Klauser Andrea S, Pamminger Mathias, Halpern Ethan J, Abd Ellah Mohamed M H, Moriggl Bernhard, Taljanovic Mihra S, Deml Christian, Sztankay Judit, Klima Guenther, Jaschke Werner R
Department of Radiology, Medical University of Innsbruck, Anich St. 35, 6020, Innsbruck, Austria.
Department of Radiology and Urology, Jefferson Prostate Diagnostic and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA.
Eur Radiol. 2017 Aug;27(8):3460-3466. doi: 10.1007/s00330-016-4711-x. Epub 2017 Jan 5.
To compare agreement between conventional B-mode ultrasound (US) and compression sonoelastography (SEL) of the common extensor tendons of the elbow with histological evaluation.
Twenty-six common extensor tendons were evaluated in 17 cadavers (11 females, median age 85 years and 6 males, median age 80 years). B-mode US was graded into: Grade 1, homogeneous fibrillar pattern; grade 2, hypoechoic areas and/or calcifications <30%; and grade 3 > 30%. SEL was graded into: Grade 1 indicated blue (hardest) to green (hard); grade 2 yellow (soft); and grade 3 red (softest). B-mode US, SEL, and a combined grading score incorporating both were compared to histological findings in 76 biopsies.
Histological alterations were detected in 55/76 biopsies. Both modalities showed similar results (sensitivity, specificity, and accuracy 84%, 81%, and 83% for B-mode US versus 85%, 86%, and 86% for SEL, respectively, P > 0.3). However, a combination of both resulted in significant improvement in sensitivity (96%, P < 0.02) without significant change in specificity (81%, P < 0.3), yielding an improved overall accuracy (92%).
Combined imaging of the extensor tendons with both modalities is superior to either modality alone for predicting the presence of pathologic findings on histology.
• Combination of B-mode US and SEL proved efficiency in diagnosing lateral epicondylitis. • Combination of B-mode US and SEL in lateral epicondylitis correlates to histology. • Combination of both modalities provides improved sensitivity without loss of specificity.
比较肘部伸肌总腱的传统B超（US）与超声弹性成像（SEL）结果与组织学评估之间的一致性。
对17具尸体（11名女性，中位年龄85岁；6名男性，中位年龄80岁）的26条伸肌总腱进行评估。B超分为：1级，均匀的纤维状模式；2级，低回声区和/或钙化<30%；3级，>30%。SEL分为：1级显示蓝色（最硬）至绿色（硬）；2级为黄色（软）；3级为红色（最软）。将B超、SEL以及结合两者的综合分级评分与76份活检组织的组织学结果进行比较。
76份活检组织中有55份检测到组织学改变。两种方法显示出相似的结果（B超的敏感性、特异性和准确性分别为84%、81%和83%，SEL分别为85%、86%和86%，P>0.3）。然而，两者结合导致敏感性显著提高（96%，P<0.02），而特异性无显著变化（81%，P<0.3），总体准确性提高（92%）。
两种方法联合对伸肌总腱进行成像，在预测组织学病理结果方面优于单独使用任何一种方法。
• B超和SEL联合在诊断外侧上髁炎方面有效。• 外侧上髁炎中B超和SEL联合与组织学相关。• 两种方法联合提高了敏感性且未损失特异性。
