Abstract
Simple SummaryStrain elastography is an ultrasound-based technique that assesses the mechanical properties of tissues and gives a relative representation of elasticity. Early diagnosis of tendon injuries and long-term monitoring of the healing process are key to equine practice; thus, an accurate method is needed for analyzing and interpreting the images obtained with strain elastography. The first aim of the study was to demonstrate the intraoperator repeatability and interoperator reproducibility of manual measurements of elastograms obtained from injured superficial digital flexor tendons of horses; the second aim was to perform a standardization of the manual measurement method by comparing it with external software. Despite their subjectivity, manual measurements proved to be repeatable and reproducible. In addition, the results obtained with the manual method matched those obtained with the external software.Early diagnosis of tendon injuries and accurate long-term monitoring of the healing process are key for equine veterinarians that use conventional ultrasonography. The development of strain elastography could improve the management of clinical cases. The aim of the study was to assess the intraobserver repeatability and interobserver reproducibility of manual measurements of the colored areas of the tendons within elastograms and to standardize this manual modality by comparing the analysis of the images with ImageJ. Twenty elastograms of the injured superficial digital flexor tendons (SDFTs) of horses were analyzed by two different operators after an acute injury was diagnosed with ultrasonography. Statistical analysis demonstrated excellent intraobserver repeatability (intraclass correlation coefficient, ICC = 0.949) and good interobserver reproducibility (ICC = 0.855) for manual measurements performed with tools available on the ultrasound unit. A good agreement between manual measurements and measurements performed with ImageJ (ICC = 0.849) was then demonstrated. Despite its subjectivity, the manual modality proved to be a valid method for analyzing images obtained with strain elastography.
Highlights
Sports horses are subject to tendon injuries
Ultrasound elastography (USE) is able to assess the mechanical properties of tissues and provide information on their elasticity
The first aim of our study was to assess the intraobserver repeatability and interobserver reproducibility of manual measurements of colored areas in the elastograms of injured tendons, obtained with an ultrasound unit equipped with strain elastography (SE) software
Summary
Sports horses are subject to tendon injuries. This is a huge issue due to the high recurrence rate and the time needed for complete healing [1,2]. Due to the use of portable ultrasound units, 2D-US is low-risk and easy to use in the field. It is not able to assess the mechanical properties of tissues, or to predict 4.0/). Injuries or detect abnormal signs in tendons over five months post-injury, even though tendons may need up to 18 months for a total recovery [1,3,4]. Ultrasound elastography (USE) is able to assess the mechanical properties of tissues and provide information on their elasticity. The two main types of USE are shear wave elastography (SWE) and strain elastography (SE)
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