Ofer Nir, Akselrod Solange, Nyska Meir, Werner Miriam, Glaser Ernesto, Shabat Shay
Abramson Center for Medical Physics, Tel Aviv University, Israel.
J Orthop Res. 2004 Nov;22(6):1296-302. doi: 10.1016/j.orthres.2004.02.014.
Degenerative or pre-degenerative processes in the tendon, which could lead to a spontaneous rupture, are well known problems, especially among athletes. Existing non-invasive diagnostic methods are mainly based on subjective analysis of static images of the tendon, but in many cases the degeneration cannot be diagnosed in time. Combining a set of existing image processing techniques, a tool for tracking the in vivo motion of a tendon imaged with dynamic ultrasound was implemented. A group of subjects that had undergone a degenerative rupture of their Achilles tendon, one subject with a traumatic rupture, and a group of control subjects were all tested. Using the motion information that was obtained from both tendons of all subjects, we developed an automatic test that examines the symmetrical properties of the tendon's motion, and defined a negative asymmetry property that could be quantified as a score. This score was found to be significantly more enhanced in the post-operative tendons (18.0 +/- 9.0) than in the contra-lateral healthy tendons of the same subjects (3.9 +/- 4.6). In the single traumatic rupture subject, this effect was not found (0.0). This leads us to believe that the negative asymmetry of tendon motion may be associated with degenerative or pre-degenerative processes in the tendon. Also, the mean degree of negative asymmetry in the healthy tendons of post-operative subjects (3.9 +/- 4.6) was found to be higher than that of healthy tendons of the control group (1.5 +/- 1.8). This finding may be associated with the fact that tendons that are contra-lateral to spontaneously ruptured tendons have a higher risk of developing degenerative processes. The method presented here is objective, low-cost, non-invasive and possibly more sensitive than existing non-invasive techniques.
肌腱中的退行性或预退行性过程可能导致自发性断裂，这是众所周知的问题，在运动员中尤为常见。现有的非侵入性诊断方法主要基于对肌腱静态图像的主观分析，但在许多情况下，退变无法及时诊断出来。结合一组现有的图像处理技术，实现了一种用于跟踪动态超声成像的肌腱体内运动的工具。对一组经历过跟腱退行性断裂的受试者、一名创伤性断裂受试者和一组对照受试者进行了测试。利用从所有受试者的两条肌腱获得的运动信息，我们开发了一种自动测试方法，用于检查肌腱运动的对称性，并定义了一种可量化为分数的负不对称性特征。结果发现，术后肌腱的该分数（18.0±9.0）比同一受试者对侧健康肌腱的分数（3.9±4.6）显著更高。在单一创伤性断裂受试者中未发现这种效应（0.0）。这使我们相信，肌腱运动的负不对称性可能与肌腱中的退行性或预退行性过程有关。此外，还发现术后受试者健康肌腱的平均负不对称程度（3.9±4.6）高于对照组健康肌腱的平均负不对称程度（1.5±1.8）。这一发现可能与以下事实有关：与自发性断裂肌腱对侧的肌腱发生退行性病变的风险更高。本文提出的方法具有客观性、低成本、非侵入性，并且可能比现有的非侵入性技术更敏感。
