title: A superficial hyperechoic band in human articular cartilage on ultrasonography with histological correlation: preliminary observations.
abstract: OBJECTIVE
  To demonstrate the superficial hyperechoic band (SHEB) in articular cartilage by using ultrasonography (US) and to assess its correlation with histological images.
  
  
  METHODS
  In total, 47 regions of interest (ROIs) were analyzed from six tibial osteochondral specimens (OCSs) that were obtained after total knee arthroplasty. Ultrasonograms were obtained for each OCS. Then, matching histological sections from all specimens were obtained for comparison with the ultrasonograms. Two types of histological staining were used: Safranin-O stain (SO) to identify glycosaminoglycans (GAG) and Masson's trichrome stain (MT) to identify collagen. In step 1, two observers evaluated whether there was an SHEB in each ROI. In step 2, the two observers evaluated which histological staining method correlated better with the SHEB by using the ImageJ software.
  
  
  RESULTS
  In step 1 of the analysis, 20 out of 47 ROIs showed an SHEB (42.6%, kappa=0.579). Step 2 showed that the SHEB correlated significantly better with the topographical variation in stainability in SO staining, indicating the GAG distribution, than with MT staining, indicating the collagen distribution (P<0.05, kappa=0.722).
  
  
  CONCLUSIONS
  The SHEB that is frequently seen in human articular cartilage on high-resolution US correlated better with variations in SO staining than with variations in MT staining. Thus, we suggest that a SHEB is predominantly related to changes in GAG. Identifying an SHEB by US is a promising method for assessing the thickness of articular cartilage or for monitoring early osteoarthritis.
authors: Department of Radiology, Ajou University School of Medicine, Suwon, Korea ; Musculoskeletal Imaging Laboratory, Ajou University Medical Center, Suwon, Korea.
authors: Tae Sun
authors: 0000-0003-1404-1578
authors: TS
authors: Han
authors: Department of Radiology, Ajou University School of Medicine, Suwon, Korea ; Musculoskeletal Imaging Laboratory, Ajou University Medical Center, Suwon, Korea.
authors: Kyu-Sung
authors: 0000-0001-6124-8948
authors: KS
authors: Kwack
authors: Department of Radiology, Ajou University School of Medicine, Suwon, Korea ; Musculoskeletal Imaging Laboratory, Ajou University Medical Center, Suwon, Korea.
authors: Sunghoon
authors: 0000-0003-0844-0521
authors: S
authors: Park
authors: Department of Orthopedic Surgery, Ajou University School of Medicine, Suwon, Korea ; Cartilage Regeneration Center, Ajou University Medical Center, Suwon, Korea.
authors: Byoung-Hyun
authors: 0000-0001-8928-414X
authors: BH
authors: Min
authors: Cartilage Regeneration Center, Ajou University Medical Center, Suwon, Korea.
authors: Seung-Hyun
authors: 0000-0003-1787-7282
authors: SH
authors: Yoon
authors: Regional Clinical Trial Center, Ajou University Medical Center, Suwon, Korea ; Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea.
authors: Hyun Young
authors: 0000-0003-4169-8284
authors: HY
authors: Lee
authors: Department of Pathology, Ajou University School of Medicine, Suwon, Korea.
authors: Kyi Beom
authors: 0000-0002-1743-7829
authors: KB
authors: Lee
keywords: Cartilage; Histology; Knee joint; Ultrasonography
references: Skeletal Radiol. 2001 Jul;30(7):361-77
references: 11499776
references: J Orthop Res. 1995 Nov;13(6):963-70
references: 8544035
references: Radiology. 2006 Feb;238(2):570-7
references: 16436818
references: Eur Radiol. 2008 Oct;18(10):2292-302
references: 18491096
references: J Orthop Res. 2006 Mar;24(3):366-74
references: 16479569
references: Osteoarthritis Cartilage. 2002 Jul;10 (7):535-41
references: 12127833
references: Osteoarthritis Cartilage. 2010 Oct;18 Suppl 3:S113-6
references: 20864017
references: Magn Reson Med. 1997 May;37(5):764-8
references: 9126951
references: Semin Arthritis Rheum. 1999 Jun;28(6):398-403
references: 10406407
references: J Ultrasound. 2009 Jun;12(2):53-60
references: 23397073
references: Osteoarthritis Cartilage. 2007 Mar;15(3):245-50
references: 17045494
references: Clin Orthop Relat Res. 1997 May;(338):253-61
references: 9170388
references: Ann Rheum Dis. 2009 Aug;68(8):1322-7
references: 18684742
references: Phys Med Biol. 1999 Nov;44(11):2723-33
references: 10588280
references: J Acoust Soc Am. 1992 Aug;92 (2 Pt 1):676-81
references: 1506524
references: Skeletal Radiol. 2002 Sep;31(9):505-10
references: 12195502
references: AJR Am J Roentgenol. 2005 Mar;184(3):752-6
references: 15728593
references: Skeletal Radiol. 2014 Jul;43(7):947-54
references: 24715200
references: Radiology. 2000 Jun;215(3):846-51
references: 10831709
references: Ultrasound Med Biol. 1998 Mar;24(3):341-54
references: 9587990
references: Radiology. 1984 Dec;153(3):781-4
references: 6387794
references: Skeletal Radiol. 1991;20(1):31-6
references: 2000502
references: J Anat. 1987 Feb;150:265-76
references: 3654339
references: Ultrasound Med Biol. 2008 Jul;34(7):1085-92
references: 18295393
references: J Magn Reson Imaging. 1993 Jul-Aug;3(4):569-74
references: 8347948
references: Physiol Meas. 2002 Aug;23 (3):491-503
references: 12214758
references: Ultrasound Med Biol. 2009 Sep;35(9):1546-54
references: 19560251
references: Radiology. 2003 Aug;228(2):303-8
references: 12819342
references: J Bone Joint Surg Am. 2003;85-A Suppl 2:78-84
references: 12721348
references: Radiology. 2011 Dec;261(3):805-12
references: 21940505
references: Skeletal Radiol. 1996 Aug;25(6):545-9
references: 8865488
references: Methods Mol Med. 2004;101:39-63
references: 15299209
references: Clin Rheumatol. 2008 Dec;27(12 ):1507-16
references: 18663556
references: AJR Am J Roentgenol. 1995 Dec;165(6):1353-8
references: 7484562
references: Radiology. 1989 Feb;170(2):495-9
references: 2911674
references: AJR Am J Roentgenol. 1998 Apr;170(4):927-31
references: 9530036
references: Phys Med Biol. 2005 Jul 21;50(14 ):3221-33
references: 16177505
references: Arthritis Rheum. 2001 Oct;44(10):2285-95
references: 11665969
references: Semin Arthritis Rheum. 2005 Jun;34(6 Suppl 2):19-23
references: 16206952