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Title: Quantitative shear wave elastography compared to standard ultrasound (qualitative B-mode grayscale sonography and quantitative power Doppler) for evaluation of achillotendinopathy in treatment-naïve individuals: A cross-sectional study. Author: Chen L, Cheng Y, Zhou L, Zhang L, Deng X. Journal: Adv Clin Exp Med; 2022 Aug; 31(8):847-854. PubMed ID: 35593220. Abstract: BACKGROUND: Achillotendinopathy is reported as an overuse disorder and/or degeneration change of the tendon. The diagnosis of tendinopathy is not always easy through imaging modalities. The B-mode grayscale sonography and power Doppler are well-established methods aimed at visualising tendon structure, but have limited sensitivity and lack conventional sonographic characteristics in symptomatic patients. Shear wave ultrasound elastography quantitatively assesses tissue stiffness. OBJECTIVES: To compare the diagnostic accuracy of shear wave ultrasound elastography to that of standard ultrasound (combined B-mode grayscale sonography and power Doppler) for diagnosis of achillotendinopathy, considering clinical symptoms as the reference standard. MATERIAL AND METHODS: Standard questionnaires regarding medical history and the Chinese version of a Victorian Institute of Sports Assessment - Achilles Questionnaires (VISA-AC) score were evaluated for a total of 14 treatment-naïve patients with complaints of localized swelling, and reduced force and/or flexibility of the Achilles tendon(s). The irregular thickening around the Achilles tendon, heterogeneity of echotexture of the tendon and calcification of the calcaneal attachment were considered incidences of tendinopathy in B-mode grayscale sonography. Tendinopathies were considered if tendons were >0.60 cm thick in power Doppler. Shear wave elasticity <350 kpa (10 m/s) was considered tendinopathy. RESULTS: A total of 28 conditions of both sides were evaluated through standard ultrasound examinations. Eighty-four tendons were assessed using shear wave ultrasound elastography. Asymptomatic tendons were visible as red and symptomatic (VISA-AC score <80) tendons were visible as blue or turquoise in the images. The rigidity of symptomatic tendons was lower than that of asymptomatic tendons (p < 0.0001). Sensitivity and accuracy for standard ultrasound were increased by the addition of shear wave ultrasound elastography for both symptomatic and asymptomatic tendons. The VISA-AC score was strongly correlated with the elasticity values (p = 0.000, Kendall's tau-beta (τβ) = 0.71) of Achilles tendons. CONCLUSIONS: Shear wave ultrasound elastography augments diagnostic confidence of standard ultrasound for the treatment of tendinopathies of Achilles tendons.[Abstract] [Full Text] [Related] [New Search]