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MUSCULOSKELETAL APPLICATIONS
of SUPERSONIC SHEAR IMAGING (SSI)
          Pictorial Essay

 HUNG THIEN NGUYEN, HAI THANH PHAN
   MEDIC MEDICAL CENTER, HCMC,
              VIETNAM
Purpose

   To apply the supersonic shear imaging
    (SSI) technique to musculoskeletal
    disorders in the situation of clinical utility is
    yet to be established.
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
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
ROTATOR CUFF TEAR
ROTATOR CUFF TEAR
ROTATOR CUFF TEAR
ROTATOR CUFF TEAR
SSI versus ARFI
SSI versus ARFI
SSI versus ARFI
CALCIFIED TENDINOSIS
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.
MYOSITIS_ARFI
MYOSITIS_ARFI
GOUT
GOUT
GOUT
GOUT in ARFI
GOUT in ARFI
GOUT in ARFI
BURSITIS
SYNOVITIS
PLANTARIS FASCIITIS
PLANTARIS FASCIITIS
PLANTARIS FASCIITIS
MUSCULAR HEMATOMA
BAKER’S CYST
BAKER’S CYST
BAKER’S CYST
BAKER’S CYST
BAKER’S CYST
GANGLION CYST
GANGLION CYST
TENDOSYNOVITIS
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.
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).

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