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

Authors

Andrea S Klauser, Department of Radiology, Medical University of Innsbruck
Mathias J Pamminger, Department of Radiology, Medical University of Innsbruck
Ethan J. Halpern, Department of Radiology and Urology, Jefferson Prostate Diagnostic and Kimmel Cancer Center, Thomas Jefferson UniversityFollow
Mohamed M H Abd Ellah, Department of Radiology, Medical University of Innsbruck; Department of Diagnostic Radiology, South Egypt Cancer Institute, Assiut University
Bernhard Moriggl, Department of Anatomy, Medical University of Innsbruck
Mihra S Taljanovic, Department of Medical Imaging, Banner-University Medical Center
Christian Deml, Department of Trauma Surgery, Medical University of Innsbruck
Judith Sztankay, Department of Radiotherapy, Medical University of Innsbruck
Guenter Klima, Department of Histology and Embryology, Medical University of Innsbruck
Leonhard Gruber, Department of Radiology, Medical University of Innsbruck
Werner R Jaschke, Department of Radiology, Medical University of Innsbruck

Document Type

Article

Publication Date

5-1-2017

Comments

This article has been peer reviewed. It was published in: Radiology.

Volume 283, Issue 2, May 2017, Pages 486-491.

The published version is available at DOI: 10.1148/radiol.2016160139

Copyright © RSNA, 2016

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.

Recommended Citation

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; and Jaschke, Werner R, "Sonoelastography of the Common Flexor Tendon of the Elbow with Histologic Agreement: A Cadaveric Study." (2017). Department of Radiology Faculty Papers. Paper 47.
https://jdc.jefferson.edu/radiologyfp/47

PubMed ID

27930090