Reliability of a New Semi-automatic Image Analysis Method for Evaluating the Doppler Signal and Intratendinous Vascular Resistance in Patellar Tendinopathy

Molina-Payá, Javier; Ríos-Díaz, José; Carrasco-Martínez, Francisco; Martínez-Payá, J.J.

doi:10.1016/j.ultrasmedbio.2021.08.010

Cited by 4 publications

(11 citation statements)

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“…The image processing and analysis method to obtain the IVR has been described previously. 11 The method was based on the measurement of pixel color intensity on the intratendon Doppler signals, considering this data as a flow velocity. In this procedure, the intensity of the intratendon Doppler signals of the image with the highest Doppler signal of the cardiac cycle was considered as the peak systolic velocity, and of the image with the lowest signal as the end-diastolic velocity.…”

Section: Methodsmentioning

confidence: 99%

“…13,26 In the present study, to average the vascular resistance of all the intratendinous vessels, a previously developed methodology based on pixel color intensity was used, with excellent reliability. 11…”

Section: Technical Issuesmentioning

confidence: 99%

“…10 In addition, the possibility of assessing tendon vascular perfusion by using analysis of intratendinous vascular resistance (IVR) based on Doppler ultrasound image analysis and the resistance index (RI) formula has recently been demonstrated. 11 The ultrasound system expresses numerically the tissue resistance to flow originating from the microvascular bed distal to the measurement site. 12 Low vascular resistance is associated with high perfusion of the distal bed and therefore with a situation compatible with the presence of inflammation.…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, analysis of IVR can be more useful for understanding the physiological state of the tissue. 11…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, analysis of IVR can be more useful for understanding the physiological state of the tissue. 11 In this context, some studies have also considered infrared thermography (IRT) as a suitable technique for the diagnosis of PT. IRT is an inexpensive, reliable, non-invasive, and accurate imaging technique that provides information on thermal, metabolic, and vascular conditions of the human body that can be used to interpret pathophysiological changes.…”

Section: Introductionmentioning

confidence: 99%

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Infrared Thermography, Intratendon Vascular Resistance, and Echotexture in Athletes with Patellar Tendinopathy: A Cross-Sectional Study

et al. 2023

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Ultrasonographic signs of tendinopathies are an increase in thickness, loss of alignment in collagen fibers and the presence of neovascularization. Nevertheless, analysis of intratendinous vascular resistance (IVR) can be more useful for understanding the physiological state of the tissue. To show thermal, echotextural, and Doppler signal differences in athletes with patellar tendinopathy and controls. Twenty-six athletes with patellar tendinopathy (PT) participants (30.1 years; SD = 9.0 years) and 27 asymptomatic athletes (23.3 years; SD = 5.38 years) were evaluated with thermographic and Doppler ultrasonography (DS). Area of Doppler signals (DS), echotextural parameters (echointensity and echovariation) and IVR were determined by image analysis. The statistical analysis was performed by Bayesian methods and the results were showed by Bayes Factor (BF10: probability of alternative hypothesis over null hypothesis), and Credibility intervals (CrI) of the effect. The absolute differences of temperature (TD) were clearly greater (BF10 = 19) in the tendinopathy group (patients) than in controls. Regarding temperature differences between the affected and healthy limb, strong evidence was found (BF10 = 14) for a higher temperature (effect = 0.53°C; 95% CrI = 0.15°C–0.95°C) and very strong for reduced IVR compared (BF10 = 71) (effect = −0.67; 95% CrI = −1.10 to 0.25). The differences in area of DS (BF10 = 266) and EV (BF10 = 266) were higher in tendinopathy group. TD showed a moderate positive correlation with VISA-P scores (tau-B = .29; 95% CrI = .04–.51) and strong correlation with IVR ( r = −.553; 95%CrI = −.75 to .18). Athletes with patellar tendinopathy showed a more pronounced thermal difference, a larger area of Doppler signal, a lower IVR and a moderately higher echovariaton than controls. The correlation between temperature changes and IVR might be related with the coexistence of degenerative and inflammatory process in PT.

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Section: Methodsmentioning

confidence: 99%

Section: Technical Issuesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, analysis of IVR can be more useful for understanding the physiological state of the tissue. 11…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Infrared Thermography, Intratendon Vascular Resistance, and Echotexture in Athletes with Patellar Tendinopathy: A Cross-Sectional Study

et al. 2023

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Determination of differences in ultrasound parameters for patellar tendons in males with unilateral patellar tendinopathy—An ancillary analysis of data from two randomized controlled trials

Hjortshoej,

Agergaard,

Larsen

et al. 2024

J of Clinical Ultrasound

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PurposeTo investigate power Doppler (PD) activity and tendon structure (between the injured and contralateral limb) in patients with unilateral patellar tendinopathy (PT) using ultrasonography (US). Secondly, the aim was to determine the intra‐rater reliability of the PD activity and tendon structure.MethodsThis study analyzed US baseline data from 57 male participants with symptomatic unilateral PT who had been enrolled in one of two randomized clinical trials. Data were analyzed to examine if systematic differences existed between injured and contralateral limbs using Fiji ImageJ.ResultsThe PD activity of the symptomatic tendon was larger 25.6 (Q1 = 14.9; Q3 = 41.6) mm2 than the asymptomatic 0 (Q1 = 0.0; Q3 = 0.0) mm2 (p < 0.001). There was a significantly greater tendon thickness at the proximal (2.5 mm 95% CI [2.0; 3.0]), mid (0.8 mm 95% CI [0.5; 1.1]), and distal (0.2 mm 95% CI [0.1; 0.4]) part of the tendon for the symptomatic compared to the asymptomatic tendon. Intra‐rater reliability for PD activity and tendon structure ranged from moderate‐to‐excellent (0.74; 0.99).ConclusionThese results provide mean estimates for tendon thickness of symptomatic and asymptomatic tendons, that can be used for clinicians to reliably estimate pathological tendon thickness.

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Sonographic Assessment of Asymptomatic Patellar and Achilles Tendons to Predict Future Pain: A Systematic Review and Meta-analysis

Cushman,

Vomer,

Teramoto

et al. 2024

Clinical Journal of Sport Medicine

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Objective: Patients with clinical tendinopathy often demonstrate significant abnormalities with ultrasound (US) imaging. Tendon abnormalities likely precede pain in these patients. The purpose of this review was to systematically evaluate the available literature regarding the utility of US imaging as a method to predict Achilles and patellar tendon pain. Design: Systematic review and meta-analysis. Inclusion criteria were as follows: prospective studies of Achilles and patellar tendon pain development with baseline US measurements, follow-up clinical measurements, and English-language studies published after 2000. Exclusion criteria were prior rupture or surgery and presence of rheumatologic disorder. Setting: N/A. Patients: Athletes without Achilles or patellar tendon pain at baseline. Interventions: N/A. Main Outcome Measures: Risk ratios (RRs) were identified for the development of pain in those with Achilles or patellar tendon sonographic abnormalities. Results: This review of 16 studies included 810 Achilles and 1156 patellar tendons from a variety of sports and demonstrated that the RR for pain development from abnormal Patellar and Achilles tendons was 6.07 [95% confidence interval (CI), 2.88-12.81; P < 0.001] and 3.96 [95% CI, 2.21-7.09; P < 0.001], respectively. The positive and negative predictive values of an abnormal US finding were 27.2% and 92.0% for the Achilles tendon and 27.2% and 93.5% for the patellar tendon, respectively. Conclusions: This systematic review and meta-analysis identified that the use of asymptomatic US scanning of the Achilles or patellar tendon has a low positive predictive value but a high negative predictive value for the future development of pain.

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Reliability of a New Semi-automatic Image Analysis Method for Evaluating the Doppler Signal and Intratendinous Vascular Resistance in Patellar Tendinopathy

Cited by 4 publications

References 43 publications

Infrared Thermography, Intratendon Vascular Resistance, and Echotexture in Athletes with Patellar Tendinopathy: A Cross-Sectional Study

Infrared Thermography, Intratendon Vascular Resistance, and Echotexture in Athletes with Patellar Tendinopathy: A Cross-Sectional Study

Determination of differences in ultrasound parameters for patellar tendons in males with unilateral patellar tendinopathy—An ancillary analysis of data from two randomized controlled trials

Sonographic Assessment of Asymptomatic Patellar and Achilles Tendons to Predict Future Pain: A Systematic Review and Meta-analysis

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