Achilles Tendon Thickness and Stiffness Evaluation with Shear-Wave Elastography in Hemodialysis Patients

Hekimoğlu, Azad; Turan, Aynur; Şimşir, Begüm Demirler; Durmaz, Hasan Ali; Aylı, Mehmet Deniz; Hekįmoğlu, Baki

doi:10.5812/iranjradiol.66274

Cited by 3 publications

(17 citation statements)

References 27 publications

(32 reference statements)

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“…Since the Zn contained in the microstructure of Al-Zn alloys is dissolved during the α phase, a distortion in this lattice structure was expected. Distortion of the lattice structure prevents the progression of dislocations, resulting in an increase in the hardness and strength of the alloy [32][33][34]. However, as shown in Fig.…”

Section: Microhardness and Wear Test Resultsmentioning

confidence: 99%

The effect of aging processes on tribo-metallurgy properties of al based ternary alloys product by P/M technique

et al. 2020

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In this study, Al matrix composites consisting of different amounts of Zn, Cu, and Mg were produced using the powder metallurgy technique. In the alloying, powders were ball milled for 120 min via mechanical alloying. After alloying process, the powders were pressed at 800 MPa at room temperature. Sintering (2 h at 600?C in argon atmosphere), solution treatment (2 h at 480?C), and aging processes (3, 6, 9, and 12 h, respectively, at 120?C) were applied to the samples. The hardness and tribo-metallurgy properties of the products were investigated. After sintering, the hardness values of the three alloys were close to each other; however, the solution treatment after sintering caused the hardness values to increase significantly. It was determined that the Al-2Zn-5Cu-4Mg alloy had the highest hardness increase with the 6-h aging heat treatment. The wear resistance of the materials in all the compositions had increased. The highest wear resistance and lowest friction coefficient were obtained for the Al-2Zn-5Cu-4Mg alloy with the 6-h aging heat treatment.

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Section: Microhardness and Wear Test Resultsmentioning

confidence: 99%

The effect of aging processes on tribo-metallurgy properties of al based ternary alloys product by P/M technique

et al. 2020

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“…There was no statistically significant difference between the groups in their study. They reported their use of only the middle portion of the tendons as a limitation of their study and stated that it could have been the reason for statistically insignificant difference in the stiffness of the Achilles tendon between patients with CKD and healthy individuals 12 . We used all portions of the tendons, including the middle portion, so our study results conflicted with those of Hekimoglu et al 12 Although our study results were contradictory with those of Hekimoglu et al, 12 our results were consistent with many studies' results in the literature on Achilles tendons of diseased and healthy individuals, which yielded statistically significant differences between groups 9,11,12,16 .…”

Section: Discussionmentioning

confidence: 99%

“…There are few studies in the literature evaluating the elasticity of the Achilles tendon in patients with CKD 11,12 . Caglar et al 11 evaluated Achilles tendon stiffness in 26 patients with CKD undergoing hemodialysis using Virtual Touch imaging quantification (Siemens Healthineers, Mountain View, CA) as an elastographic method and compared it with that of healthy individuals.…”

Section: Discussionmentioning

confidence: 99%

“…Hekimoglu at al 12 assessed Achilles tendon stiffness in 34 patients with CKD undergoing hemodialysis and compared it with that of healthy individuals using shear wave elastography. They found that Achilles tendon stiffness values were 26 ± 9.74 kPa in the patient group and 26.64 ± 6.64 kPa in the control group.…”

Section: Discussionmentioning

confidence: 99%

“…Force can be manual by transducer compression or physiologic pressure changes (heartbeat or breathing movements) 10 Strain elastography provides a more objective evaluation of tissue stiffness by the help of the strain ratio (SR) calculation, which is a semiquantitative evaluation of the lesion stiffness by comparing the lesion elasticity with that of surrounding tissue 6 . Limited studies have been conducted to evaluate UE changes of the Achilles tendon in patients with CKD 11,12 . To our knowledge, there is no study in the literature evaluating the SR of the Achilles tendon in patients with CKD.…”

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Evaluation of the Achilles Tendon Using B‐Mode Ultrasound and Strain Elastography in Patients With Chronic Kidney Disease

Mutlu

Toslak

İnci

et al. 2020

J of Ultrasound Medicine

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Objectives To investigate the B‐mode ultrasound (US) features and elasticity of the Achilles tendon in patients with chronic kidney disease (CKD) using US elastography and to compare them with those of healthy individuals. Methods From March 2019 through May 2019, 30 consecutive patients with variable stages of CKD and 30 healthy individuals were prospectively included in this study. Ultrasound and strain elastographic examinations were performed on both Achilles tendons of all individuals. Degrees of tendinopathy, if existed, were classified as defined by Archambault et al (J Clin Ultrasound 1998; 26:335–339), and thicknesses were documented with US. Strain ratios (SRs) were calculated by measuring the strain values from the Achilles tendon and Kager fat pad. Statistical differences in the SRs of Achilles tendons between the control group and patients with CKD were calculated. Results The 30 patients with CKD ranged in age from 24 to 73 years, and the 30 healthy individuals ranged in age from 25 to 78 years. Both distal and left middle thirds of the Achilles tendons were thicker in patients with CKD than in healthy individuals (P < .05). The mean SRs ± SDs in the patient group (4.71 ± 0.95 and 4.85 ± 1.47 on the right and left, respectively) were significantly higher (P < .05) than in healthy individuals (2.31 ± 0.42 and 2.65 ± 0.55 on the right and left), which indicated an increased stiffness of Achilles tendons in the patient group. Conclusions As a semiquantitative and noninvasive imaging modality, strain elastography has the potential to detect the morphologic and elasticity changes of Achilles tendons in patients with CKD, which may give an opportunity to help physicians predict possible leading partial or complete tears.

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Strain and shearwave sonoelastographic findings of quadriceps tendon in patients with chronic kidney disease. Are they reliable?

Gulseren

Aslan

Buz

2022

J of Clinical Ultrasound

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Aim In this study, we aimed to compare the strain (SE) and shear wave elastography (SWE) findings of the quadriceps tendons (QT) of the patients with chronic kidney disease (CKD) and healthy volunteers (HV), and estimate the reliability of the evaluations. Materials and Methods Twenty‐nine HV and twenty‐seven patients with CKD were enrolled. All sonoelastographic examinations were performed separately by two observers. The QT thickness (QTT), SWE, and SE findings including the tissue elastic modulus (EM), shear wave velocity (SWV), and the elasticity patterns were obtained and compared. Interobserver agreement was evaluated to test the reliability of the findings. Results The QT in CKD patients is thinner than HV (p = 0.001 for both observers). The elasticity patterns of QT were mostly intermediate stiffness for both observers (p < 0.05 for both observers). The mean EM values in the patient group were significantly higher than HV for both observers (p < 0.05 for both observers). The mean SWVs were significantly higher in the patient group (p < 0.05 for both observers). SWV showed weak, significant, and negative correlations with the hemodialysis (HD) duration (p < 0.05 for both observers). The interobserver agreements were moderate to excellent for QTT, EM, SWS, and SE patterns (p < 0.01 for all parameters). Conclusion QTT and its elasticity are decreased in patients with CKD. The QTT and SE patterns may be the choice to determine the elasticity in CKD patients with good reliability values rather than SWE. But, there is still debate on the reliability of sonoelastographic findings, to ensure standardization of the factors affecting reliability, they should be well understood.

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Achilles Tendon Thickness and Stiffness Evaluation with Shear-Wave Elastography in Hemodialysis Patients

Cited by 3 publications

References 27 publications

The effect of aging processes on tribo-metallurgy properties of al based ternary alloys product by P/M technique

The effect of aging processes on tribo-metallurgy properties of al based ternary alloys product by P/M technique

Evaluation of the Achilles Tendon Using B‐Mode Ultrasound and Strain Elastography in Patients With Chronic Kidney Disease

Strain and shearwave sonoelastographic findings of quadriceps tendon in patients with chronic kidney disease. Are they reliable?

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