by Joan Trombetti
, Writer | December 23, 2008
Researchers from Austria, Italy, and Egypt are evaluating several possible ultrasound elastography applications in musculoskeletal radiology. These applications have the potential to provide wide-reaching benefits if the studies determine they are effective.
Musculoskeletal radiologists are moving toward more quantitative, functional studies. But they need the right imaging tools to explain how MSK structures work instead of simply describing their appearance. Elastography, performed by ultrasound or MRI, has emerged as a way to characterize the mechanical properties of tissue. It has been praised as a useful diagnostic tool in breast, prostate, cervix, and thyroid applications.
Now musculoskeletal radiologists could also use real-time sonoelastography for diagnosis of tissue softening or tears of heel, elbow and shoulder tendons.
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Associate Professor of Radiology Dr. Andrea Klauser and colleagues at the Medical University of Innsbruck compared sonoelastography and standard sonography in assessments of Achilles tendons in 25 patients with chronic tendinopathy and 25 healthy subjects. They found elastography just as accurate to detect tendon abnormalities in symptomatic and asymptomatic patients.
During the same scientific session at RSNA 2008, investigators from the University of Genoa presented results of their own sonoelastography study of Achilles tendon degeneration in healthy athletes. They enrolled 16 patients referred for tendon pain associated with sport activity plus 24 healthy controls. They found sonoelastography useful for characterization of stiffness in symptomatic tendons compared to normal ones.
In another study by the Sonoelastography Project Innsbruck, researchers used the modality to assess 32 patients previously diagnosed with elbow tendon lesions and 28 healthy volunteers. They compared results with those of the clinical exam plus standard and Doppler sonography.
Sonoelastography provided sensitivity, specificity, accuracy, and positive and negative predictive values of 100%, 89%, 94%, 88%, and 100%, respectively, compared with 95%, 89%, 91%, 88%, and 95% for conventional sonography. Findings suggest that elastography could work as a diagnostic adjunct to power Doppler for a more detailed assessment of patients presenting with elbow tendon lesions.
Also, researchers from Giza, Egypt, used sonoelastography to assess the supraspinatus tendon in 20 healthy volunteers and 40 patients complaining of shoulder pain. They compared results with MRI and found that sonoelastography was a sensitive method for diagnosis of rotator cuff tears.
Further studies will reveal how effective sonoelastography would be in diagnosing pathology, said session chair Dr. Jon A. Jacobson. Researchers need to define the diagnostic and prognostic benefit of elastography over gray-scale, color, or power Doppler imaging.