Al-Razi Orthopedic and Rehabilitation Hospital, Kuwait City, Kuwait.
Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait.
J Anat. 2020 Jul;237(1):74-84. doi: 10.1111/joa.13183. Epub 2020 Mar 20.
Musculoskeletal conditions can change tissue elasticity. Knowledge of musculoskeletal elasticity could therefore aid clinical diagnosis and management. Sonoelastography is an ultrasound-based system that examines the material properties of tissues, and it may be useful in musculoskeletal practice. Therefore, it is important to establish its clinimetric properties. This study aimed to explore the intra-rater reliability and the smallest detectable changes of sonoelastography in examining musculoskeletal structures. A quantitative reliability design was used to examine 22 healthy participants using a compression sonoelastography system that produces color-coded images. The deltoid, biceps brachii, brachioradialis, rectus femoris, gastrocnemius medius muscles, and Achilles tendon were examined twice at 1-hr intervals to assess the intra-rater reliability. The sonoelastography images were analyzed using the strain index, strain ratio, and color pixels. The intra-rater reliability and the smallest detectable changes of each outcome variable were determined. The intra-class correlation coefficient was used to quantify the repeatability of the measurements, and the smallest detectable changes were calculated to determine clinically important differences above the error of measurement. The intra-rater reliability for the strain index, strain ratio, and color pixel analysis ranged from moderate to excellent (intra-class correlation coefficients: .734-.950, .776-.921, and .754-.990, respectively), with color pixel analysis demonstrating the highest reliability. The smallest detectable changes were determined for all structures, including the Achilles tendon (0.11 for the higher boundary of the strain index, 1.80 for the strain ratio, and 2.90% for red pixels, representing soft tissues). Color pixel analysis may be more reliable for sonoelastography interpretation compared with the strain index and strain ratio. The calculated smallest detectable changes could be used to identify clinically important differences.
肌肉骨骼状况会改变组织的弹性。因此，了解肌肉骨骼的弹性有助于临床诊断和管理。超声弹性成像是一种基于超声的系统，用于检查组织的材料特性，它在肌肉骨骼实践中可能很有用。因此，确定其临床计量特性很重要。本研究旨在探讨超声弹性成像检查肌肉骨骼结构的内部观察者可靠性和最小可检测变化。采用定量可靠性设计，使用产生彩色编码图像的压缩超声弹性成像系统检查 22 名健康参与者。肱二头肌、肱桡肌、股四头肌、腓肠肌中肌和跟腱分别在 1 小时内检查两次，以评估内部观察者的可靠性。使用应变指数、应变比和彩色像素分析超声弹性成像图像。确定每个结果变量的内部观察者可靠性和最小可检测变化。使用组内相关系数来量化测量的可重复性，计算最小可检测变化以确定测量误差以上的临床重要差异。应变指数、应变比和彩色像素分析的内部观察者可靠性从中度到优秀（组内相关系数：分别为.734-.950、.776-.921 和.754-.990），彩色像素分析的可靠性最高。确定了所有结构（包括跟腱）的最小可检测变化（应变指数的较高边界为 0.11，应变比为 1.80，红色像素为 2.90%，代表软组织）。与应变指数和应变比相比，彩色像素分析可能更可靠地用于超声弹性成像解释。计算得出的最小可检测变化可用于确定临床重要差异。
