Statistical and Texture Descriptors of Symptomatic Plantar Fasciitis Using Ultrasound Shear Wave Elastography

Hongmei Zhang,Zhihui Liu,Lei Xu,Jichao Yin,Shukuan Lu,Xiaofeng Yang,Mingxi Wan,Sibo Tian

doi:10.1109/access.2020.3005829

Hongmei Zhang, Zhihui Liu + Show 6 more

Open Access

https://doi.org/10.1109/access.2020.3005829

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Abstract

Plantar fasciitis (PFis) is a common cause of heel pain. This study aims to assess the plantar fascia (PF) quantitatively by using feature descriptors and seek valuable imaging biomarkers that can reliably diagnose PFis. A total of 63 participants underwent B-mode and longitudinal shear wave elastography (SWE) on unilateral plantar fasciae. To characterize the statistical and spatial texture features of the PF, ten statistical descriptors of the shear modulus in the standardized region of interest in PF and twenty texture descriptors in the SWE measurement window (in both horizontal and vertical directions) are proposed. Four statistical quantities ( mode, avg, med, qG ) and four texture descriptors ( autoc, sosvh, savgh svarh ) showed potential for diagnosing PFis, based on significant differences between the PFis and the healthy groups. Receiver operating characteristic (ROC) curve analysis revealed that the statistical descriptors have area under the curve (AUC) of approximately 0.9 (likelihood ratio >6.798) and the texture descriptors have AUC of approximately 0.85 (likelihood ratio >3.195). Combinations of statistical and texture descriptors can achieve higher AUCs~0.968. In addition, these descriptors were related to the clinical indices (body mass index and visual analogue scale) with Spearman’s correlation coefficient of $r=-0$ .5~−0.4( $p ). The proposed statistical and texture descriptors showed valuable potential if applied to clinical shear wave elastography for the diagnosis of PFis. This work lays the foundation of using ultrasound shear wave image features for describing symptomatic PFis.

Highlights

The plantar fascia (PF) is mostly composed of type I collagen fibers forming bundles arranged in a proximal-distal direction, and the large fibrous bundles are embedded within a matrix of loose connective tissue containing type III collagen [1]
The four statistical descriptors of the shear modulus were much higher in healthy PF than those in Plantar fasciitis (PFis), due to healthy PF being capable of bearing greater loads for its higher elasticity
The shear wave elastography (SWE) image showed that PFis had relative homogeneous focal soft areas with loss of fibrillar patterns leading to inflammatory exudates that decreased elasticity [6]

Summary

Introduction

The plantar fascia (PF) is mostly composed of type I collagen fibers forming bundles arranged in a proximal-distal direction, and the large fibrous bundles are embedded within a matrix of loose connective tissue containing type III collagen [1]. Plantar fasciitis (PFis) is a musculoskeletal disorder primarily affecting the fascial. Enthesis, resulting from fiber microtears, collagen degeneration, chronic inflammation, and calcification caused by repetitive overstrain [2]. These microscopic changes within the PF may lead to reduction of elasticity. PFis can cause considerable heel pain and disability, seriously affecting activities of daily living [3]. PFis is primarily a clinical diagnosis, as determined by the orthopedist through an examination with tapping and touching combined with the visual analogue scale (VAS) score [4]. Magnetic resonance imaging (MRI) and ultrasound are common imaging modalities for evaluating

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