Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, 110029, India.
Department of Physical Medicine and Rehabilitation, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, 110029, India.
J Ultrasound. 2023 Jun;26(2):385-391. doi: 10.1007/s40477-022-00694-z. Epub 2022 Aug 10.
To assess the advantage of the addition of shear wave elastography (SWE) to gray-scale sonography in the diagnosis of plantar fasciitis.
30 subjects between 18-60 years of age with unilateral heel pain who were clinically suspected of having plantar fasciitis were included in this study. Their affected feet were taken as cases; while their contralateral feet served as controls. On gray-scale ultrasound, the thickness of plantar fascia, its echopattern, presence of hypoechoic areas, and perifasicular collections were recorded. SWE was done by placing seven ROIs within the plantar fascia; and the mean of their Young's modulus was taken in kPa.
Plantar fascial thickening more than 4 mm had 70% sensitivity and 66.7% specificity, echopattern had 90% sensitivity and 96.7% specificity, hypoechoic areas had 80% sensitivity and 96.7% specificity, and perifascial edema had 26.7% sensitivity and 100% specificity for diagnosing plantar fasciitis. Using the ROC curve, the cut-off value of Young's modulus for the diagnosis of plantar fasciitis was found to be ≤ 99.286 kPa. This predicted plantar fasciitis with 97% sensitivity and 100% specificity. The primary diagnostic feature of ultrasound of plantar fascia thickness more than 4 mm detected 21 out of 30 cases of plantar fasciitis; whereas elastography detected an additional 8 cases which would have been missed on B-mode ultrasound alone.
SWE is a useful supplement and improves the diagnostic accuracy of gray-scale ultrasound in plantar fasciitis.
评估剪切波弹性成像（SWE）在灰阶超声诊断足底筋膜炎中的优势。
本研究纳入了 30 名年龄在 18-60 岁之间、单侧足跟疼痛且临床疑似足底筋膜炎的患者。他们的患足为病例组，对侧足为对照组。在灰阶超声上，记录足底筋膜的厚度、回声模式、有无低回声区及筋膜周围积液。在足底筋膜内放置 7 个 ROI 进行 SWE，以 kPa 为单位记录其平均杨氏模量。
足底筋膜厚度大于 4mm 的敏感度为 70%，特异度为 66.7%；回声模式的敏感度为 90%，特异度为 96.7%；低回声区的敏感度为 80%，特异度为 96.7%；筋膜周围水肿的敏感度为 26.7%，特异度为 100%。使用 ROC 曲线，发现杨氏模量的截断值≤99.286kPa 可用于诊断足底筋膜炎。该值预测足底筋膜炎的敏感度为 97%，特异度为 100%。超声检测足底筋膜厚度大于 4mm 这一主要诊断特征发现了 30 例足底筋膜炎中的 21 例；而弹性成像额外发现了单独使用 B 型超声会遗漏的 8 例。
SWE 是一种有用的补充方法，可提高灰阶超声诊断足底筋膜炎的准确性。
