A Multicenter Large‐Sample Shear Wave Ultrasound Elastographic Study of the Achilles Tendon in Chinese Adults

Cao, Wen; Sun, Yang; Liu, Li; Wang, Zhu; Wu, Jhao-Ying; Qiu, Li; Wang, Yue Xiang; Yuan, Yu; Shen, Su Fang; Chen, Qin; Chen, Tao; Zhang, Wen; Wu, Changjun; Liu, Feng Xia; Zhong, Shi Gen; Chen, Li; Tong, Ming Hui; Cui, Li; Guo, Rui

doi:10.1002/jum.14797

Cited by 14 publications

(10 citation statements)

References 48 publications

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“…The averaged value of Young's modulus for the tested samples was equal to 264.78 ± 55.11 MPa (Table 1) that is comparable with the values reported in (Chen et al, 2013). The values of the elastic modulus reported in literature are between 374.24 kPa (Cao et al, 2018) and 2.0 GPa (Kongsgaard et al, 2011) and depend on e.g. the cadaver age type of study (Kongsgaard et al, 2011) and strain rate (Wren et al, 2001).…”

Section: Resultssupporting

confidence: 80%

The application of digital image correlation to investigate the heterogeneity of Achilles tendon deformation and determine its material parameters

Kohut¹,

Holak²,

Ekiert³

et al. 2020

Journal of Theoretical and Applied Mechanics

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The challenge for researchers is to develop measurement techniques that can deal with biological specimens (e.g. the human Achilles tendon) characterized by high deformation during examination. The relevant quantity which has to be investigated in laboratory experiments is the deformation or strain field of the specimen subjected to a given load. In experimental mechanics, the most remarkable technique used for strain field computation is the Digital Image Correlation (DIC) method. In the paper, the DIC method is employed to study biomaterial parameters of human Achilles tendons (AT) subjected to tensile uniaxial loadings. The application of DIC allows the heterogeneity of tendon deformation to be taken into consideration. Young's modulus of AT based on the strain field obtained from a vision-based measurement is estimated and the results are discussed. A map of Young's modulus (YM) is demonstrated as well.

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Section: Resultssupporting

confidence: 80%

The application of digital image correlation to investigate the heterogeneity of Achilles tendon deformation and determine its material parameters

Kohut¹,

Holak²,

Ekiert³

et al. 2020

Journal of Theoretical and Applied Mechanics

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“…One of the major drawbacks of shear wave imaging is that it can result in saturation of the elastogram in ankle positions around 0° of flexion since the Achilles tendon bears high tensile loads in this position or when dorsiflexed. Given this limitation, authors [ 38 ] of previous research suggested that the evaluation of AT should be limited to a relaxed or plantar flexed position and not stretched or loaded tendon with additional weight as this will increase the shear wave velocity [ 39 , 57 ] leading to saturation and possibly false results.…”

Section: Discussionmentioning

confidence: 99%

Elastography in the assessment of the Achilles tendon: a systematic review of measurement properties

Mifsud¹,

Gatt²,

Micallef-Stafrace³

et al. 2023

Journal of Foot and Ankle Research

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Background Managing and rehabilitating Achilles tendinopathy can be difficult, and the results are often unsatisfactory. Currently, clinicians use ultrasonography to diagnose the condition and predict symptom development. However, relying on subjective qualitative findings using ultrasound images alone, which are heavily influenced by the operator, may make it difficult to identify changes within the tendon. New technologies, such as elastography, offer opportunities to quantitatively investigate the mechanical and material properties of the tendon. This review aims to evaluate and synthesise the current literature on the measurement properties of elastography, which can be used to assess tendon pathologies. Methods A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. CINAHL, PubMed, Cochrane, Scopus, MEDLINE Complete, and Academic Search Ultimate were searched. Studies assessing the measurement properties concerning reliability, measurement error, validity, and responsiveness of the instruments identified in healthy and patients with Achilles tendinopathy were included. Two independent reviewers assessed the methodological quality using the Consensus-based Standards for the Selection of Health Measurement Instruments methodology. Results Out of the 1644 articles identified, 21 were included for the qualitative analysis investigating four different modalities of elastography: axial strain elastography, shear wave elastography, continuous shear wave elastography, and 3D elastography. Axial strain elastography obtained a moderate level of evidence for both validity and reliability. Although shear wave velocity was graded as moderate to high for validity, reliability obtained a very low to moderate grading. Continuous shear wave elastography was graded as having a low level of evidence for reliability and very low for validity. Insufficient data is available to grade three-dimensional shear wave elastography. Evidence on measurement error was indeterminate so evidence could not be graded. Conclusions A limited number of studies explored quantitative elastography on Achilles tendinopathy as most evidence was conducted on a healthy population. Based on the identified evidence on the measurement properties of elastography, none of the different types showed superiority for its use in clinical practice. Further high-quality studies with longitudinal design are needed to investigate responsiveness.

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“…The criteria for normal SWE values in Achilles tendon were taken by following two previous multicenter studies. 40 41 These studies calculated the mean elasticity of normal Achilles tendon to be >300kPa.…”

Section: Methodsmentioning

confidence: 99%

Role of Shear-Wave Elastography in Achilles Tendon in Psoriatic Arthritis and Its Correlation with Disease Severity Score, Psoriasis Area and Severity Index

Saha

Prakash

Sinha

et al. 2022

Indian J Radiol Imaging

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Purpose The aim of this study was to compare accuracy of shear-wave elastography (SWE) with gray scale (GS) ultrasound and power Doppler (pD) for diagnosing Achilles tendinopathy in psoriatic patients with and without arthritis and correlation with achillodynia and disease severity score, psoriasis area and severity index (PASI). Methods A total of 100 Achilles tendons were evaluated where 56% were cases of psoriatic arthritis with achillodynia; 44% were controls of psoriasis without arthritis in this prospective study. Evaluation was done with GS, pD, SWE at proximal, mid, and distal third of the tendon. Qualitative (color maps) and quantitative data, elastic modulus, kilopascal (kPa), were generated. Pearson's correlation was done to see association between kPa, PASI and clinical symptoms, achillodynia, scored using visual analog scale (VAS). Results Significant negative correlation was seen between duration of arthritis, VAS and PASI with SWE values with r = −0.34, −0.47, and −0.41, respectively. SWE could identify abnormal tendons in 71/100 (71%) in the overall study, 53/56 (94.6%) in cases, and 18/44 (40.9%) in control. The statistical significance was set at p ≤ 0.05. In comparison, conventional ultrasound, GS, and pD together could identify 13/56 (23.21%) in cases and no abnormal tendon was identified in the control group. Conclusion SWE is a reliable, noninvasive, and valuable tool to detect early tendinopathy and monitor progression of disease.

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A Multicenter Large‐Sample Shear Wave Ultrasound Elastographic Study of the Achilles Tendon in Chinese Adults

Abstract: The Young modulus of the Achilles tendon as measured by shear wave elastography is related to body weight as well as the perimeter or thickness of the tendon.

Cited by 14 publications

References 48 publications

The application of digital image correlation to investigate the heterogeneity of Achilles tendon deformation and determine its material parameters

The application of digital image correlation to investigate the heterogeneity of Achilles tendon deformation and determine its material parameters

Elastography in the assessment of the Achilles tendon: a systematic review of measurement properties

Role of Shear-Wave Elastography in Achilles Tendon in Psoriatic Arthritis and Its Correlation with Disease Severity Score, Psoriasis Area and Severity Index

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