Sonographic Imaging of the Distal Biceps Tendon - An Experimental and Clinical Study

Zusammenfassung

Studienziel: Es sollte geprüft werden, ob sich mit der Sonographie die distale Bizepssehne an humanen Leichenpräparaten und an freiwilligen Probanden sicher darstellen lässt. Methode: Zunächst erfolgte die sonographische Darstellung der distalen Bizepssehne einschließlich der sonographisch kontrollierten perkutanen Markierung der Sehne mittels Kanüle an sechs humanen Ganzarmpräparaten. Anschließend untersuchten wir an 25 freiwilligen Probanden die distale Bizepssehne sonographisch (50 Sonogramme). Alle Untersuchungen wurden mit unterschiedlich frequenten Linearschallköpfen (5 bis 13,5 MHz) durchgeführt. Die Sonogramme wurden von zwei erfahrenen Untersuchern unabhängig voneinander bewertet. Resultate: Die Identifizierung der Sehne gelang in allen Fällen. Die besten Resultate wurden mit dem 7,5-MHz-Schallkopf erreicht. Unsere Studie zeigt weiterhin, dass innerhalb der Standardebenen insbesondere ein medianer Längsschnitt und transversale Schnitte in Höhe des Gelenkspalts zur korrekten Beurteilung der distalen Bizepssehne notwendig sind. Eine dynamische Untersuchung ist zur exakten Beurteilung der Sehne immer zu empfehlen. Schlussfolgerung: Bei ausreichender Erfahrung des Untersuchers ist die Sonographie als diagnostisches Verfahren zur Darstellung der distalen Bizepssehne als Mittel der ersten Wahl anzusehen.

Abstract

Aim: With this study we aimed to determine the reliability of ultrasound imaging in depicting the normal anatomy of the distal biceps tendon in human cadaver specimens and to provide an accurate visualisation of ruptures of the distal biceps tendon in healthy volunteers. Method: The distal biceps tendons of six whole-arm human cadaver specimens were investigated. The tendons were subsequently marked with a biopsy needle and re-examined. In addition, ultrasound imaging of the distal biceps tendon was performed in 25 healthy volunteers (50 sonograms). All examinations were carried out using linear ultrasonic transducers of various frequencies (5 - 13.5 MHz). The sonographic images were submitted to two experienced examiners for analysis. Results: Positive identification of the tendon was achieved in all cases. The best results were achieved using 7.5 MHz transducers. Our study also suggests that the medial longitudinal scan and the articular transversal scan are a definite prerequisite for a correct diagnosis in the region of the distal biceps tendon. The dynamic examination is very useful to visualise the tendon with sufficient accuracy. Conclusion: Based on this study, ultrasound imaging is recommended as the method of choice for visualisation of the distal biceps tendon if performed with the necessary accuracy.

Distale Bizepssehne - Bizepssehnenruptur - Ellenbogengelenk - Ultraschall - standardisierte sonographische Untersuchung

Distal biceps tendon - elbow joint - ultrasound - sonography - standardised ultrasound examination

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