musculoskeletal applications of supersonic shear imaging (ssi)

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MUSCULOSKELETAL APPLICATIONS of SUPERSONIC SHEAR IMAGING (SSI) Pictorial Essay HUNG THIEN NGUYEN, HAI THANH PHAN HUNG THIEN NGUYEN, HAI THANH PHAN MEDIC MEDICAL CENTER, HCMC, MEDIC MEDICAL CENTER, HCMC, VIETNAM VIETNAM

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A pictorial essay of musculoskeletal disorders using supersonic shear elastography in comparison to MRI and histopathologic results.

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Page 1: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

MUSCULOSKELETAL APPLICATIONS of SUPERSONIC SHEAR IMAGING (SSI)

Pictorial Essay

HUNG THIEN NGUYEN, HAI THANH PHANHUNG THIEN NGUYEN, HAI THANH PHAN

MEDIC MEDICAL CENTER, HCMC, MEDIC MEDICAL CENTER, HCMC, VIETNAMVIETNAM

Page 2: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

Purpose

To apply the supersonic shear imaging To apply the supersonic shear imaging (SSI) technique to musculoskeletal (SSI) technique to musculoskeletal disorders in the situation of clinical utility is disorders in the situation of clinical utility is yet to be established. yet to be established.

Page 3: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

Materials and Methods

1.1. A pictorial essay presentation.A pictorial essay presentation.2.2. Using conventional ultrasound and SSI Using conventional ultrasound and SSI

technique with the linear probe (4-15MHz) of technique with the linear probe (4-15MHz) of the Supersonic Imagine System, Aithe Supersonic Imagine System, AiXXplorer. plorer. The range we used was 0-180 kPa. Using a The range we used was 0-180 kPa. Using a Qbox of 1 cm in diameter elasticity values Qbox of 1 cm in diameter elasticity values were measured.were measured.

3.3. Some cases were compared to ARFI Some cases were compared to ARFI technology from Acuson S2000 Siemenstechnology from Acuson S2000 Siemens

Page 4: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

Results

The present pictorial essay includes The present pictorial essay includes

supraspinatus, rotator cuff tears, supraspinatus, rotator cuff tears, Baker’s cyst, Baker’s cyst, plantatis fasciitis,plantatis fasciitis,gout,gout,synovitis, bursitissynovitis, bursitissoft tissue lesions (inflammatory myositis, muscle soft tissue lesions (inflammatory myositis, muscle

tuberculosis),tuberculosis),ganglion cystganglion cyst

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ROTATOR CUFF TEAR

Page 6: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

ROTATOR CUFF TEAR

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ROTATOR CUFF TEAR

Page 8: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

ROTATOR CUFF TEAR

Page 9: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

SSI versus ARFI

Page 10: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

SSI versus ARFI

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SSI versus ARFI

Page 12: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

CALCIFIED TENDINOSIS

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Calf Muscle Tuberculosis

Histopathologic results= Some tubercular vesicles of muscle and soft tissues  included caseum in the central  and surrounding with degenerative cells, lymphocytes and Langhans giant cells.

Page 14: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

MYOSITIS_ARFI

Page 15: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

MYOSITIS_ARFI

Page 16: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

GOUT

Page 17: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

GOUT

Page 18: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

GOUT

Page 19: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

GOUT in ARFI

Page 20: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

GOUT in ARFI

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GOUT in ARFI

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BURSITIS

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SYNOVITIS

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PLANTARIS FASCIITIS

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PLANTARIS FASCIITIS

Page 26: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

PLANTARIS FASCIITIS

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MUSCULAR HEMATOMA

Page 28: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

BAKER’S CYST

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BAKER’S CYST

Page 30: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

BAKER’S CYST

Page 31: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

BAKER’S CYST

Page 32: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

BAKER’S CYST

Page 33: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

GANGLION CYST

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GANGLION CYST

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TENDOSYNOVITIS

Page 36: Musculoskeletal Applications of Supersonic Shear Imaging (SSI)

Conclusions

SSI technique can be used for various SSI technique can be used for various musculoskeletal applications. musculoskeletal applications.

SSI is able to provide quantitative and local SSI is able to provide quantitative and local elastic information in real time.elastic information in real time.

Further multicenter studies with the Further multicenter studies with the histopathological correlation need to be histopathological correlation need to be performed in order to establish the clinical utility performed in order to establish the clinical utility of supersonic shear imaging.of supersonic shear imaging.

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References 1/ Minoru Shinohara, Karim Sabra, Jean-Luc Gennisson, 1/ Minoru Shinohara, Karim Sabra, Jean-Luc Gennisson,

Mathias Flink and Mickael Tanter: Real-Time Mathias Flink and Mickael Tanter: Real-Time Visualization of Muscle Stiffness Distribution with Visualization of Muscle Stiffness Distribution with Ultrasound Shear Wave Imaging During Muscle Ultrasound Shear Wave Imaging During Muscle Contraction, Muscle & Nerve Month 2010.Contraction, Muscle & Nerve Month 2010.

2/ P. S. Zoumpoulis, A. Plagou, E. Fandridis, 2/ P. S. Zoumpoulis, A. Plagou, E. Fandridis, N. Gerostathopoulos: Ultrasound Imaging and N. Gerostathopoulos: Ultrasound Imaging and Elastography of the Rotator Cuff Muscles: Elasticity Elastography of the Rotator Cuff Muscles: Elasticity Measurements of the Supraspinatus and Infraspinatus Measurements of the Supraspinatus and Infraspinatus Muscles using Shear Wave Elastography (ECR 2011, Muscles using Shear Wave Elastography (ECR 2011, poster).poster).