Scuola di Specializzazione di Radiodiagnostica, Università degli Studi di Milano, Via Di Rudinì, 20142, Milano, Italy.
Dipartimento di Scienze Diagnostiche- UOC di Radiologia, Ospedale San Carlo Borromeo, via Pio II, 3, 20147, Milan, Italy.
Radiol Med. 2016 Aug;121(8):667-74. doi: 10.1007/s11547-016-0642-5. Epub 2016 May 12.
Evaluating prospectively elastosonographyc (EUS) findings of distal third of Achilles tendon in asymptomatic volunteers and correlating with subject characteristics and ultrasound (US) findings and, subsequently, calculating reproducibility of method.
70 consecutives Achilles tendons were examined with US and EUS in 35 asymptomatic volunteers. Mean age 42.3 years (±7.6), 22 were female (mean age 41 ± 8.7) and 13 were male (mean age 42.5 ± 11.4). Information about population was collected (anthropometric data, sport activity, taken therapy and associated conditions/pathologies).
Statistically significant correlation was found between BMI and EUS findings (p = 0.007) and between EUS aspect and US diagnosis (p = 0.039) both to the right tendon. Possible influence of smoking (p = 0.063 to right) and associated conditions (p = 0. 059 to left), has been found. The multivariate analysis showed that EUS results are correlated only with BMI (high BMI corresponds to the best EUS results), independently from smoke and associated conditions on right side. No correlations have emerged for the left tendon. The 22.8 % of the volunteers took on chronic therapies, none statistically significant correlation. In the past, 80 % of subjects played sports (7.4 % agonistic and 92.6 % non-agonistic). The 22.9 % of volunteers played sporadic or no activity. The 60 % of volunteers has played sports that may lead overload of the Achilles tendon. The 61.5 % of subjects with BMI ≥ 25 was active little or nothing; 63.6 % of the subjects with BMI < 25 is playing sports. US examination showed 57.1 % normal tendons and 42.9 % tendinosic. Rate of tendinosic tendons was similar in both left and right (40 and 45.7 %, respectively). Statistically significant correlation was found between EUS aspect and US diagnosis on the right tendon but not on the left Correlation between thickness and EUS aspect was calculated: no correlation was found. Interoperator correlation was excellent (k = 0.89 for left tendon and k = 0.91 for right tendon).
The EUS is an interesting and useful technique, characterised by a high reproducibility. Its results are related to BMI and US appearance of the tendon, and they are probably influenced by the smoke and associated conditions. However, the flexed ankle position, needed to properly examine the distal third by US, alters the elasticity of the tendon and causes false negative results to EUS. Then, for the EUS study of the distal third, it would be appropriate the relaxed position, with a gel pad to optimise the probe adhesion.
前瞻性评估无症状志愿者跟腱远段的弹性超声（EUS）表现，并与患者特征、超声（US）表现相关联，随后计算该方法的可重复性。
对 35 名无症状志愿者的 70 例连续跟腱进行了 US 和 EUS 检查。平均年龄 42.3 岁（±7.6），其中 22 名女性（平均年龄 41 ± 8.7），13 名男性（平均年龄 42.5 ± 11.4）。收集了有关人群的信息（人体测量数据、运动活动、接受的治疗和相关疾病/病理学）。
在右侧跟腱中，BMI 与 EUS 表现之间存在统计学显著相关性（p = 0.007），EUS 表现与 US 诊断之间存在统计学显著相关性（p = 0.039）。吸烟（p = 0.063）和相关疾病（p = 0.059）对右侧有潜在影响。多变量分析显示，EUS 结果仅与 BMI 相关（高 BMI 对应最佳 EUS 结果），与右侧的吸烟和相关疾病无关。对于左侧跟腱，没有相关性。22.8%的志愿者接受慢性治疗，无统计学意义。过去，80%的受试者进行运动（7.4%为竞技性，92.6%为非竞技性）。22.9%的志愿者进行零星或无活动。60%的志愿者从事可能导致跟腱超负荷的运动。61.5%的 BMI≥25 的受试者活动很少或没有；63.6%的 BMI<25 的受试者参加运动。US 检查显示 57.1%的跟腱正常，42.9%的腱骨。左右两侧的腱骨率相似（分别为 40%和 45.7%）。在右侧跟腱中，EUS 表现与 US 诊断之间存在统计学显著相关性，但在左侧跟腱中则没有。计算了厚度与 EUS 表现之间的相关性：未发现相关性。操作者间相关性良好（左腱 k=0.89，右腱 k=0.91）。
EUS 是一种有趣且有用的技术，具有较高的可重复性。其结果与 BMI 和肌腱的 US 表现相关，可能受到吸烟和相关疾病的影响。然而，为了正确检查跟腱远段，需要使踝关节处于弯曲位，这会改变肌腱的弹性，导致 EUS 出现假阴性结果。因此，对于跟腱远段的 EUS 研究，应采用放松体位，并使用凝胶垫以优化探头贴合度。
