Strain Elastography of Injured Equine Superficial Digital Flexor Tendons: A Reliability Study of Manual Measurements.
Authors: Secchi Valentina, Masala Gerolamo, Corda Andrea, Corda Francesca, Potop Enrica, Barbero Fernandez Alicia, Pinna Parpaglia Maria Luisa, Sanna Passino Eraldo
Journal: Animals : an open access journal from MDPI
Summary
Strain elastography represents a promising advancement over conventional ultrasonography for detecting tissue stiffness changes in equine tendon injuries, yet its clinical utility depends on reliable measurement protocols. Researchers evaluated whether sonographers could consistently quantify elastographic colour-coded areas of damaged superficial digital flexor tendons using manual tools integrated into ultrasound machines, comparing this approach against dedicated image analysis software (ImageJ) across 20 injured tendons assessed by two independent operators. Manual measurements demonstrated excellent intraobserver repeatability (ICC = 0.949) and good interobserver reproducibility (ICC = 0.855), with similarly strong agreement between manual and ImageJ measurements (ICC = 0.849), indicating that operator-dependent analysis need not compromise diagnostic consistency. For practitioners already equipped with modern ultrasound units, this finding validates strain elastography as a clinically feasible monitoring tool without requiring additional software investment, potentially enabling earlier intervention decisions and more objective long-term assessment of healing progression than conventional B-mode imaging alone. Standardising measurement protocols across practitioners remains essential, but the technique's reliability suggests it could meaningfully enhance clinical decision-making in tendon injury management.
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Practical Takeaways
- •You can reliably use manual measurement tools on your ultrasound machine to assess SDFT injury severity and monitor healing without requiring specialized software like ImageJ
- •Strain elastography adds a functional assessment dimension to conventional ultrasonography, enabling better early diagnosis and long-term tracking of tendon healing in your patients
- •Standardized measurement protocols for manual elastography analysis can be implemented in routine clinical practice to improve consistency and accuracy of tendon injury monitoring
Key Findings
- •Manual measurements of strain elastography images showed excellent intraobserver repeatability (ICC = 0.949) for assessment of injured equine SDFTs
- •Interobserver reproducibility was good (ICC = 0.855) when two different operators analyzed the same elastograms
- •Good agreement (ICC = 0.849) was demonstrated between manual measurements and ImageJ software analysis, validating the manual method
- •Manual strain elastography analysis using ultrasound unit tools is a reliable and practical method for monitoring tendon injury healing despite inherent subjectivity