Computerized “Ultrasound Tissue Characterization” (UTC) consists of both hard- and soft- ware. A pivotal role in the configuration plays the UTC-Tracker, a precision instrument that moves the ultrasound probe automatically across the region of interest, e.g. along a tendon’s long axis, collecting transverse images at even distances of 0.2 mm over a length of 12 cm. These images are stored real-time in a high-capacity laptop computer and by compounding contiguous transverse images, a 3-D ultrasound data-block is created that can be used for (A) tomographic visualization and (B) tissue characterization and quantification of architecture and integrity of the collagenous matrix.
The 3-D ultrasound data-block can be scrolled-through and regions of interest can be visualized instantaneously in 3 planes of view plus a 3-D rendered view over a length of 12 cm. For instance, tendons and ligaments are visualized in:
In this way, scrolling through the ultrasound data facilitates a real-time “surgeon’s view” in which skin, paratenon and tendon’s interior can be discriminated. This inward view allows a reliable evaluation of integrity or extent of disintegration. As such, this tomographic visualization can be used for targeted and minimally invasive interventions.
Fundamental research revealed that the dynamism of echo-patterns is strongly related to the architecture and integrity of collagenous matrices. Dedicated UTC-Algorithms can quantify the dynamism of echo-patterns in contiguous images and these features can be related to architecture and integrity of the collagenous matrix with histo-morphology of tissue specimen as reference test. For instance, in tendon tissue 4 different echo-types can be discriminated and related to stages of integrity, namely:
This ultra-structural information is A. visualized tomographically in 3 planes of view and B. quantified by means of the calculation of respective percentages of echo-types. The ratios of these 4 echo-types appeared to be highly correlated with histo-morphological characteristics of tendon tissue, showing the discriminative power of UTC for tissue characterization.