• C C Ooi, P Malliaras, M E Schneider, and D A Connell.
• Department of Medical Imaging & Radiation Sciences, Faculty of Medicine, Nursing & Health Sciences, Monash University, Clayton Campus, Building 13C, Melbourne, VIC, 3800, Australia.
• Skeletal Radiol. 2014 Jan 1; 43 (1): 1-12.

AbstractInjury to a tendon leads to alterations in the mechanical properties of the tendon. Axial-strain sonoelastography and shear-wave elastography are relatively new, real-time imaging techniques that evaluate the mechanical properties of tendons in addition to the existing morphological and vascular information that is obtained with traditional imaging tools. Axial-strain sonoelastography displays the subjective distribution of strain data on an elastogram caused by tissue compression, whereas shear-wave elastography provides a more objective, quantitative measure of the intrinsic tissue elasticity using the acoustic push-pulse. Recent studies suggest that axial-strain sonoelastography is able to distinguish between asymptomatic and diseased tendons, and is potentially more sensitive than conventional ultrasound in detecting early tendinopathy. Shear-wave elastography seems to be a feasible tool for depicting elasticity and functional recovery of tendons after surgical management. While initial results have been promising, axial-strain sonoelastography and shear-wave elastography have not yet found routine use in wider clinical practice. Possible barriers to the dissemination of axial-strain sonoelastography technique include operator dependency, technical limitations such as artefacts and lack of reproducibility and quantification of sonoelastography data. Shear-wave elastography may improve the reproducibility of elastography data, although there is only one published study on the topic to date. Large-scale longitudinal studies are needed to further elucidate the clinical relevance and potential applications of axial-strain sonoelastography and shear-wave elastography in diagnosing, predicting, and monitoring the progress of tendon healing before they can be widely adopted into routine clinical practice.

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