Tissue characterization of equine tendons with clinical B-scan images using a shock filter thinning algorithm.

The fiber bundle density (FBD) calculated from ultrasound B-scan images of the equine superficial digital flexor tendon (SDFT) can serve as an objective measurement to characterize the three metacarpal sites of normal SDFTs, and also to discriminate a healthy SDFT from an injured one. In this paper, we propose a shock filter algorithm for the thinning of hyper-echoic structures observed in B-scan images of the SDFT. This algorithm is further enhanced by applying closing morphological operations on filtered images to facilitate extraction and quantification of fiber bundle fascicles. The mean FBD values were calculated from a clinical B-scan image dataset of eight normal and five injured SDFTs. The FBD values measured at three different tendon sites in normal cases show a highest density on the proximal site (five cases out of eight) and a lowest value on the distal part (seven cases out of eight). The mean FBD values measured on the entire tendon from the whole B-scan image dataset show a significant difference between normal and injured SDFTs: 51 (±9) for the normal SDFTs and 39 (±7) for the injured ones (p = 0.004) . This difference likely indicates disruption of some fiber fascicle bundles where lesions occurred. To conclude, the potential of this imaging technique is shown to be efficient for anatomical structural SDFT characterizations, and opens the way to clinically identifying the integrity of SDFTs.