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Original Contribution| Volume 35, ISSUE 12, P1973-1981, December 2009

Speckle Tracking Ultrasound for Assessment of the Relative Motion of Flexor Tendon and Subsynovial Connective Tissue in the Human Carpal Tunnel

      Abstract

      The objective of this study was to compare tissue Doppler imaging and speckle tracking ultrasound to assess the relative motion of flexor tendon and surrounding subsynovial connective tissue (SSCT). Twenty normal human wrists were imaged with an ultrasound scanner. The two ultrasound methods measured the excursion and maximum velocity of the tendon and SSCT while subjects gripped three different sized acrylic tubes and these were correlated with tendon excursions estimated from finger joint angle changes. The maximum velocity ratio (=SSCT/tendon velocity) and the shear index (=[(Tendon excursion–SSCT excursion)/Tendon excursion]×100%) were calculated. The intraclass correlation coefficient was higher for joint angle/speckle tracking tendon excursion (0.642) than for joint angle/tissue Doppler excursion (0.377). The speckle tracking method could also discriminate differences in maximum velocity ratio and shear index for different tube sizes. We conclude that speckle tracking may be useful in assessing the relative motion of tendon and SSCT. (E-mail: [email protected])

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      References

        • An K.N.
        • Ueba Y.
        • Chao E.Y.
        • Cooney W.P.
        • Linscheid R.L.
        Tendon excursion and moment arm of index finger muscles.
        J Biomech. 1983; 16: 419-425
        • Bordalo-Rodrigues M.P.
        • Amin P.
        • Rosenberg Z.S.
        MR imaging of common entrapment neuropathies at the wrist.
        Magn Reson Imaging Clin N Am. 2004; 12: 265-279
        • Buch-Jaeger N.
        • Foucher G.
        Correlation of clinical signs with nerve conduction tests in the diagnosis of carpal tunnel syndrome.
        J Hand Surg Br. 1994; 19: 720-724
        • Castro P.L.
        • Greenberg N.L.
        • Drinko J.
        • Garcia M.J.
        • Thomas J.D.
        Potential pitfalls of strain rate imaging: Angle dependency.
        Biomed Sci Instrum. 2000; 36: 197-202
        • Chen J.
        • Cao T.
        • Duan Y.
        • Yuan L.
        • Yang Y.
        Velocity vector imaging in assessing the regional systolic function of patients with post myocardial infarction.
        Echocardiography. 2007; 24: 940-945
        • Cigali B.S.
        • Buyruk H.M.
        • Snijders C.J.
        • Lameris J.S.
        • Holland W.P.
        • Mesut R.
        • Stam H.J.
        Measurement of tendon excursion velocity with colour Doppler imaging: A preliminary study on flexor pollicis longus muscle.
        Eur J Radiol. 1996; 23: 217-221
        • Cobb T.K.
        • Cooney W.P.
        • An K.N.
        Pressure dynamics of the carpal tunnel and flexor compartment of the forearm.
        J Hand Surg Am. 1995; 20: 193-198
        • Ettema A.M.
        • Amadio P.C.
        • Zhao C.
        • Wold L.E.
        • An K.N.
        A histological and immunohistochemical study of the subsynovial connective tissue in idiopathic carpal tunnel syndrome.
        J Bone Joint Surg Am. 2004; 86: 1458-1466
        • Ettema A.M.
        • Amadio P.C.
        • Zhao C.
        • Wold L.E.
        • O'Byrne M.M.
        • Moran S.L.
        • An K.N.
        Changes in the functional structure of the tenosynovium in idiopathic carpal tunnel syndrome: A scanning electron microscope study.
        Plast Reconstr Surg. 2006; 118: 1413-1422
        • Ettema A.M.
        • Belohlavek M.
        • Zhao C.
        • Oh S.H.
        • Amadio P.C.
        • An K.N.
        High-resolution ultrasound analysis of subsynovial connective tissue in human cadaver carpal tunnel.
        J Orthop Res. 2006; 24: 2011-2020
        • Ettema A.M.
        • An K.N.
        • Zhao C.
        • O'Byrne M.M.
        • Amadio P.C.
        Flexor tendon and synovial gliding during simultaneous and single digit flexion in idiopathic carpal tunnel syndrome.
        J Biomech. 2008; 41: 292-298
        • Galderisi M.
        • Olibet M.
        • Sidiropulos M.
        • Innelli P.
        • D'Errico A.
        • de Divitiis O.
        Currently available technology for echocardiographic assessment of left ventricular function.
        Expert Rev Med Devices. 2006; 3: 207-214
        • Guimberteau J.C.
        The sliding system. Vascularized flexor tendon transfers in new ideas in hand flexor tendon surgery.
        Institut Aquitain De La Main, 2001
        • Helle-Valle T.
        • Crosby J.
        • Edvardsen T.
        • Lyseggen E.
        • Amundsen B.H.
        • Smith H.J.
        • Rosen B.D.
        • Lima J.A.
        • Torp H.
        • Ihlen H.
        • Smiseth O.A.
        New noninvasive method for assessment of left ventricular rotation: Speckle tracking echocardiography.
        Circulation. 2005; 112: 3149-3156
        • Hough A.D.
        • Moore A.P.
        • Jone M.P.
        Peripheral nerve motion measurement with spectral Doppler sonography: A reliability study.
        J Hand Surg Br. 2000; 25: 585-589
        • Klauser A.S.
        • Halpern E.J.
        • De Zordo T.
        • Feuchtner G.M.
        • Arora R.
        • Gruber J.
        • Marinoli C.
        • Loscher W.N.
        Carpal tunnel syndrome assessment with US: Value of additional cross-sectional area measurements of the median nerve in patients versus healthy volunteers.
        Radiology. 2009; 250: 171-177
        • Notomi Y.
        • Lysyansky P.
        • Setser R.M.
        • Shiota T.
        • Popović Z.B.
        • Martin-Miklovic M.G.
        • Weaver J.A.
        • Oryszak S.J.
        • Greenberg N.L.
        • White R.D.
        • Thomas J.D.
        Measurement of ventricular torsion by two-dimensional ultrasound speckle tracking imaging.
        J Am Coll Cardiol. 2005; 21: 2034-2041
        • Oh S.
        • Belohlavek M.
        • Zhao C.
        • Osamura N.
        • Zobitz M.E.
        • An K.N.
        • Amadio P.C.
        Detection of differential gliding characteristics of the flexor digitorum superficialis tendon and subsynovial connective tissue using color Doppler sonographic imaging.
        J Ultrasound Med. 2007; 26: 149-155
        • Pirat B.
        • McCulloch M.L.
        • Zoghbi W.A.
        Evaluation of global and regional right ventricular systolic function in patients with pulmonary hypertension using a novel speckle tracking method.
        Am J Cardiol. 2006; 98: 699-704
        • Steinman A.H.
        • Tavakkoli J.
        • Myers Jr., J.G.
        • Cobbold R.S.
        • Johnston K.W.
        Sources of error in maximum velocity estimation using linear phased-array Doppler systems with steady flow.
        Ultrasound Med Biol. 2001; 27: 655-664
        • Wong S.M.
        • Griffith J.F.
        • Hui A.C.
        • Tang A.
        • Wong K.S.
        Discriminatory sonographic criteria for the diagnosis of carpal tunnel syndrome.
        Arthritis Rheum. 2002; 46: 1914-1921
        • Yoshii Y.
        • Zhao C.
        • Zhao K.D.
        • Zobitz M.E.
        • An K.N.
        • Amadio P.C.
        The effect of wrist position on the relative motion of tendon, nerve, and subsynovial connective tissue within the carpal tunnel in a human cadaver model.
        J Orthop Res. 2008; 26: 1153-1158
        • Zhang H.
        • Zhu T.
        • Tian X.
        • Zhou X.
        • Li J.
        • Wei Z.
        • Zhu Y.
        • Qian Y.
        • Zhang J.
        Quantitative echocardiographic assessment of myocardial acceleration in normal left ventricle by using velocity vector imaging.
        J Am Soc Echocardiogr. 2008; 21: 813-817
        • Ziswiler H.R.
        • Reichenbach S.
        • Vögelin E.
        • Bachmann L.M.
        • Villiger P.M.
        • Jüni P.
        Diagnostic value of sonography in patients with suspected carpal tunnel syndrome: A prospective study.
        Arthritis Rheum. 2005; 52: 304-311