Abstract
ObjectivesChanges in mechanical loading as well as pathology can modify the Achilles tendon mechanical properties and therefore detection of these changes is relevant for the diagnosis and management of Achilles tendinopathy. The aim of this study was to evaluate strain and shear wave sonoelastography for their ability to detect changes in the Achilles tendon mechanical properties during a series of isometric contractions.MethodsLongitudinal sonoelastography images of the Achilles tendon were acquired from 20 healthy participants using four different ultrasound devices; two implementing strain sonoelastography technology (SE1, SE2) and two, shear wave elastography technology (SWE1, SWE2).ResultsSE1 measured a decreasing strain ratio (tendon become harder) during the different contraction levels from 1.51 (0.92) to 0.33 (0.16) whereas SE2 mesaured a decreasing strain ratio from 1.08 (0.76) to 0.50 (0.32). SWE1 measured decreasing tendon stiffness during contractions of increasing intensity from 33.40 (19.61) to 16.19 (2.68) whereas SWE2 revealed increasing tendon stiffness between the first two contraction levels from 428.65 (131.5) kPa to 487.9 (121.5) kPa followed by decreasing stiffness for the higher contraction levels from 459.35 (113.48) kPa to 293.5 (91.18) kPa.ConclusionsStrain elastography used with a reference material was able to detect elasticity changes between the different contraction levels whereas shear wave elastography was less able to detect changes in Achilles tendon stiffness when under load. Inconsistent results between the two technologies should be further investigated.
Highlights
Achilles tendon (AT) is the thickest tendon in the human body; it connects the triceps surae to the calcaneus bone and produces plantar flexion of the ankle
AT stiffness and elasticity have been evaluated with different ultrasound-based technologies, in particular shear wave sonoelastography (SWE) and strain sonoelastography (SE) [5,6,7,8,9,10]
Longitudinal sonoelastography images of the left and right AT were performed with three ultrasound devices, using two different systems of SE and Shear wave elastography (SWE) technologies
Summary
Achilles tendon (AT) is the thickest tendon in the human body; it connects the triceps surae to the calcaneus bone and produces plantar flexion of the ankle. Schneebeli et al Insights Imaging (2021) 12:26 mechanical and morphological changes of the AT occur with aging and in individuals with chronic tendinopathy [2, 3]. Ultrasonography evaluation is usually the first-line imaging examination for patients with suspected Achilles tendinopathy since it is widely available, has a relatively low cost and provides a real-time assessment [4]. Conventional ultrasound images can only provide information about the anatomical and morphological features of the AT and cannot assess tendon mechanical properties. AT stiffness and elasticity have been evaluated with different ultrasound-based technologies, in particular shear wave sonoelastography (SWE) and strain sonoelastography (SE) [5,6,7,8,9,10]
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