Bagcilar Medical Bulletin (Jun 2024)

Evaluation of the Long Head of the Biceps Tendon Using Shear Wave Elastography and Superb Microvascular Imaging in Cases of Biceps Tendinopathy

  • Fatma Ustabaşıoğlu,
  • Gülşah Burgazdere,
  • Burak Günay,
  • Canan Büşra Akbaş,
  • Fethi Emre Ustabaşıoğlu

DOI
https://doi.org/10.4274/BMB.galenos.2024.2023-11-104
Journal volume & issue
Vol. 9, no. 2
pp. 127 – 134

Abstract

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Objective: To evaluate biceps tendon long head (LHBT) tendinopathy cases using shear wave elastography (SWE) and superb microvascular imaging (SMI) methods, compare the findings with magnetic resonance imaging (MRI) findings, and make an early diagnosis of tendinopathy. Method: Twenty patients diagnosed with LHBT tendinopathy on MRI and 20 healthy volunteers with normal LHBT on MRI were prospectively evaluated using the SWE and SMI methods. Quantitative measurements of LHBT hardness by SWE were performed in kilopascals (kPa). SMI values were determined using a rating system. A four-stage grading system was used as follows: grade 0 (no significant vascularity focus), grade 1 (1-2 focal vascularity focus), grade 2 (1 linear or more than 2 focal vascularity focus), and grade 3 (more than 1 linear vascularity focus). Results: While the average SWE values for the biceps tendon with tendinopathy were measured as 38.715 and 37.685 kPa in the longitudinal and transverse planes, respectively, the average SWE values of the control group were measured as 19.385 and 18.41 kPa in the longitudinal and transverse planes, respectively. This shows that there is a statistically significant difference (p<0.01). In the evaluation performed using SMI, intratendinous grade 1, 2, or 3 flow was detected in all patients with tendinopathy. According to the ANOVA test, there was a statistically significant difference between the degree of vascularization determined by the SMI method and the average symptom onset in cases with tendinopathy (p<0.001). No statistically significant correlation was found between symptom onset time and SWE values measured in the transverse and longitudinal planes. Conclusion: The combined use of SMI and SWE in addition to conventional US can be useful diagnostic methods as easy and practical techniques in the evaluation of the tendon in cases with LHBT tendinopathy.

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