Dickson Diane M, Fawole Henrietta O, Hendry Gordon J, Smith Stephanie L
Glasgow Caledonian University, School of Health and Life Sciences, Glasgow, Scotland.
Physiotherapy Department, University of Benin, School of Basic Medical Sciences, Benin City, Nigeria.
J Ultrasound Med. 2020 Jul;39(7):1343-1353. doi: 10.1002/jum.15228. Epub 2020 Jan 25.
To evaluate intermachine variation and compare intraoperator and interoperator agreement and repeatability characteristics of 2 ultrasound (US) systems for measurements of quadriceps and patellar tendons by strain elastography (SE).
Forty tendons from 20 healthy participants were investigated by operators with different experience (operator 1, 12 years of US experience and >50 SE examinations; operator 2, no US experience and 1 day of SE training). Repeated measures were performed on GE Healthcare (Waukesha, WI) and Esaote (Genoa, Italy) US systems. The percentage of agreement, Cohen κ, intraclass correlation coefficient, and correlation tests assessed agreement, repeatability, and associations of SE measures. A paired t test and Wilcoxon signed rank test assessed differences in SE measures.
The study participants included 5 male and 15 female volunteers (mean [range] age, 29.3 [21-39] years). Better agreement and repeatability characteristics were observed for the patellar compared to the quadriceps tendon and the color score (CS) method over the elasticity ratio (ER). Intraoperator agreement was better for the experienced operator. Intraoperator repeatability was achieved in 55% of ER (intraclass correlation coefficient, 0.40-0.91; P < .05) and 77% to 85% (κ = -0.25-1) of CS measures. Interoperator repeatability was achieved in 35% (t/z, -2.93-7.94; P < .001-.048) of all ER measures. No significant differences in proximal (z, -0.13- -0.78) and distal patellar (z, -1.52-2.26; P > .5) patellar ER measures were observed. Seventy-four percent to 75% mean agreement (κ = 0-0.5) for CS measures comparable across both US systems was observed. Intermachine ER associations were poor (r = -0.39-0.13; P > .05), whereas greater than 70% agreement (κ = -0.87-0.53) for the CS was achieved.
The reproducibility of knee tendon SE measurements is influenced by the operator experience, US system, and tendon site.
评估两台超声（US）系统在通过应变弹性成像（SE）测量股四头肌和髌腱时的机器间差异，并比较同一操作者和不同操作者之间的一致性及重复性特征。
由不同经验的操作者（操作者1，有12年超声经验且>50次SE检查；操作者2，无超声经验且接受过1天SE培训）对20名健康参与者的40条肌腱进行检查。在通用电气医疗集团（威斯康星州沃基沙）和百胜（意大利热那亚）的US系统上进行重复测量。一致性百分比、科恩κ系数、组内相关系数和相关性检验评估了SE测量的一致性、重复性和相关性。配对t检验和Wilcoxon符号秩检验评估了SE测量的差异。
研究参与者包括5名男性和15名女性志愿者（平均[范围]年龄，29.3[21 - 39]岁）。与股四头肌肌腱相比，髌腱以及颜色评分（CS）方法在弹性比（ER）方面表现出更好的一致性和重复性特征。经验丰富的操作者的同一操作者间一致性更好。在55%的ER测量中实现了同一操作者间的重复性（组内相关系数，0.40 - 0.91；P <.05），在77%至85%（κ = -0.25 - 1）的CS测量中实现了重复性。在所有ER测量的35%中实现了不同操作者间的重复性（t/z，-2.93 - 7.94；P <.001 -.048）。在髌腱近端（z，-0.13 - -0.78）和远端髌腱（z，-1.52 - 2.26；P >.5）的ER测量中未观察到显著差异。在两种US系统中，CS测量的平均一致性为74%至75%（κ = 0 - 0.5）。机器间ER相关性较差（r = -0.39 - 0.13；P >.05），而CS的一致性大于70%（κ = -0.87 - 0.53）。
膝关节肌腱SE测量的可重复性受操作者经验、US系统和肌腱部位的影响。
