Department of Diagnostic Radiology, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
Radiology. 2013 Jun;267(3):837-42. doi: 10.1148/radiol.13121936. Epub 2013 Feb 28.
To compare and determine the level of agreement of findings at conventional B-mode ultrasonography (US) and sonoelastography of the Achilles tendon with findings at histologic assessment.
This study was conducted with the approval of the institutional review boards, and all cadavers were in legal custody of the study institution. Thirteen Achilles tendons in 10 cadavers (four male, six female; age range, 70-90 years) were examined with B-mode US and sonoelastography. B-mode US grading was as follows: Grade 1 indicated a normal-appearing tendon with homogeneous fibrillar echotexture; grade 2, a focal fusiform or diffuse enlarged tendon; and grade 3, a hypoechoic area with or without tendon enlargement. Sonoelastography grading was as follows: Grade 1 indicated blue (hardest) to green (hard); grade 2, yellow (soft); and grade 3, red (softest). Twenty-five biopsy specimens from representative lesions of the middle and distal thirds of the Achilles tendons were evaluated histologically. The concordance of B-mode US grading compared with sonoelastographic grading was assessed by using κ analysis.
With B-mode US and sonoelastography, all 11 tendon thirds of histologically normal tendons were verified as normal (grade 1). Sonoelastography depicted 14 of 14 (100%) tendon thirds with histologic degeneration (grade 2 or 3), whereas B-mode US could depict only 12 of 14 (86%) lesions (grade 2 or 3). Only moderate agreement between B-mode US and sonoelastography was seen (κ = 0.52, P < .001).
Sonoelastography might help predict signs of histopathologic degeneration of Achilles tendinosis, potentially more sensitively than B-mode US.
比较并确定常规 B 型超声（US）和跟腱超声弹性成像的发现与组织学评估的发现的一致性水平。
本研究经机构审查委员会批准进行，所有尸体均由研究机构合法保管。10 具尸体的 13 个跟腱（4 名男性，6 名女性；年龄范围 70-90 岁）进行了 B 型 US 和超声弹性成像检查。B 型 US 分级如下：1 级表示肌腱外观正常，纤维状回声纹理均匀；2 级，局灶性梭形或弥漫性增大的肌腱；3 级，低回声区伴或不伴肌腱增大。超声弹性成像分级如下：1 级表示蓝色（最硬）至绿色（硬）；2 级，黄色（软）；3 级，红色（最软）。对跟腱中、下段代表性病变的 25 个活检标本进行组织学评估。通过 κ 分析评估 B 型 US 分级与超声弹性成像分级的一致性。
B 型 US 和超声弹性成像显示，所有 11 个组织学正常的肌腱段均被证实为正常（1 级）。超声弹性成像显示 14 个（100%）具有组织学退变（2 级或 3 级）的肌腱段，而 B 型 US 仅能显示 12 个（86%）病变（2 级或 3 级）。B 型 US 与超声弹性成像之间仅存在中度一致性（κ=0.52，P<.001）。
超声弹性成像可能有助于预测跟腱腱病组织病理学退变的迹象，其敏感性可能高于 B 型 US。
