Strain Elastography of Injured Equine Superficial Digital Flexor Tendons: A Reliability Study of Manual Measurements.
Abstract: Early diagnosis of tendon injuries and accurate long-term monitoring of the healing process are key for equine veterinarians that use conventional ultrasonography. The development of strain elastography could improve the management of clinical cases. The aim of the study was to assess the intraobserver repeatability and interobserver reproducibility of manual measurements of the colored areas of the tendons within elastograms and to standardize this manual modality by comparing the analysis of the images with ImageJ. Twenty elastograms of the injured superficial digital flexor tendons (SDFTs) of horses were analyzed by two different operators after an acute injury was diagnosed with ultrasonography. Statistical analysis demonstrated excellent intraobserver repeatability (intraclass correlation coefficient, ICC = 0.949) and good interobserver reproducibility (ICC = 0.855) for manual measurements performed with tools available on the ultrasound unit. A good agreement between manual measurements and measurements performed with ImageJ (ICC = 0.849) was then demonstrated. Despite its subjectivity, the manual modality proved to be a valid method for analyzing images obtained with strain elastography.
Publication Date: 2021-03-12 PubMed ID: 33809249PubMed Central: PMC8001570DOI: 10.3390/ani11030795Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
- Biomechanics
- Clinical Study
- Diagnostic Technique
- Equine Diseases
- Equine Health
- Equine Science
- Horses
- Imaging Techniques
- Injury
- Ligaments
- Musculoskeletal System
- Physiology
- Reproducibility of Results
- Statistical Analysis
- Superficial Digital Flexor Tendon
- Tendons
- Ultrasound
- Veterinary Care
- Veterinary Medicine
- Veterinary Research
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
This research article discusses a study that assessed the effectiveness of manual measurements in strain elastography in diagnosing and monitoring the healing process of injured equine superficial digital flexor tendons. The manual measurements proved to be reliable and in good agreement with another method, ImageJ.
Objective of the Research
- The main aim of the study was to evaluate the repeatability and reliability of manual measurements of colored areas of tendons within elastograms, a type of image produced in strain elastography.
- The study aimed to improve and standardize this manual mode, comparing its effectiveness with that of ImageJ, a public domain Java image processing program.
Methodology
- The study was carried out by diagnosing acute injuries in the superficial digital flexor tendons (SDFTs) of horses using ultrasonography.
- Two different operators then analysed twenty elastograms of the injured SDFTs.
- The effectiveness and reliability of the manual measurements were then evaluated statistically.
Key Findings
- The results showed an excellent intraobserver repeatability, with an intraclass correlation coefficient (ICC) of 0.949. This means that the same observer making the manual measurements consistently delivered similar results.
- There was also a good degree of interobserver reproducibility, an ICC of 0.855, indicating consistent results were obtained between the two operators conducting the measurements.
- The comparison of manual measurements and measurements performed with ImageJ demonstrated a good agreement, with an ICC of 0.849, showing that the manual measurements are as accurate as those carried out using ImageJ.
Conclusion
- Despite the perceived subjectivity of manual measurements in strain elastography, the study confirmed that this method was a reliable way to analyze images obtained with strain elastography for diagnosing and monitoring the healing of injured SDFTs in horses.
- The good agreement with an established imaging processing program ImageJ, further supports the validity of this approach.
Cite This Article
APA
Secchi V, Masala G, Corda A, Corda F, Potop E, Barbero Fernandez A, Pinna Parpaglia ML, Sanna Passino E.
(2021).
Strain Elastography of Injured Equine Superficial Digital Flexor Tendons: A Reliability Study of Manual Measurements.
Animals (Basel), 11(3), 795.
https://doi.org/10.3390/ani11030795 Publication
Researcher Affiliations
- Department of Veterinary Medicine, University of Sassari, 07100 Sassari, Italy.
- Veterinary Teaching Hospital, University of Sassari, 07100 Sassari, Italy.
- Department of Veterinary Medicine, University of Sassari, 07100 Sassari, Italy.
- Veterinary Teaching Hospital, University of Sassari, 07100 Sassari, Italy.
- Comparative Surgery Research Laboratory, University of Sassari, 07100 Sassari, Italy.
- Department of Veterinary Medicine, University of Sassari, 07100 Sassari, Italy.
- Veterinary Teaching Hospital, University of Sassari, 07100 Sassari, Italy.
- Department of Veterinary Medicine, University of Sassari, 07100 Sassari, Italy.
- Veterinary Teaching Hospital, University of Sassari, 07100 Sassari, Italy.
- Department of Veterinary Medicine, University of Sassari, 07100 Sassari, Italy.
- Department of Veterinary Medicine, University Alfonso X el Sabio, 28691 Villanueva de la Cañada, Madrid, Spain.
- Department of Veterinary Medicine, University of Sassari, 07100 Sassari, Italy.
- Veterinary Teaching Hospital, University of Sassari, 07100 Sassari, Italy.
- Department of Veterinary Medicine, University of Sassari, 07100 Sassari, Italy.
- Veterinary Teaching Hospital, University of Sassari, 07100 Sassari, Italy.
- Comparative Surgery Research Laboratory, University of Sassari, 07100 Sassari, Italy.
Conflict of Interest Statement
The authors declare no conflict of interest.
References
This article includes 47 references
- O'Meara B, Bladon B, Parkin TD, Fraser B, Lischer CJ. An investigation of the relationship between race performance and superficial digital flexor tendonitis in the Thoroughbred racehorse.. Equine Vet J 2010 May;42(4):322-6.
- Fortier LA, Smith RK. Regenerative medicine for tendinous and ligamentous injuries of sport horses.. Vet Clin North Am Equine Pract 2008 Apr;24(1):191-201.
- Marr CM, McMillan I, Boyd JS, Wright NG, Murray M. Ultrasonographic and histopathological findings in equine superficial digital flexor tendon injury.. Equine Vet J 1993 Jan;25(1):23-9.
- Avella CS, Ely ER, Verheyen KL, Price JS, Wood JL, Smith RK. Ultrasonographic assessment of the superficial digital flexor tendons of National Hunt racehorses in training over two racing seasons.. Equine Vet J 2009 May;41(5):449-54.
- Barr RG. Breast Elastography. Thieme Medical Publishers, Inc.; New York, NY, USA: 2015. Strain elastography; pp. 11–30.
- Lustgarten M, Redding WR, Labens R, Morgan M, Davis W, Seiler GS. Elastographic characteristics of the metacarpal tendons in horses without clinical evidence of tendon injury.. Vet Radiol Ultrasound 2014 Jan-Feb;55(1):92-101.
- Ooi CC, Malliaras P, Schneider ME, Connell DA. "Soft, hard, or just right?" Applications and limitations of axial-strain sonoelastography and shear-wave elastography in the assessment of tendon injuries.. Skeletal Radiol 2014 Jan;43(1):1-12.
- De Zordo T, Chhem R, Smekal V, Feuchtner G, Reindl M, Fink C, Faschingbauer R, Jaschke W, Klauser AS. Real-time sonoelastography: findings in patients with symptomatic achilles tendons and comparison to healthy volunteers.. Ultraschall Med 2010 Aug;31(4):394-400.
- Winn N, Lalam R, Cassar-Pullicino V. Sonoelastography in the musculoskeletal system: Current role and future directions.. World J Radiol 2016 Nov 28;8(11):868-879.
- Busilacchi A, Olivieri M, Ulisse S, Gesuita R, Skrami E, Lording T, Fusini F, Gigante A. Real-time sonoelastography as novel follow-up method in Achilles tendon surgery.. Knee Surg Sports Traumatol Arthrosc 2016 Jul;24(7):2124-32.
- Tamura N, Kuroda T, Kotoyori Y, Fukuda K, Nukada T, Kato T, Kuwano A, Kasashima Y. Application of sonoelastography for evaluating the stiffness of equine superficial digital flexor tendon during healing.. Vet Rec 2017 Feb 4;180(5):120.
- Tamura N, Nukada T, Kato T, Kuroda T, Kotoyori Y, Fukuda K, Kasashima Y. The use of sonoelastography to assess the recovery of stiffness after equine superficial digital flexor tendon injuries: A preliminary prospective longitudinal study of the healing process.. Equine Vet J 2017 Sep;49(5):590-595.
- De Zordo T, Fink C, Feuchtner GM, Smekal V, Reindl M, Klauser AS. Real-time sonoelastography findings in healthy Achilles tendons.. AJR Am J Roentgenol 2009 Aug;193(2):W134-8.
- Klauser AS, Miyamoto H, Tamegger M, Faschingbauer R, Moriggl B, Klima G, Feuchtner GM, Kastlunger M, Jaschke WR. Achilles tendon assessed with sonoelastography: histologic agreement.. Radiology 2013 Jun;267(3):837-42.
- Smith RKW, Cauvin ERJ. Ultrasonography of the Metacarpus and Metatarsus. In: Kidd J.A., Lu K.G., Frazer M.L., editors. Atlas of Equine Ultrasonography. John Wiley & Sons, Ltd.; Chichester, UK: 2014. pp. 73–105.
- Palgrave K, Kidd JA. Introduction. In: Kidd J.A., Lu K.G., Frazer M.L., editors. Atlas of Equine Ultrasonography. John Wiley & Sons, Ltd.; Chichester, UK: 2014. pp. 1–22.
- Schneider CA, Rasband WS, Eliceiri KW. NIH Image to ImageJ: 25 years of image analysis.. Nat Methods 2012 Jul;9(7):671-5.
- R Core Team. R: A Language and Environment for Statistical Computing. R Core Team; Vienna, Austria: 2019.
- Aitchison J. The Statistical Analysis of Compositional Data. J. R. Stat. Soc. Ser. B 1982;44:139–177.
- Aitchison J. The Statistical Analysis of Compositional Data. Chapman & Hall, Ltd.; London, UK: 1986.
- Egozcue JJ, Pawlowsky-Glahn V, Mateu-Figueras G, Barceló-Vidal C. Isometric Logratio Transformations for Compositional Data Analysis. Math. Geol. 2003;35:279–300.
- Van den Boogaart KG, Tolosana-Delgado R. Analyzing Compositional Data with R. Springer; Berlin/Heidelberg, Germany: 2013. Use R!.
- Van den Boogaart KG, Tolosana-Delgado R, Bren M. Compositions: Compositional Data Analysis. [(accessed on 10 November 2020)];2020 R Package Version 2.0-0. Available online: https://CRAN.R-project.org/package=compositions.
- Martin-Fernández JA, Barceló-Vidal C, Pawlowsky-Glahn V. Dealing with Zeros and Missing Values in Compositional Data Sets Using Nonparametric Imputation. Math. Geol. 2003;35:253–278.
- Bates D, Mächler M, Bolker B, Walker S. Fitting Linear Mixed-Effects Models Using {lme4}. J. Stat. Softw. 2015;67:1–48.
- Korkmaz S, Goksuluk D, Zararsiz G. MVN: An R Package for Assessing Multivariate Normality. R J. 2014;6:151–162.
- Fox J, Friendly M, Monette G. Heplots: Visualizing Tests in Multivariate Linear Models. [(accessed on 10 November 2020)];2020 R Package Version 1.3-8. Available online: https://CRAN.R-project.org/package=heplots.
- Nakagawa S, Johnson PCD, Schielzeth H. The coefficient of determination R(2) and intra-class correlation coefficient from generalized linear mixed-effects models revisited and expanded.. J R Soc Interface 2017 Sep;14(134).
- Nordhausen K, Sirkia S, Oja H, Tyler DE. ICSNP: Tools for Multivariate Nonparametrics. [(accessed on 10 November 2020)];2018 R Package Version 1.1-1. Available online: https://CRAN.R-project.org/package=ICSNP.
- Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement.. Lancet 1986 Feb 8;1(8476):307-10.
- Koo TK, Li MY. A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research.. J Chiropr Med 2016 Jun;15(2):155-63.
- Prado-Costa R, Rebelo J, Monteiro-Barroso J, Preto AS. Ultrasound elastography: compression elastography and shear-wave elastography in the assessment of tendon injury.. Insights Imaging 2018 Oct;9(5):791-814.
- Fusini F, Langella F, Busilacchi A, Tudisco C, Gigante A, Massé A, Bisicchia S. Real-time sonoelastography: principles and clinical applications in tendon disorders. A systematic review.. Muscles Ligaments Tendons J 2017 Jul-Sep;7(3):467-477.
- Klauser AS, Faschingbauer R, Jaschke WR. Is sonoelastography of value in assessing tendons?. Semin Musculoskelet Radiol 2010 Sep;14(3):323-33.
- Patterson-Kane JC, Firth EC. The pathobiology of exercise-induced superficial digital flexor tendon injury in Thoroughbred racehorses.. Vet J 2009 Aug;181(2):79-89.
- Williams IF, Heaton A, McCullagh KG. Cell morphology and collagen types in equine tendon scar.. Res Vet Sci 1980 May;28(3):302-10.
- Cheung DT, DiCesare P, Benya PD, Libaw E, Nimni ME. The presence of intermolecular disulfide cross-links in type III collagen.. J Biol Chem 1983 Jun 25;258(12):7774-8.
- Sharma P, Maffulli N. Tendon injury and tendinopathy: healing and repair.. J Bone Joint Surg Am 2005 Jan;87(1):187-202.
- Drakonaki EE, Allen GM, Wilson DJ. Real-time ultrasound elastography of the normal Achilles tendon: reproducibility and pattern description.. Clin Radiol 2009 Dec;64(12):1196-202.
- Piccionello AP, Serrani D, Busoni V, Salvaggio A, Bonazzi M, Bergamino C, Volta A. Sonoelastographic Features of the Patellar Ligament in Clinically Normal Dogs.. Vet Comp Orthop Traumatol 2018 Jul;31(4):279-284.
- Del Signore F, De Dominicis S, Mastromatteo G, Simeoni F, Scapolo PA, Tamburro R, Vignoli M. Sonoelastography of Normal Canine Common Calcaneal Tendon: Preliminary Results.. Vet Comp Orthop Traumatol 2021 May;34(3):200-205.
- Lustgarten M, Redding WR, Labens R, Davis W, Daniel TM, Griffith E, Seiler GS. ELASTOGRAPHIC EVALUATION OF NATURALLY OCCURING TENDON AND LIGAMENT INJURIES OF THE EQUINE DISTAL LIMB.. Vet Radiol Ultrasound 2015 Nov-Dec;56(6):670-9.
- De Gasperi D, Dzierzak SL, Muir P, Vanderby R Jr, Brounts SH. In vivo evaluation of effects of sedation on results of acoustoelastography of the superficial digital flexor tendons in clinically normal horses.. Am J Vet Res 2017 Dec;78(12):1421-1425.
- Martínez-Payá JJ, Del Baño-Aledo ME, Ríos-Díaz J, Fornés-Ferrer V, Vázquez-Costa JF. Sonoelastography for the Assessment of Muscle Changes in Amyotrophic Lateral Sclerosis: Results of a Pilot Study.. Ultrasound Med Biol 2018 Dec;44(12):2540-2547.
- Teng PPC, Lo YL. A Comparison Study of Conventional Ultrasound and Ultrasound Strain Elastography in the Evaluation of Myopathy.. Ultrasound Q 2020 Mar;36(1):32-37.
- Ríos-Díaz J, Martínez-Payá JJ, del Baño-Aledo ME, de Groot-Ferrando A, Botía-Castillo P, Fernández-Rodríguez D. Sonoelastography of Plantar Fascia: Reproducibility and Pattern Description in Healthy Subjects and Symptomatic Subjects.. Ultrasound Med Biol 2015 Oct;41(10):2605-13.
- Magarelli N, Carducci C, Bucalo C, Filograna L, Rapisarda S, De Waure C, Dell'Atti C, Maccauro G, Leone A, Bonomo L. Sonoelastography for qualitative and quantitative evaluation of superficial soft tissue lesions: a feasibility study.. Eur Radiol 2014 Mar;24(3):566-73.
Citations
This article has been cited 1 times.- Guerri G, Palozzo A, Straticò P, Varasano V, Celani G, Di Francesco P, Vignoli M, Petrizzi L. 2D-SWE of the Metacarpophalangeal Joint Capsule in Horses.. Vet Sci 2022 Sep 4;9(9).
Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists