To test the anisotropy of human tendons in conventional B-mode ultrasound, we prospectively
performed ultrasound scans of 40 normal patella tendons and 24 patella tendons with
chronic tendinopathy in adults. We scanned all tendons in longitudinal orientation
(parallel to tendon fibers) using a linear array transducer (8.5 MHz) with beam steering
at 0°, 5°, 10°, 15° and 20°. We used ImageJ histogram analysis to process B-mode images
offline for assessing backscatter as a function of angle, known as backscatter anisotropy,
between normal tendons and the subcutaneous tissues and between normal tendons and
tendons with tendinopathy. We compared the results using the slopes of linear regression
lines drawn through the angle-dependent data, and we concluded that the tissue anisotropy
was significantly different if the 95% confidence intervals of the line slopes for
different tissues did not overlap. We observed significant differences between normal
tendons and both the adjacent subcutaneous tissues and tendons with tendinopathy.
However, the difference in the regression slopes between tendons with tendinopathy
and the adjacent subcutaneous soft tissues was not significant. It appears that changes
in anisotropic backscatter could be used to detect tendon abnormalities and in assessing
the significance of disease and the effectiveness of therapy.
Keywords
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References
- Method of data reduction for accurate determination of acoustic backscatter coefficients.J Acoust Soc Am. 1984; 76: 913-923
- Frequency analysis of echo texture in tendon.Ultrasound Med Biol. 1999; 25: 959-968
- Ultrasonic tissue characterization of skeletal muscle.Eur J Clin Invest. 1983; 13: 469-473
- The hypoechoic normal tendon—a pitfall.J Ultrasound Med. 1987; 6: 19-22
- Connective tissue: I. Cells and fibers. In: Introduction to functional histology.Harper Collins College, New York1995: 78-98
- Sonography of common tendon injuries.AJR Am J Roentgenol. 2009; 193: 607-618
- The Achilles tendon.Semin Musculoskelet Radiol. 2010; 14: 307-322
- The aging tendon.Scand J Med Sci Sports. 1997; 7: 72-77
- Comparative accuracy of magnetic resonance imaging and ultrasonography in confirming clinically diagnosed patella tendinopathy.Am J Sports Med. 2007; 35: 427-436
- Multimodal ultrasound versus MRI for the diagnosis and monitoring of Achilles tendinopathy: a prospective longitudinal study.Orthop J Sports Med. 2021; 923259671211006826
- Analysis of echotexture of tendons with US.Radiology. 1993; 186: 839-843
- Rehabilitation of tendon injury in sport.Sports Med. 1997; 24: 347-358
- Quantitative ultrasound imaging to assess skeletal muscles in adults with multiple sclerosis: a feasibility study.J Ultrasound Med. 2019; 38: 2915-2923
- MRI of the Achilles tendon: a comprehensive review of the anatomy, biomechanics, and imaging of overuse tendinopathy.Acta Radiol. 2010; 51: 438-454
- Tendon and ligament imaging.Br J Radiol. 2012; 85: 1157-1172
- Histopathology of common tendinopathy: update and implications for clinical management.Sports Med. 1999; 27: 393-408
- High-frequency ultrasound attenuation and backscatter coefficients of in vivo normal human dermis and subcutaneous fat.Ultrasound Med Biol. 2001; 27: 1543-1556
- Regional stiffening with aging in the tibialis anterior tendons of mice occurs independent of changes in collagen fibril morphology.J Appl Physiol. 2011; 111: 999-1006
- Prevalence and patterns of tendon calcification in patients with chondrocalcinosis of the knee: radiologic study of 156 patients.Clin Imaging. 1998; 22: 371-375
- Ultrasonography in chondrocalcinosis.Joint Bone Spine. 2010; 77: 218-221
- Ultrashort TE spectroscopic imaging (UTESI): application to the imaging of short T2 relaxation tissues in the musculoskeletal system.J Magn Reson Imaging. 2009; 29: 412-421
- Magnetic resonance: an introduction to ultrashort TE (UTE) imaging.J Comput Assist Tomogr. 2003; 27: 825-846
- Anterior knee pain.Eur J Radiol. 2007; 62: 27-43
Article info
Publication history
Published online: March 04, 2023
Accepted:
January 30,
2023
Received in revised form:
November 14,
2022
Received:
March 19,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 World Federation for Ultrasound in Medicine & Biology. All rights reserved.
