Department of Radiology, University Hospital, Heraklion, Greece.
Clin Radiol. 2009 Dec;64(12):1196-202. doi: 10.1016/j.crad.2009.08.006. Epub 2009 Oct 8.
To investigate the feasibility and reproducibility of real-time freehand ultrasound elastography (RTE) of the normal Achilles tendon and to describe its elastographic appearances.
Fifty normal Achilles tendons were prospectively examined using RTE performed by tissue compression using the hand-held transducer. The information was colour-coded (red=soft, green=medium, blue=hard) and superimposed on the B-mode image. Each tendon was examined three times transversely and longitudinally by two radiologists and the ratio between tendon and retro-Achilles fat strain (strain index) was calculated. The reproducibility of the elastograms was assessed qualitatively and quantitatively using the strain index inter and intra observer variation coefficient (intra/inter-CV and intra/inter-CC, respectively).
All tendons were clearly visualized on the elastograms. Nineteen tendons (19/50, 38%) appeared homogeneously green/blue (type 1). Thirty-one tendons (31/50, 62%) appeared green with longitudinal red stripes (type 2). The intra- and inter-CC values of the strain index were lower for the transverse plane than for the longitudinal plane (0.43, 0.45, 0.41 and 0.78, 0.66, 0.51, respectively). The intra-CV and inter-CV values were higher for the transverse than for the longitudinal plane measurements (39%, 37%, 30% and 30.50%, 30.10%, 29.60%, respectively).
RTE of the normal Achilles tendon is a feasible method. The reproducibility of the strain index is good and higher for longitudinal elastograms. Qualitative assessment enables the discrimination of two distinct elastographic patterns. Further studies are required to assess the clinical value of this method.
探讨实时徒手超声弹性成像（RTE）检测正常跟腱的可行性和可重复性，并描述其弹性成像表现。
前瞻性地使用 RTE 对 50 例正常跟腱进行检查，使用手持换能器进行组织压迫。信息以颜色编码（红色=软，绿色=中等，蓝色=硬）并叠加在 B 模式图像上。两位放射科医生分别对每条肌腱进行三次横向和纵向检查，并计算肌腱与跟腱后脂肪应变比（应变指数）。使用应变指数观察者内和观察者间变异系数（分别为 intra/inter-CV 和 intra/inter-CC）定性和定量评估弹性图的可重复性。
所有肌腱在弹性图像上均清晰可见。19 根肌腱（19/50，38%）呈均匀的绿色/蓝色（1 型）。31 根肌腱（31/50，62%）呈绿色伴纵向红色条纹（2 型）。应变指数的 intra/inter-CC 值在横断面上低于在纵断面上（分别为 0.43、0.45、0.41 和 0.78、0.66、0.51）。横向测量的 intra-CV 和 inter-CV 值高于纵向测量（分别为 39%、37%、30%和 30.50%、30.10%、29.60%）。
RTE 检测正常跟腱是一种可行的方法。应变指数的可重复性良好，且纵向弹性图的可重复性更高。定性评估能够区分两种不同的弹性成像模式。需要进一步研究来评估该方法的临床价值。
