Abstract
We introduce an ultrasound elastography method for examining the ACL. It consisted of imaging the distal ACL while applying a drawer test and analyzing the resulting displacement and strain maps, where a map refers to how a variable is distributed spatially throughout an image. Our method was applied to healthy knees of cadaveric sheep to determine whether 1) our method can consistently generate displacements and strain maps in healthy ACLs; 2) displacement and strain maps are repeatable; and 3) healthy ACLs experience similar maps. We found that our method could consistently provide displacements and strain maps of the distal ACL region. Moreover, these ACLs experienced displacement and strain maps that were positively-correlated between trials, knees, and specimens. This correlation was statistically significant between pairs of trials and between left and right knees (p < 0.05). These results suggest that the maps are indeed repeatable and similar for healthy ACLs.
Highlights
Ultrasound is increasingly recognized for its diagnostic value when applied to musculoskeletal soft tissues [1]
We present a freehand, ultrasound elastography method for the ACL
Even though the distal ACL was consistently captured, the size of the delineated portion of the ACL varied among trials and specimens
Summary
Ultrasound is increasingly recognized for its diagnostic value when applied to musculoskeletal soft tissues [1]. Ultrasound promises accurate diagnoses of many medical disorders of musculoskeletal soft tissues. One such disorder is the rupture of the anterior cruciate ligament [2,3]. Even if MRI remains the more popular modality for diagnosing ACL ruptures, ultrasound may help improve the outcome of patients with ACL injuries, that is, if it can be used to diagnose partial ruptures or monitor the ACL during treatment. Ultrasound may not provide useful information in these settings. It is unclear whether ultrasound can detect structural changes to the ACL other than complete ruptures
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