Timm Dirrichs, Presenter: Nothing to Disclose

Christiane Katharina Kuhl MD, Abstract Co-Author: Nothing to Disclose

Simone Schrading MD, Abstract Co-Author: Nothing to Disclose

Non-invasive evaluation of tendon elasticity may enhance diagnosis of tendon injury, and if so, could be used to monitor treatment effects. Shear wave elastography (SWE) has shown to be a powerful tool to estimate tissue stiffness. Aim of this study was to evaluate the feasibility and imaging findings of SWE in healthy and symptomatic patellar and achilles tendons.  

55 achilles tendons (35 symptomatic and 20 asymptomatic tendons) and 50 patellar tendons (30 symptomatic and 20 asymptomatic tendons) were systematically examined with SWE in the longitudinal and axial plane using a high-resolution linear 15 MHz probe (Aixplorer, Supersonic Imagine, Aix-en-Provence, France). In all tendons at least 3 SWE color maps were acquired in the distal, middle and proximal part of the tendon. A semi-quantitative analysis was done by analyzing the SWE color maps (homogenously blue = soft, turquoise=intermediate stiffness, yellow-red= high rigidity) (max. 180kPA). In addition, a quantitative, ROI-based analysis of tendon elasticity was done. SWE values of symptomatic and healthy tendons were compared by using the student’s t-test.  

 At semiquantitative analysis of the SWI color map, symptomatic tendons were rated as “soft” in 87.6% (57/65), as “intermediate” in 9.2% (6/65), and as “rigid” in 0.3% (2/65). In contrast, healthy tendons were rated as “soft” in 10% (4/40), as “intermediate” in 37.5% (15/40), and as “rigid” in 52.5% (21/40). At quantitative analysis, the symptomatic tendons exhibited significantly lower mean SWE values (43 kPa, range 19-65 kPa) than healthy tendons (185 kPa, range 56-265 kPa) (p=0.0004). No differences were observed between SWE values of symptomatic achilles (40.2 kPa) vs. symptomatic patellar tendons (45.4 kPa).

SWE appears to be a simple and reproducible way to identify tendon pathology. Symptomatic tendons can be identified due to their reduced SWE rigidity. SWE may therefore prove to be a sensitive tool to monitor treatment effects.  

Shear wave elastography (SWE) is a simple and reproducible tool to identify tendon pathology in patellar and achilles tendons due to reduced tendon rigidity.    

Dirrichs, T, Kuhl, C, Schrading, S, Characterization of Healthy and Symptomatic Patellar and Achilles Tendons by Shear Wave Elastography (SWE).  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045591.html