Abstract
Objectives: The role of neovascularisation in tendinopathy is still poorly understood, potentially due to technical limitations of conventional power Doppler ultrasound. This study aimed to investigate the association between contrast-enhanced ultrasound (CEUS) microvascular volume (MV), Victorian Institute of Sports Assessment-Achilles (VISA-A) scores and intrinsic Achilles tendon tenderness, as well as two different Power Doppler modes. Design: Cross-sectional study. Methods: 20 individuals with uni- or bilateral Achilles tendinopathy completed a VISA-A questionnaire, and underwent microvascular volume measurements of the Achilles tendon mid-portion using both conventional, ultrasensitive (SMI™) power Doppler ultrasound and CEUS. Intrinsic tendon tenderness was assessed with sensation detection threshold to extracorporeal shock waves (ESW). Linear Mixed Model analysis was used to determine the association between microvascular volume (MV), VISA-A, and ESW-detection threshold for both symptomatic and asymptomatic Achilles tendons. Results: There was a significant association between VISA-A and MV (B = −5.3, 95%CI = [−8.5; −2.0], P = 0.0004), and between MV and symptom duration (B = −1.7, 95%CI = [−3.2; −5.0], P = 0.023). No significant associations were found between power Doppler ultrasound and CEUS-based MV or between CEUS-based MV and ESW-detection threshold. In comparison with conventional power Doppler ultrasound, SMI™ showed on average similar detection capacity for neovessels in the mid-portion of the Achilles tendon, whilst being superior for detecting neovessels within Kager's fat pad (t = 3.46, 95%CI = [0.27; 1.03], P < 0.005). Conclusions: Our results indicate that CEUS-based MV of the Achilles tendon is moderately associated with Achilles tendon symptoms. In accordance, CEUS-detected MV could be a novel target for treatment as it seems to be more sensitive than PDU and is correlated with symptoms.
| Original language | English |
|---|---|
| Article number | 1853 |
| Pages (from-to) | 1185-1191 |
| Number of pages | 7 |
| Journal | Journal of Science and Medicine in Sport |
| Volume | 21 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - 2018 |
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Microvascular volume in symptomatic Achilles tendons is associated with VISA-A score. / Praet, S. F.E.; Ong, J. H.; Purdam, C.; Welvaert, M.; Lovell, G.; Dixon, L.; Gaida, J. E.; Anglim, J.; Manzanero, S.; Vlahovich, N.; Hughes, D.; Waddington, G.
In: Journal of Science and Medicine in Sport, Vol. 21, No. 12, 1853, 2018, p. 1185-1191.Research output: Contribution to journal › Article
TY - JOUR
T1 - Microvascular volume in symptomatic Achilles tendons is associated with VISA-A score
AU - Praet, S. F.E.
AU - Ong, J. H.
AU - Purdam, C.
AU - Welvaert, M.
AU - Lovell, G.
AU - Dixon, L.
AU - Gaida, J. E.
AU - Anglim, J.
AU - Manzanero, S.
AU - Vlahovich, N.
AU - Hughes, D.
AU - Waddington, G.
PY - 2018
Y1 - 2018
N2 - Objectives: The role of neovascularisation in tendinopathy is still poorly understood, potentially due to technical limitations of conventional power Doppler ultrasound. This study aimed to investigate the association between contrast-enhanced ultrasound (CEUS) microvascular volume (MV), Victorian Institute of Sports Assessment-Achilles (VISA-A) scores and intrinsic Achilles tendon tenderness, as well as two different Power Doppler modes. Design: Cross-sectional study. Methods: 20 individuals with uni- or bilateral Achilles tendinopathy completed a VISA-A questionnaire, and underwent microvascular volume measurements of the Achilles tendon mid-portion using both conventional, ultrasensitive (SMI™) power Doppler ultrasound and CEUS. Intrinsic tendon tenderness was assessed with sensation detection threshold to extracorporeal shock waves (ESW). Linear Mixed Model analysis was used to determine the association between microvascular volume (MV), VISA-A, and ESW-detection threshold for both symptomatic and asymptomatic Achilles tendons. Results: There was a significant association between VISA-A and MV (B = −5.3, 95%CI = [−8.5; −2.0], P = 0.0004), and between MV and symptom duration (B = −1.7, 95%CI = [−3.2; −5.0], P = 0.023). No significant associations were found between power Doppler ultrasound and CEUS-based MV or between CEUS-based MV and ESW-detection threshold. In comparison with conventional power Doppler ultrasound, SMI™ showed on average similar detection capacity for neovessels in the mid-portion of the Achilles tendon, whilst being superior for detecting neovessels within Kager's fat pad (t = 3.46, 95%CI = [0.27; 1.03], P < 0.005). Conclusions: Our results indicate that CEUS-based MV of the Achilles tendon is moderately associated with Achilles tendon symptoms. In accordance, CEUS-detected MV could be a novel target for treatment as it seems to be more sensitive than PDU and is correlated with symptoms.
AB - Objectives: The role of neovascularisation in tendinopathy is still poorly understood, potentially due to technical limitations of conventional power Doppler ultrasound. This study aimed to investigate the association between contrast-enhanced ultrasound (CEUS) microvascular volume (MV), Victorian Institute of Sports Assessment-Achilles (VISA-A) scores and intrinsic Achilles tendon tenderness, as well as two different Power Doppler modes. Design: Cross-sectional study. Methods: 20 individuals with uni- or bilateral Achilles tendinopathy completed a VISA-A questionnaire, and underwent microvascular volume measurements of the Achilles tendon mid-portion using both conventional, ultrasensitive (SMI™) power Doppler ultrasound and CEUS. Intrinsic tendon tenderness was assessed with sensation detection threshold to extracorporeal shock waves (ESW). Linear Mixed Model analysis was used to determine the association between microvascular volume (MV), VISA-A, and ESW-detection threshold for both symptomatic and asymptomatic Achilles tendons. Results: There was a significant association between VISA-A and MV (B = −5.3, 95%CI = [−8.5; −2.0], P = 0.0004), and between MV and symptom duration (B = −1.7, 95%CI = [−3.2; −5.0], P = 0.023). No significant associations were found between power Doppler ultrasound and CEUS-based MV or between CEUS-based MV and ESW-detection threshold. In comparison with conventional power Doppler ultrasound, SMI™ showed on average similar detection capacity for neovessels in the mid-portion of the Achilles tendon, whilst being superior for detecting neovessels within Kager's fat pad (t = 3.46, 95%CI = [0.27; 1.03], P < 0.005). Conclusions: Our results indicate that CEUS-based MV of the Achilles tendon is moderately associated with Achilles tendon symptoms. In accordance, CEUS-detected MV could be a novel target for treatment as it seems to be more sensitive than PDU and is correlated with symptoms.
KW - Achilles tendon
KW - Contrast agent
KW - Doppler ultrasound
KW - Medical imaging
KW - Microvessels
KW - Sensory threshold
UR - http://www.scopus.com/inward/record.url?scp=85047208454&partnerID=8YFLogxK
UR - http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L2000772916 http://dx.doi.org/10.1016/j.jsams.2018.05.013
UR - http://www.mendeley.com/research/microvascular-volume-symptomatic-achilles-tendons-associated-visaa-score-2
U2 - 10.1016/j.jsams.2018.05.013
DO - 10.1016/j.jsams.2018.05.013
M3 - Article
VL - 21
SP - 1185
EP - 1191
JO - Australian Journal of Science and Medicine in Sport
JF - Australian Journal of Science and Medicine in Sport
SN - 1440-2440
IS - 12
M1 - 1853
ER -