41465
document
Ultrasonographic tissue characterisation of human Achilles tendons : quantification of tendon structure through a novel non-invasive approach . OBJECTIVE To assess whether three-dimensional imaging of the Achilles tendon by ultrasonographic tissue characterisation ( UTC ) can differentiate between symptomatic and asymptomatic tendons . DESIGN Case-control study . SETTING Sports Medical Department of the Hague Medical Centre . PATIENTS Twenty-six tendons from patients with chronic midportion Achilles tendinopathy were included . The " matched " control group consisted of 26 asymptomatic tendons . INTERVENTIONS Symptomatic and asymptomatic tendons were scanned using the UTC procedure . One researcher performed the ultrasonographic data collection . These blinded data were randomised , and outcome measures were determined by two independent observers . MAIN OUTCOME MEASUREMENTS The raw ultrasonographic images were analysed with a custom-designed algorithm that quantifies the three-dimensional stability of echo patterns , qua intensity and distribution over contiguous transverse images . This three-dimensional stability was related to tendon structure in previous studies . UTC categorises four different echotypes that represent ( I ) highly stable ; ( II ) medium stable ; ( III ) highly variable and ( IV ) constantly low intensity and variable distribution . The percentages of echo-types were calculated , and the maximum tendon thickness was measured . Finally , the inter-observer reliability of UTC was determined . RESULTS Symptomatic tendons showed less pixels in echo-types I and II than asymptomatic tendons ( 51.5 % vs 76.6 % , p < 0.001 ) , thus less three-dimensional stability of the echo pattern . The mean maximum tendon thickness was 9.2 mm in the symptomatic group and 6.8 mm in the asymptomatic group ( p < 0.001 ) . The Intraclass Correlation Coefficient ( ICC ) for the interobserver reliability of determining the echo-types I+II was 0.95 . The ICC for tendon thickness was 0.84 . CONCLUSION UTC can quantitatively evaluate tendon structure and thereby discriminate symptomatic and asymptomatic tendons . As such , UTC might be useful to monitor treatment protocols .
41466
Intervention_Physical
Ultrasonographic tissue characterisation
41467
Intervention_Physical
three-dimensional imaging
41468
Intervention_Other
of the Achilles tendon by
41469
Intervention_Physical
ultrasonographic tissue characterisation ( UTC )
41470
Intervention_Physical
scanned using the UTC procedure
41471
Intervention_Physical
ultrasonographic data collection
41472
Intervention_Physical
UTC
41473
Intervention_Physical
UTC
41474
Outcome_Other
UTC procedure
41475
Outcome_Other
three-dimensional stability of echo patterns
41476
Outcome_Other
qua intensity
41477
Outcome_Other
distribution over contiguous transverse images
41478
Outcome_Physical
echotypes
41479
Outcome_Other
highly stable
41480
Outcome_Other
medium stable
41481
Outcome_Other
highly variable
41482
Outcome_Other
constantly low
41483
Outcome_Other
echo-types
41484
Outcome_Other
tendon thickness
41485
Outcome_Other
echo pattern
41486
Outcome_Other
tendon thickness
41487
Outcome_Other
Intraclass Correlation Coefficient
41488
Outcome_Other
tendon thickness
41489
Participant_Sample-size
Twenty-six
41490
Participant_Condition
tendons
41491
Participant_Condition
chronic midportion Achilles tendinopathy
41492
Participant_Sample-size
26
41493
Participant_Condition
asymptomatic tendons