Quantitative Assessment of First Annular Pulley and Adjacent Tissues Using High-Frequency Ultrasound

Due to a lack of appropriate image resolution, most ultrasound scanners are unable to sensitively discern the pulley tissues. To extensively investigate the properties of the A1 pulley system and the surrounding tissues for assessing trigger finger, a 30 MHz ultrasound system was implemented to perform in vitro experiments using the hypodermis, A1 pulley, and superficial digital flexor tendon (SDFT) dissected from cadavers. Ultrasound signals were acquired from both the transverse and sagittal planes of each tissue sample. The quantitative ultrasonic parameters, including sound speed, attenuation coefficient, integrated backscatter (IB) and Nakagami parameter (m), were subsequently estimated to characterize the tissue properties. The results demonstrated that the acquired ultrasound images have high resolution and are able to sufficiently differentiate the variations of tissue textures. Moreover, the attenuation slope of the hypodermis is larger than those of the A1 pulley and SDFT. The IB of A1 pulley is about the same as that of the hypodermis, and is very different from SDFT. The m parameter of the A1 pulley is also very different from those of hypodermis and SDFT. This study demonstrated that high-frequency ultrasound images in conjunction with ultrasonic parameters are capable of characterizing the A1 pulley system and surrounding tissues.

[1]  A. Tagliafico,et al.  The thickness of the A1 pulleys reflects the disability of hand mobility in scleroderma. A pilot study using high-frequency ultrasound. , 2011, European journal of radiology.

[2]  Hiroyuki Isayama,et al.  Stiffness of the first annular pulley in normal and trigger fingers. , 2011, The Journal of hand surgery.

[3]  C. A. Miles.  Ultrasonic properties of tendon: velocity, attenuation, and backscattering in equine digital flexor tendons. , 1996, The Journal of the Acoustical Society of America.

[4]  P. Shankar,et al.  Ultrasound speckle analysis based on the K distribution. , 1991, The Journal of the Acoustical Society of America.

[5]  Y P Huang,et al.  High frequency ultrasound assessment of skin fibrosis: clinical results. , 2007, Ultrasound in medicine & biology.

[6]  P. Kuo,et al.  Elastic properties of tendon measured by two different approaches. , 2001, Ultrasound in medicine & biology.

[7]  Yi-Hsun Lin,et al.  Quantitative assessments of burn degree by high-frequency ultrasonic backscattering and statistical model , 2011, Physics in medicine and biology.

[8]  Qifa Zhou,et al.  Determining the acoustic properties of the lens using a high-frequency ultrasonic needle transducer. , 2007, Ultrasound in medicine & biology.

[9]  M J Saldana,et al.  Trigger Digits: Diagnosis and Treatment , 2001, The Journal of the American Academy of Orthopaedic Surgeons.

[10]  C A Miles,et al.  Factors affecting the ultrasonic properties of equine digital flexor tendons. , 1996, Ultrasound in medicine & biology.

[11]  C. Martinoli,et al.  High-frequency ultrasound examination of the wrist and hand , 1999, Skeletal Radiology.

[12]  Guy Cloutier,et al.  Ultrasound B-scan image simulation, segmentation, and analysis of the equine tendon. , 2010, Medical physics.

[13]  C R Hill,et al.  Ultrasonic attenuation and propagation speed in mammalian tissues as a function of temperature. , 1979, Ultrasound in medicine & biology.

[14]  C. Burckhardt.  Speckle in ultrasound B-mode scans , 1978, IEEE Transactions on Sonics and Ultrasonics.

[15]  Tait S. Smith,et al.  Pathomechanics of Closed Rupture of the Flexor Tendon Pulleys in Rock Climbers* , 1998, The Journal of bone and joint surgery. American volume.

[16]  P. Tsui,et al.  The effect of transducer characteristics on the estimation of Nakagami paramater as a function of scatterer concentration. , 2004, Ultrasound in medicine & biology.

[17]  C. Martinoli,et al.  Sonographic evaluation of digital annular pulley tears , 2000, Skeletal Radiology.

[18]  Shyh-Hau Wang,et al.  Quantitative assessment on the orientation and distribution of carbon fibers in a conductive polymer composite using high-frequency ultrasound , 2012, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control.

[19]  P. Mohana Shankar,et al.  A general statistical model for ultrasonic backscattering from tissues , 2000, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control.

[20]  D Resnick,et al.  Pulley system in the fingers: normal anatomy and simulated lesions in cadavers at MR imaging, CT, and US with and without contrast material distention of the tendon sheath. , 2000, Radiology.

[21]  R. Kuc,et al.  Estimating the Acoustic Attenuation Coefficient Slope for Liver from Reflected Ultrasound Signals , 1979, IEEE Transactions on Sonics and Ultrasonics.

[22]  J. Dick.  Observations on the elastic tissue of the skin with a note on the reticular layer at the junction of the dermis and epidermis. , 1947, Journal of anatomy.

[23]  P M Shankar,et al.  A model for ultrasonic scattering from tissues based on the K distribution. , 1995, Physics in medicine and biology.

[24]  J. G. Miller,et al.  Comparison of the anisotropy of apparent integrated ultrasonic backscatter from fixed human tendon and fixed human myocardium. , 1995, The Journal of the Acoustical Society of America.

[25]  P. Tsui,et al.  Detection of blood coagulation and clot formation using quantitative ultrasonic parameters. , 2005, Ultrasound in medicine & biology.

[26]  P.M. Shankar,et al.  A compound scattering pdf for the ultrasonic echo envelope and its relationship to K and Nakagami distributions , 2003, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control.

[27]  R. F. Wagner,et al.  Statistical properties of radio-frequency and envelope-detected signals with applications to medical ultrasound. , 1987, Journal of the Optical Society of America. A, Optics and image science.

[28]  K. Shung,et al.  An approach for measuring ultrasonic backscattering from biological tissues with focused transducers , 1997, IEEE Transactions on Biomedical Engineering.

[29]  Nicolas Theumann,et al.  Sonographic Appearance of Trigger Fingers , 2008, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[30]  K. An,et al.  Functional anatomy of the human digital flexor pulley system. , 1989, The Journal of hand surgery.

[31]  J. Greenleaf,et al.  Measurement of ultrasonic nonlinear parameter in excised fat tissues. , 1988, Ultrasound in medicine & biology.

[32]  J R Doyle,et al.  Anatomy of the finger flexor tendon sheath and pulley system. , 1988, The Journal of hand surgery.

[33]  William D O'Brien,et al.  Frequency-dependent attenuation-compensation functions for ultrasonic signals backscattered from random media. , 2002, The Journal of the Acoustical Society of America.

[34]  Hideo Noguchi,et al.  Sonographic appearance of the flexor tendon, volar plate, and A1 pulley with respect to the severity of trigger finger. , 2012, The Journal of hand surgery.

[35]  K. Shung,et al.  Ultrasonic backscatter from flowing whole blood. I: Dependence on shear rate and hematocrit. , 1988, The Journal of the Acoustical Society of America.

[36]  Fong-Chin Su,et al.  Assessment of the Kinetic Trajectory of the Median Nerve in the Wrist by High-Frequency Ultrasound , 2014, Sensors.

[37]  Hae-Rim Kim,et al.  Ultrasonographic assessment of clinically diagnosed trigger fingers , 2010, Rheumatology International.

[38]  M. Srinivasan,et al.  Statistics of envelope of high-frequency ultrasonic backscatter from human skin in vivo , 2002, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control.

[39]  J C Bamber,et al.  Ultrasonic propagation properties of excised human skin. , 1995, Ultrasound in medicine & biology.

[40]  Shyh-Hau Wang,et al.  The Effect of Kinetic Properties on Statistical Variations of Ultrasound Signals Backscattered from Flowing Blood , 2009 .

[41]  Characterization of bony tissues from ultrasonic backscattering using statistical models , 2001, 2001 IEEE Ultrasonics Symposium. Proceedings. An International Symposium (Cat. No.01CH37263).

[42]  K. Shung,et al.  Diagnostic Ultrasound: Imaging and Blood Flow Measurements , 2005 .

[43]  A. Cotten,et al.  High‐Frequency Ultrasonographic Examination of the Finger Pulley System , 2005, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[44]  Matthew O'Donnell,et al.  Broadband Integrated Backscatter: An Approach to Spatially Localized Tissue Characterization in Vivo , 1979 .

[45]  Yung-Nien Sun,et al.  Identification of the Position and Thickness of the First Annular Pulley in Sonographic Images. , 2016, Ultrasound in medicine & biology.

[46]  M. V. van Holsbeeck,et al.  Sonographic Depiction of Trigger Fingers in Acromegaly , 2009, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[47]  Distribution and deposition of organic fouling on the microfiltration membrane evaluated by high-frequency ultrasound. , 2013, Journal of membrane science.

[48]  J. Greenleaf,et al.  Ultrasound echo envelope analysis using a homodyned K distribution signal model. , 1994, Ultrasonic imaging.

[49]  Farid Amirouche,et al.  Biomechanics of the digit , 2005 .

[50]  Shyh-Hau Wang,et al.  Review: Study of the Blood Coagulation by Ultrasound , 2011 .

[51]  W. O’Brien,et al.  Speed of Sound in Mammalian Tendon Threads Using Various Reference Media , 1985, IEEE Transactions on Sonics and Ultrasonics.

[52]  B. Goldberg,et al.  Classification of ultrasonic B-mode images of breast masses using Nakagami distribution , 2001, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control.

[53]  M A Srinivasan,et al.  High-frequency ultrasonic attenuation and backscatter coefficients of in vivo normal human dermis and subcutaneous fat. , 2001, Ultrasound in medicine & biology.

[54]  J. Greenleaf,et al.  Clinical Imaging with Transmissive Ultrasonic Computerized Tomography , 1981, IEEE Transactions on Biomedical Engineering.

[55]  L. Bancroft,et al.  Injuries of the fingers and thumb in the athlete. , 2006, Clinics in sports medicine.

[56]  Chien-Cheng Chang,et al.  Imaging local scatterer concentrations by the Nakagami statistical model. , 2007, Ultrasound in medicine & biology.

[57]  D. A. Christopher,et al.  Advances in ultrasound biomicroscopy. , 2000, Ultrasound in medicine & biology.

[58]  Rajeev Agrawal,et al.  Study of ultrasonic echo envelope based on Nakagami-inverse Gaussian distribution. , 2006, Ultrasound in medicine & biology.

[59]  Estimation of cell concentration using high-frequency ultrasonic backscattering , 2012 .