Reliability of Quantitative Ultrasound Measures of the Biceps and Supraspinatus Tendons

Abstract

Rationale and Objectives-Ultrasound is a proven method for examining soft tissue structures including tendons, and recently quantitative ultrasound has become more prevalent in research settings. However, limited reliability data has been published for these new quantitative ultrasound measures. The main study objective is to quantify the reliability and measurement error of multiple quantitative ultrasound imaging protocols for the biceps and supraspinatus tendons.Materials and Methods-Two examiners captured ultrasound images of the non-dominant long head of the biceps tendon and supraspinatus tendon from 15 able-bodied participants and five manual wheelchair users. Each examiner captured two images per subject under two different preparations which includes subject positioning and reference marker placement. Image processing (reading) was performed twice to compute nine quantitative ultrasound measures of greyscale tendon appearance using first-order statistics and texture analysis. Generalizability theory was applied to compute interand intra-rater reliability using the coefficient of dependability (Φ) for multiple study design protocols.Results-Inter-rater reliability was generally low (0.26 <Φ< 0.82), and we recommend that a single evaluator capture all images for quantitative ultrasound protocols. Most (n = 14 of 18) of the quantitative ultrasound measures exhibited at least moderate (Φ>0.50) intra-rater reliability for a single image, captured under one preparation, and read once.Conclusion-By following a protocol designed to minimize measurement error, one can increase the reliability of quantitative ultrasound measures. We believe that an appropriately designed protocol will allow quantitative ultrasound to be used as an outcome measure to identify structural changes within the tendon.

The Clinical and Sonographic Effects of Kinesiotaping and Exercise in Comparison With Manual Therapy and Exercise for Patients With Subacromial Impingement Syndrome: A Preliminary Trial

“…72 Thus, as an evidence-based outcome measure, the sonographic assessment of cross-sectional supraspinatus tendon thickness was used because significant functional improvement may be related to structural changes of the tendon. 18,63,73 The finding of this study pointed out that not only the manual therapy intervention but also the kinesiotape intervention with exercise had no effect on tendon structure within 6 weeks. Furthermore, although the affected side, supraspinatus tendon, was a little bit thicker than the nonaffected side, no statistically differences were observed before and after the intervention or in the affected and nonaffected sides within and between groups.…”

“…The radiologist examined anatomical structures and measured maximal supraspinatus tendon thickness with a longitudinal angle in 1 cm proximal of the lateral aspect of humerus head with GE Logiq 9 scanner (General Electric Medical Systems, Milwaukee, WI) and linear 12-MHz (10-14 MHz) probe while the participant was sitting with the hand on his/her back at the gluteal region. 18,19,62,63 In compound imaging, a 60-dB gain parameter was used. Supraspinatus tendon thickness in centimeters and any structural changes were recorded (Fig 4).…”

“…Thus, the measurement of supraspinatus tendon thickness was found reliable. [16][17][18] The ultrasonographic diagnosis has the potential for becoming a valuable aid to the clinician in allowing confident diagnosis, and it enables to follow up treatment efficiency. [19][20][21][22] Rehabilitation of the patients with SIS is a complex process that requires a comprehensive evaluation and multifactorial treatment program.…”

Shoulder kinetics and ultrasonography changes after performing a high-intensity task in spinal cord injury subjects and healthy controls

“…This reduced the variation in transducer location for the ultrasound measurements, making the procedure more reliable. 31 The protocol used to examine the structures in the shoulder was the same in both ultrasound examinations, and it was based on previously described techniques. [32][33][34] To examine the transverse image of the biceps tendon, the subject′s hand was placed on their thigh with the palm facing upward.…”

Repeatability of ultrasound in assessment of distal biceps brachii tendon

“…[14][15][16] Given the number of studies that have reported reliability and repeatability of the patel-lar and Achilles tendons it is surprising that few reports are available for tendons of the upper limb. Although reliability of tendon thickness for the proximal long head tendon of the biceps brachii was reported, [17] the distal biceps brachii (dBB) tendon was not studied. This tendon is particularly important as most upper limb movements are regulated through its contribution to forearm flexion and supination.…”