seliger ◽  
Katharina Chaoui ◽  
Christian Kunze ◽  
Yasmina Dridi ◽  
Klaus-Vitold Jenderka ◽  
...  

Aims: The elastic properties of circumscribed tissues (e.g., tendons, lymph nodes, prostates, brain tumors) are of considerable clinical interest. The purpose of this study was thus to compare the Intra-/Inter-observer variation and accuracy in vitro of point shear wave elastography (pSWE) with that of 2D-SWE and to assess 2D-SWE’s precision with variable ROI (vROI) incircumscribed objects.Material and methods: Round targets (Elasticity QA Phantom Model 049) were examined for varying degrees of stiffness (8, 14, 45, and 80 kPa) and diameters (20/10 mm). Three ultrasound systems and four probes were applied (pSWE: Acuson/S3000 9L4/4C1 and Epiq7 C51, 2D-SWE: Aplio/500 PVT375BT). Three different ROIs were used, namely fixed ROI (fROI) and variable ROI: rectangular-best-fitted ROI, and round-best-fitted ROI. Each measurement was performed twice by four observers.Results: A total of 3,604 measurements were conducted. The intra-observer variation of 2D-SWE measurements indicated better agreement (Intraclass Correlation Coefficient (ICC) = 0.971; 95% CI=[0.945; 0.985]), than for the pSWE measurements (ICC = 0.872; 95% CI=[0.794; 0.92]). With both methods, the shear wave elastography applied showed low inter-observer variation: ICC = 0.980; 95% CI=[0.970; 0.987]. However, a significant difference was observed between fROI (pSWE) and vROI (2D-SWE) on circumscribed objects in terms of accuracy. The lowest degree of observationerror was detected in situations where the ROI was not “best fitted”, but placed within the target of 3mm from the border (target diameter: 20mm; mean relative error = 0.15).Conclusions: When estimating the elastic properties of circumscribed tissues, the different measurement techniques performed by commercial shear wave elastography systems reveal a strong susceptibility for observational errors, depending upon the fixed vs. variable ROI of the pSWE vs. 2D-SWE technique.


2020 ◽  
Vol 30 (11) ◽  
pp. 5942-5951 ◽  
Author(s):  
Stephan J. Breda ◽  
Arco van der Vlist ◽  
Robert-Jan de Vos ◽  
Gabriel P. Krestin ◽  
Edwin H. G. Oei

Abstract Objectives (1) To determine the association between patellar tendon stiffness and the presence of patellar tendinopathy (PT). (2) To evaluate the reliability of shear-wave elastography (SWE). Methods Participants were consecutively enrolled between January 2017 and June 2019. PT was diagnosed clinically and confirmed by either grayscale US or power Doppler US, or both. Controls had no history of anterior knee pain and no clinical signs of PT. Patellar tendon stiffness (kilopascal, kPa) was assessed using SWE. Logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Reliability analyses included coefficients-of-variation (CV), coefficients-of-repeatability (CR), intraclass correlation coefficient (ICC) for intraobserver and interobserver reliability, and Bland-Altman analysis. Results In total, 76 participants with PT (58 men, mean age 24.4 ± 3.8 years) and 35 asymptomatic controls (16 men, mean age 21.5 ± 3.8 years) were included. Univariate analyses (OR 1.094, 95% CI 1.061–1.128, p < .001) and adjusted multivariate analyses (OR 1.294, 95% CI 1.044–1.605, p = .018) showed that athletes with PT had significantly increased patellar tendon stiffness. ICC for intraobserver reliability was 0.95 (95% CI 0.92–0.97), CR (CV) 12 kPa (10%) and 0.79 (95% CI 0.65–0.88), CR (CV) 18 kPa (21%) for interobserver reliability. Mean differences from Bland-Altman analysis were 5.6 kPa (95% CI 3.1–8.1, p < .001) for intraobserver reliability and 4.6 kPa (95% CI 1.9–7.2, p < .001) for interobserver reliability. Conclusions PT is associated with significantly higher patellar tendon stiffness. SWE measurements demonstrate excellent intraobserver reliability and good interobserver reliability. Therefore, SWE is a promising tool to implement in longitudinal studies and future studies should evaluate its prognostic value and utility as a monitoring tool in athletes with PT. Key Points • Patellar tendon stiffness measured with shear-wave elastography (SWE) is higher in athletes with patellar tendinopathy than in healthy controls, also after adjusting for potential confounders. • Excellent intraobserver reliability and good interobserver reliability were found for the quantitative assessment of patellar tendon stiffness using SWE.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bertrand Gachon ◽  
Xavier Fritel ◽  
Fabrice Pierre ◽  
Antoine Nordez

AbstractOur main objective was to assess the intraoperator intersession reproducibility of transperineal ultrasound Shear Wave Elastography (SWE) to measure the levator ani muscle (LAM) elastic properties. Secondary objective was to compare reproducibility when considering the mean of three consecutives measurements versus one. In this prospective study involving non-pregnant nulliparous women, two visits were planned, with a measurement of the shear modulus (SM) on the right LAM at rest, during Valsalva maneuver and maximal contraction. Assessments were done with a transperineal approach, using an AIXPLORER device with a linear SL 18–5 (5-18 MHz) probe. For each condition, 3 consecutive measures were performed at each visit. The mean of the three measures, then the first one, were considered for the reproducibility by calculating intraclass correlation coefficient (ICC), and coefficient of variation (CV). Twenty women were included. Reproducibility was excellent when considering the mean of the 3 measures at rest (ICC = 0.90; CV = 15.7%) and Valsalva maneuver (ICC = 0.94; CV = 10.6%), or the first of the three measures at rest (ICC = 0.87; CV = 18.6%) and Valsalva maneuver (ICC = 0.84; CV = 19.9%). Reproducibility was fair for measurement during contraction. Transperineal ultrasound SWE is a reliable tool to investigate LAM elastic properties at rest and during Valsalva maneuver.


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