title: Influence of tendon tears on ultrasound echo intensity in response to loading.
abstract: Acoustoelastic (AE) ultrasound image analysis is a promising non-invasive approach that uses load-dependent echo intensity changes to characterize stiffness of tendinous tissue. The purpose of this study was to investigate whether AE can detect localized changes in tendon stiffness due to partial and full-thickness tendon tears. Ovine infraspinatus tendons with different levels of damage (Intact, 33%, 66% and full thickness cuts initiated on the articular and bursal sides) were cyclically loaded in a mechanical testing system while cine ultrasound images were recorded. The load-induced changes in echo intensity on the bursal and articular side of the tendon were determined. Consistent with AE theory, the undamaged tendons exhibited an increase in echo intensity with tendon loading, reflecting the strain-stiffening behavior of the tissue. In the intact condition, the articular region demonstrated a significantly greater increase in echo intensity during loading than the bursal region. Cuts initiated on the bursal side resulted in a progressive decrease in echo intensity of the adjacent tissue, likely reflecting the reduced load transmission through that region. However, image intensity information was less sensitive for identifying load transmission changes that result from partial thickness cuts initiated on the articular side. We conclude that AE approaches may be useful to quantitatively assess load-dependent changes in tendon stiffness, and that disruption of AE behavior may be indicative of substantial tendon damage.
authors.affiliation: Department of Engineering/Dordt College/Sioux Center, Iowa, United States. Electronic address: kayt.frisch@dordt.edu.
authors.forename: Kayt E
authors.initials: KE
authors.lastname: Frisch
authors.affiliation: Sauk Prairie Memorial Hospital, Prairie du Sac, Wiscosin, United States. Electronic address: dmarcu@spmh.org.
authors.forename: David
authors.initials: D
authors.lastname: Marcu
authors.affiliation: Department of Orthopedics and Rehabilitation/University of Wisconsin, Madison, Wiscosin, United States. Electronic address: baer@ortho.wisc.edu.
authors.forename: Geoffrey S
authors.initials: GS
authors.lastname: Baer
authors.affiliation: Department of Biomedical Engineering, Department of Mechanical Engineering/University of Wisconsin, Madison, Wiscosin, United States. Electronic address: thelen@engr.wisc.edu.
authors.forename: Darryl G
authors.initials: DG
authors.lastname: Thelen
authors.affiliation: Departments of Orthopedics and Rehabilitation and Biomedical Engineering/University of Wisconsin, Madison, Wiscosin, United States. Electronic address: Vanderby@ortho.wisc.edu.
authors.forename: Ray
authors.initials: R
authors.lastname: Vanderby
mesh_terms: D000818:Animals; D054459:Elasticity Imaging Techniques; D005260:Female; D017006:Rotator Cuff / Q000000981:diagnostic imaging* / Q000502:physiology; D000070636:Rotator Cuff Injuries; D012756:Sheep; D034561:Sheep, Domestic; D013180:Sprains and Strains; D013708:Tendon Injuries / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013710:Tendons / Q000502:physiology; D014465:Ultrasonics; D016474:Weight-Bearing
keywords: Acoustoelastic; Damage; Mechanics; Tear; Tendon; Ultrasound