PDF(Pubmed)
Abstract：
Ultrasound is widely used for tendon assessment due to its safety, affordability, and portability, but its subjective nature poses challenges. This study aimed to develop a new quantitative analysis tool based on artificial intelligence to identify statistical patterns of healthy and pathological tendons. Furthermore, we aimed to validate this new tool by comparing it to experts\' subjective assessments. A pilot database including healthy controls and patients with patellar tendinopathy was constructed, involving 14 participants with asymptomatic (n = 7) and symptomatic (n = 7) patellar tendons. Ultrasonographic images were assessed twice, utilizing both the new quantitative tool and the subjective scoring method applied by an expert across five regions of interest. The database contained 61 variables per image. The robustness of the clinical and quantitative assessments was tested via reliability analyses. Lastly, the prediction accuracy of the quantitative features was tested via cross-validated generalized linear mixed-effects logistic regressions. These analyses showed high reliability for quantitative variables related to \"Bone\" and \"Quality\", with ICCs above 0.75. The ICCs for \"Edges\" and \"Thickness\" varied but mostly exceeded 0.75. The results of this study show that certain quantitative variables are capable of predicting an expert\'s subjective assessment with generally high cross-validated AUC scores. A new quantitative tool for the ultrasonographic assessment of the tendon was designed. This system is shown to be a reliable and valid method for evaluating the patellar tendon structure.
摘要：
超声由于其安全性而广泛用于肌腱评估，负担能力，和便携性，但它的主观性带来了挑战。本研究旨在开发一种基于人工智能的新定量分析工具，以识别健康和病理肌腱的统计模式。此外，我们的目标是通过将它与专家的主观评估进行比较来验证这个新工具。建立了一个包含健康对照和髌腱病患者的试点数据库，涉及14名无症状（n=7）和有症状（n=7）髌骨肌腱的参与者。超声图像被评估两次，利用新的定量工具和专家在五个感兴趣的区域应用的主观评分方法。数据库每个图像包含61个变量。通过可靠性分析来测试临床和定量评估的稳健性。最后,通过交叉验证的广义线性混合效应逻辑回归检验了定量特征的预测准确性.这些分析显示了与“骨骼”和“质量”相关的定量变量的高可靠性，ICC高于0.75。“边缘”和“厚度”的ICC变化，但大多超过0.75。这项研究的结果表明，某些定量变量能够预测具有通常较高的交叉验证AUC评分的专家的主观评估。设计了一种用于肌腱超声检查的新定量工具。该系统被证明是评估髌腱结构的可靠和有效的方法。
