Aşil Tendonunun Sonoelastografisinde Farklı Cihazlar ve Gözleyiciler Arasındaki Uyumluluğun Değerlendirilmesi

Abstract

Amaç: Aynı prensiple çalışan farklı sonoelastografi cihazlarında, farklı gözleyiciler tarafından sağlıklı gönüllülerden elde edilen aşil tendonu gerinim oranlarını karşılaştırarak sonoelastografinin güvenilirliğini araştırmak.

Gereç ve Yöntemler: Kronik hastalığı olmayan 40 gönüllüde toplam 80 aşil tendonu, real-time elastografi prensibi ile çalışan Toshiba ve Hitachi marka cihazlar kullanılarak değerlendirildi. Gerinim oranı ölçümü için Kager yağ planı seçildi. Her bir tendon, her iki cihazda her iki gözleyici tarafından iki kez değerlendirildi. Gözleyici içi ve gözleyiciler arası uyum, iki yönlü ANOVA modelinden mutlak uyum için elde edilen sınıf içi korelasyon katsayısı (SKK) ile incelenerek Ko ve Li’nin (11) önerdiği sınıflandırmaya göre yorumlandı.

Bulgular: Hitachi marka cihazda yapılan birinci ve ikinci ölçümlerde, Toshiba marka cihazda yapılan ikinci ölçümde gözleyiciler arası uyumun iyi seviyede olduğu tespit edildi. (ortalama SKK>0,75). Toshiba marka cihazda yapılan birinci ölçümde ise gözleyiciler arası uyumun daha düşük olduğu saptandı (ortalama SKK=0,729, p<0,001). Her iki cihazda da gözleyiciler içi uyumun mükemmel seviyede olduğu izlendi (SKK>0,90). Toshiba marka cihaz için gözleyiciler arası uyumun Hitachi marka cihaza göre daha düşük olduğu görüldü. Gerinim oranlarının ortalaması Hitachi marka cihaz için 2.96±1.07 ve Toshiba marka cihaz için 3.54±1.03 idi. Toshiba marka cihazdan elde edilen ölçümlerin, Hitachi marka cihazdan elde edilen ölçümlere göre anlamlı düzeyde yüksek olduğu belirlendi.

Sonuç: Farklı cihazlarla yapılan çalışmalarda cihazların kompresyon uygulama sınırlarına bağlı olarak gerinim oranlarında farklılıklar olabilir. Bu nedenle her cihaz için gözleyici içi ve gözleyiciler arası uyum ayrı ayrı değerlendirilmelidir.

Keywords

• sonoelastografi,gerinim oranı,aşil tendonu

Evaluation of Sonoelastography Compatibility on the Achilles Tendon Between Different Devices and Observers

Abstract

Aim: To investigate the reliability of sonoelastography by comparing the Achilles tendon strain ratio obtained in healthy volunteers by different observers with different sonoelastography devices working on the same principle.

Material and Methods: A total of 80 Achilles tendons in 40 volunteers without chronic disease were evaluated using Toshiba and Hitachi devices using real-time elastography principle. The Kager fat pad was selected for strain ratio measurement. Each tendon was evaluated with both devices twice by both observers. The intraobserver and interobserver agreement were examined by intraclass correlation coefficient (ICC) obtained by two-way mixed ANOVA model for absolute agreement and interpreted as Ko and Li (11) suggested.

Results: Interobserver agreement in the first and second measurements of the Hitachi device and in the second measurements of the Toshiba device was found to be good (average ICC>0.75). The interobserver agreement in the first measurements made on the Toshiba device was found to be lower (average ICC=0.729, p<0.001). The intraobserver agreement was found to be excellent (ICC>0.90) for both device. The interobserver agreement for the Toshiba device was found lower than for the Hitachi device. Mean strain ratio was 2.96±1.07 for the Hitachi device and 3.54±1.03 for the Toshiba device. Measurements obtained from the Toshiba device were determined as significantly higher than those from the Hitachi device.

Conclusion: There may be differences in strain rates depending on the compression application limits of the devices, in studies carried out using different devices. Therefore, intraobserver and interobserver agreement should be evaluated separately for each device.

Keywords

• sonoelastography,strain ratio,achilles tendon

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