Sonoelastography of the Common Flexor Tendon of the Elbow with Histologic Agreement: A Cadaveric Study
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, unemba...
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| Published in | Radiology Vol. 283; no. 2; pp. 486 - 491 |
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| Main Authors | , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
01.05.2017
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0033-8419 1527-1315 |
| DOI | 10.1148/radiol.2016160139 |
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| Abstract | 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. |
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| AbstractList | 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. 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. |
| Author | Klauser, Andrea S. Klima, Guenter Deml, Christian Jaschke, Werner R. Taljanovic, Mihra S. Abd Ellah, Mohamed M. H. Moriggl, Bernhard Sztankay, Judith Pamminger, Mathias J. Gruber, Leonhard Halpern, Ethan J. |
| Author_xml | – sequence: 1 givenname: Andrea S. surname: Klauser fullname: Klauser, Andrea S. organization: From the Departments of Radiology (A.S.K., M.J.P., M.M.H.A.E., L.G., W.R.J.), Anatomy (B.M.), Trauma Surgery (C.D.), Radiotherapy (J.S.), and Histology and Embryology (G.K.), Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; Department of Radiology and Urology, Jefferson Prostate Diagnostic and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pa (E.J.H.); Department of Diagnostic Radiology, South Egypt Cancer Institute, Assiut University, Egypt (M.M.H.A.E.); and – sequence: 2 givenname: Mathias J. surname: Pamminger fullname: Pamminger, Mathias J. organization: From the Departments of Radiology (A.S.K., M.J.P., M.M.H.A.E., L.G., W.R.J.), Anatomy (B.M.), Trauma Surgery (C.D.), Radiotherapy (J.S.), and Histology and Embryology (G.K.), Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; Department of Radiology and Urology, Jefferson Prostate Diagnostic and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pa (E.J.H.); Department of Diagnostic Radiology, South Egypt Cancer Institute, Assiut University, Egypt (M.M.H.A.E.); and – sequence: 3 givenname: Ethan J. surname: Halpern fullname: Halpern, Ethan J. organization: From the Departments of Radiology (A.S.K., M.J.P., M.M.H.A.E., L.G., W.R.J.), Anatomy (B.M.), Trauma Surgery (C.D.), Radiotherapy (J.S.), and Histology and Embryology (G.K.), Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; Department of Radiology and Urology, Jefferson Prostate Diagnostic and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pa (E.J.H.); Department of Diagnostic Radiology, South Egypt Cancer Institute, Assiut University, Egypt (M.M.H.A.E.); and – sequence: 4 givenname: Mohamed M. H. surname: Abd Ellah fullname: Abd Ellah, Mohamed M. H. organization: From the Departments of Radiology (A.S.K., M.J.P., M.M.H.A.E., L.G., W.R.J.), Anatomy (B.M.), Trauma Surgery (C.D.), Radiotherapy (J.S.), and Histology and Embryology (G.K.), Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; Department of Radiology and Urology, Jefferson Prostate Diagnostic and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pa (E.J.H.); Department of Diagnostic Radiology, South Egypt Cancer Institute, Assiut University, Egypt (M.M.H.A.E.); and – sequence: 5 givenname: Bernhard surname: Moriggl fullname: Moriggl, Bernhard organization: From the Departments of Radiology (A.S.K., M.J.P., M.M.H.A.E., L.G., W.R.J.), Anatomy (B.M.), Trauma Surgery (C.D.), Radiotherapy (J.S.), and Histology and Embryology (G.K.), Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; Department of Radiology and Urology, Jefferson Prostate Diagnostic and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pa (E.J.H.); Department of Diagnostic Radiology, South Egypt Cancer Institute, Assiut University, Egypt (M.M.H.A.E.); and – sequence: 6 givenname: Mihra S. surname: Taljanovic fullname: Taljanovic, Mihra S. organization: From the Departments of Radiology (A.S.K., M.J.P., M.M.H.A.E., L.G., W.R.J.), Anatomy (B.M.), Trauma Surgery (C.D.), Radiotherapy (J.S.), and Histology and Embryology (G.K.), Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; Department of Radiology and Urology, Jefferson Prostate Diagnostic and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pa (E.J.H.); Department of Diagnostic Radiology, South Egypt Cancer Institute, Assiut University, Egypt (M.M.H.A.E.); and – sequence: 7 givenname: Christian surname: Deml fullname: Deml, Christian organization: From the Departments of Radiology (A.S.K., M.J.P., M.M.H.A.E., L.G., W.R.J.), Anatomy (B.M.), Trauma Surgery (C.D.), Radiotherapy (J.S.), and Histology and Embryology (G.K.), Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; Department of Radiology and Urology, Jefferson Prostate Diagnostic and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pa (E.J.H.); Department of Diagnostic Radiology, South Egypt Cancer Institute, Assiut University, Egypt (M.M.H.A.E.); and – sequence: 8 givenname: Judith surname: Sztankay fullname: Sztankay, Judith organization: From the Departments of Radiology (A.S.K., M.J.P., M.M.H.A.E., L.G., W.R.J.), Anatomy (B.M.), Trauma Surgery (C.D.), Radiotherapy (J.S.), and Histology and Embryology (G.K.), Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; Department of Radiology and Urology, Jefferson Prostate Diagnostic and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pa (E.J.H.); Department of Diagnostic Radiology, South Egypt Cancer Institute, Assiut University, Egypt (M.M.H.A.E.); and – sequence: 9 givenname: Guenter surname: Klima fullname: Klima, Guenter organization: From the Departments of Radiology (A.S.K., M.J.P., M.M.H.A.E., L.G., W.R.J.), Anatomy (B.M.), Trauma Surgery (C.D.), Radiotherapy (J.S.), and Histology and Embryology (G.K.), Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; Department of Radiology and Urology, Jefferson Prostate Diagnostic and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pa (E.J.H.); Department of Diagnostic Radiology, South Egypt Cancer Institute, Assiut University, Egypt (M.M.H.A.E.); and – sequence: 10 givenname: Leonhard surname: Gruber fullname: Gruber, Leonhard organization: From the Departments of Radiology (A.S.K., M.J.P., M.M.H.A.E., L.G., W.R.J.), Anatomy (B.M.), Trauma Surgery (C.D.), Radiotherapy (J.S.), and Histology and Embryology (G.K.), Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; Department of Radiology and Urology, Jefferson Prostate Diagnostic and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pa (E.J.H.); Department of Diagnostic Radiology, South Egypt Cancer Institute, Assiut University, Egypt (M.M.H.A.E.); and – sequence: 11 givenname: Werner R. surname: Jaschke fullname: Jaschke, Werner R. organization: From the Departments of Radiology (A.S.K., M.J.P., M.M.H.A.E., L.G., W.R.J.), Anatomy (B.M.), Trauma Surgery (C.D.), Radiotherapy (J.S.), and Histology and Embryology (G.K.), Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; Department of Radiology and Urology, Jefferson Prostate Diagnostic and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pa (E.J.H.); Department of Diagnostic Radiology, South Egypt Cancer Institute, Assiut University, Egypt (M.M.H.A.E.); and |
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| SubjectTerms | 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 |
| Title | Sonoelastography of the Common Flexor Tendon of the Elbow with Histologic Agreement: A Cadaveric Study |
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