Sonoelastography of the Common Flexor Tendon of the Elbow with Histologic Agreement: A Cadaveric Study

• Published in: Radiology Vol. 283; no. 2; pp. 486 - 491
• Main Authors: Klauser, Andrea S., Pamminger, Mathias J., Halpern, Ethan J., Abd Ellah, Mohamed M. H., Moriggl, Bernhard, Taljanovic, Mihra S., Deml, Christian, Sztankay, Judith, Klima, Guenter, Gruber, Leonhard, Jaschke, Werner R.
• Format: Journal Article
• Language: English
• Published: United States 01.05.2017
• Subjects: Aged; Cadaver; Elasticity Imaging Techniques - methods; Elbow Joint - diagnostic imaging; Elbow Joint - pathology; Elbow Tendinopathy - diagnostic imaging; Elbow Tendinopathy - pathology; Female; Humans; Male; Reproducibility of Results; Sensitivity and Specificity; Tendons - diagnostic imaging; Tendons - pathology
• ISSN: 0033-8419; 1527-1315
• DOI: 10.1148/radiol.2016160139

Purpose To determine the correlation of the results of conventional B-mode ultrasonography (US) and compression sonoelastography with histologic results in common flexor tendons of the elbow in human cadavers. Materials and Methods Twenty-five common flexor tendons were evaluated in 16 fresh, unembalmed cadavers of 11 women with a median age of 85 years (range, 71-101 years) and five men with a median age of 78 years (range, 70-88 years). Informed consent was provided according to the last will of the donors. B-mode US results were classified as grade 1, normal tendon with homogeneous fibrillar pattern; grade 2, tendon thickening or hypoechoic areas and/or calcifications in less than 30% of the tendon; or grade 3, hypoechoic areas and/or calcifications greater than 30% of the tendon. Sonoelastographic results were grade 1, blue (hardest) to green (hard); grade 2, yellow (soft); and grade 3, red (softest). The intraclass correlation coefficient was calculated to determine agreement with histologic findings for each B-mode US, sonoelastographic, and combined B-mode US and sonoelastographic examination. Histologic results were grade 1, normal, with parallel fibrillar pattern; grade 2, mild tendinopathy, with cellular infiltration, angiogenesis, or fatty vacuoles; or grade 3, severe tendinopathy, with loss of parallel collagen structure and necrosis. Results Histologic alterations were detected in 44% (11 of 25) of biopsy specimens. Intraclass correlation with histologic results was 0.57 for B-mode US, 0.68 for sonoelastography, and 0.84 for the combination of the two approaches. Conclusion The addition of sonoelastography to B-mode US provided statistically significant improvement in correlation with histologic results compared with the use of B-mode US alone (P < .02). RSNA, 2016 Online supplemental material is available for this article.