title: Achilles tendon assessed with sonoelastography: histologic agreement.
abstract: OBJECTIVE
  To compare and determine the level of agreement of findings at conventional B-mode ultrasonography (US) and sonoelastography of the Achilles tendon with findings at histologic assessment.
  
  
  METHODS
  This study was conducted with the approval of the institutional review boards, and all cadavers were in legal custody of the study institution. Thirteen Achilles tendons in 10 cadavers (four male, six female; age range, 70-90 years) were examined with B-mode US and sonoelastography. B-mode US grading was as follows: Grade 1 indicated a normal-appearing tendon with homogeneous fibrillar echotexture; grade 2, a focal fusiform or diffuse enlarged tendon; and grade 3, a hypoechoic area with or without tendon enlargement. Sonoelastography grading was as follows: Grade 1 indicated blue (hardest) to green (hard); grade 2, yellow (soft); and grade 3, red (softest). Twenty-five biopsy specimens from representative lesions of the middle and distal thirds of the Achilles tendons were evaluated histologically. The concordance of B-mode US grading compared with sonoelastographic grading was assessed by using κ analysis.
  
  
  RESULTS
  With B-mode US and sonoelastography, all 11 tendon thirds of histologically normal tendons were verified as normal (grade 1). Sonoelastography depicted 14 of 14 (100%) tendon thirds with histologic degeneration (grade 2 or 3), whereas B-mode US could depict only 12 of 14 (86%) lesions (grade 2 or 3). Only moderate agreement between B-mode US and sonoelastography was seen (κ = 0.52, P < .001).
  
  
  CONCLUSIONS
  Sonoelastography might help predict signs of histopathologic degeneration of Achilles tendinosis, potentially more sensitively than B-mode US.
authors: Department of Diagnostic Radiology, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
authors: Andrea S
authors: AS
authors: Klauser
authors: Hideaki
authors: H
authors: Miyamoto
authors: Mario
authors: M
authors: Tamegger
authors: Ralph
authors: R
authors: Faschingbauer
authors: Bernhard
authors: B
authors: Moriggl
authors: Guenther
authors: G
authors: Klima
authors: Gudrun M
authors: GM
authors: Feuchtner
authors: Martin
authors: M
authors: Kastlunger
authors: Werner R
authors: WR
authors: Jaschke
mesh_terms: D000125:Achilles Tendon / Q000000981:diagnostic imaging* / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002102:Cadaver; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male