Identification of the Position and Thickness of the First Annular Pulley in Sonographic Images

Tai-Hua Yang; Yi-Hsun Lin; Bo-I Chuang; Hsin-Chen Chen; Wei-Jr Lin; Dee-Shan Yang; Shyh-Hau Wang; Yung-Nien Sun; I-Ming Jou; Li-Chieh Kuo; Fong-Chin Su

doi:10.1016/j.ultrasmedbio.2015.12.007

Identification of the Position and Thickness of the First Annular Pulley in Sonographic Images

Ultrasound Med Biol. 2016 May;42(5):1075-83. doi: 10.1016/j.ultrasmedbio.2015.12.007. Epub 2016 Jan 28.

Authors

Tai-Hua Yang¹, Yi-Hsun Lin², Bo-I Chuang², Hsin-Chen Chen³, Wei-Jr Lin⁴, Dee-Shan Yang⁵, Shyh-Hau Wang⁶, Yung-Nien Sun⁶, I-Ming Jou⁷, Li-Chieh Kuo⁸, Fong-Chin Su⁹

Affiliations

¹ Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Orthopedic Biomechanics Laboratory, Division of Orthopedic Research, Mayo Clinic, Rochester, MN, USA; Department of Orthopedics, China Medical University Hospital, Taichung, Taiwan.
² Department of Computer Science & Information Engineering, National Cheng Kung University, Tainan, Taiwan.
³ Department of Radiation Oncology, Washington University in Saint Louis, Saint Louis, MO, USA.
⁴ Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan.
⁵ Department of Orthopedic Surgery, Ton-Yen General Hospital, Hsinchu, Taiwan.
⁶ Department of Computer Science & Information Engineering, National Cheng Kung University, Tainan, Taiwan; Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan.
⁷ Department of Orthopedics, National Cheng Kung University, Tainan, Taiwan.
⁸ Department of Occupational Therapy, National Cheng Kung University, Tainan, Taiwan. Electronic address: jkkuo@mail.ncku.edu.tw.
⁹ Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan. Electronic address: fcsu@mail.ncku.edu.tw.

PMID: 26831343
DOI: 10.1016/j.ultrasmedbio.2015.12.007

Abstract

The purpose was to identify the A1 pulley's exact location and thickness by comparing measurements from a clinical high-frequency ultrasound scanner system (CHUS), a customized high-frequency ultrasound imaging research system (HURS) and a digital caliper. Ten cadaveric hands were used. We explored the pulley by layers, inserted guide pins and scanned it with the CHUS. After identifying the pulley, we measured each long finger's thickness using the CHUS and excised the pulley to measure its thickness with a digital caliper and the HURS. The thin hypo-echoic layer was revealed to be the synovial fluid space, and the pulley appears hyper-echoic regardless of scan direction. We also defined the pulley's boundaries. Moreover, the CHUS provided a significantly lower measurement of the pulley's thickness than the digital caliper and HURS. Likewise, based on the digital caliper's measurement, the HURS had significantly lower mean absolute and relative errors than the CHUS.

Keywords: Flexor tendon pulley; High frequency ultrasound; Pulley thickness; Sonographic image; Trigger finger.

Publication types

Comparative Study
Evaluation Study
Research Support, Non-U.S. Gov't

MeSH terms

Anatomic Landmarks / anatomy & histology
Anatomic Landmarks / diagnostic imaging
Cadaver
Female
Finger Joint / anatomy & histology*
Finger Joint / diagnostic imaging*
Humans
Image Interpretation, Computer-Assisted / methods
Male
Middle Aged
Physical Examination / methods*
Reproducibility of Results
Sensitivity and Specificity
Taiwan
Tendons / anatomy & histology*
Tendons / diagnostic imaging*
Ultrasonography / methods*