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

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

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

3. Materials and Methods
• A pictorial essay presentation.
• Using conventional ultrasound and SSI
technique with the linear probe (4-15MHz) of
the Supersonic Imagine System, AiXplorer.
The range we used was 0-180 kPa. Using a
Qbox of 1 cm in diameter elasticity values
were measured.
• Some cases were compared to ARFI
technology from Acuson S2000 Siemens

4. Results
The present pictorial essay includes
supraspinatus, rotator cuff tears,
Baker’s cyst,
plantatis fasciitis,
gout,
synovitis, bursitis
soft tissue lesions (inflammatory myositis, muscle
tuberculosis),
ganglion cyst

5. ROTATOR CUFF TEAR

6. ROTATOR CUFF TEAR

7. ROTATOR CUFF TEAR

8. ROTATOR CUFF TEAR

9. SSI versus ARFI

10. SSI versus ARFI

11. SSI versus ARFI

12. CALCIFIED TENDINOSIS

13. 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.

14. MYOSITIS_ARFI

15. MYOSITIS_ARFI

16. GOUT

17. GOUT

18. GOUT

19. GOUT in ARFI

20. GOUT in ARFI

21. GOUT in ARFI

22. BURSITIS

23. SYNOVITIS

24. PLANTARIS FASCIITIS

25. PLANTARIS FASCIITIS

26. PLANTARIS FASCIITIS

27. MUSCULAR HEMATOMA

28. BAKER’S CYST

29. BAKER’S CYST

30. BAKER’S CYST

31. BAKER’S CYST

32. BAKER’S CYST

33. GANGLION CYST

34. GANGLION CYST

35. TENDOSYNOVITIS

36. Conclusions
 SSI technique can be used for various
musculoskeletal applications.
 SSI is able to provide quantitative and local
elastic information in real time.
 Further multicenter studies with the
histopathological correlation need to be
performed in order to establish the clinical utility
of supersonic shear imaging.

37. References
 1/ Minoru Shinohara, Karim Sabra, Jean-Luc Gennisson,
Mathias Flink and Mickael Tanter: Real-Time
Visualization of Muscle Stiffness Distribution with
Ultrasound Shear Wave Imaging During Muscle
Contraction, Muscle & Nerve Month 2010.
 2/ P. S. Zoumpoulis, A. Plagou, E. Fandridis,
N. Gerostathopoulos: Ultrasound Imaging and
Elastography of the Rotator Cuff Muscles: Elasticity
Measurements of the Supraspinatus and Infraspinatus
Muscles using Shear Wave Elastography (ECR 2011,
poster).