Assessment of Neovascularization in de Quervain's Disease With Superb Microvascular Imaging.

Abstract

Purpose: This study aimed to evaluate the first extensor compartment tenosynovitis of the wrist using the novel superb microvascular imaging (SMI) technique, which can accurately detect small vessels and slow-flow blood signals.

Methods: Twenty-eight patients diagnosed with de Quervain's disease between January 2022 and August 2022 (71.4% female, median age 40.5 [interquartile range: 28-50] years), and 14 age- and gender-matched healthy volunteers (71.4% female, mean ± standard deviation age 39.4 ± 8.2 years) were included. B-mode and SMI evaluations were performed sonographically on the tendons of the first extensor compartment.

Results: The tendon area was higher in the symptomatic group compared to the control group (24.5 [interquartile range: 22.25-40] mm² vs. 18.5 ± 5.7 mm², p < 0.001, respectively). The vascular index (VI) (%) was measured higher in the symptomatic group compared to the asymptomatic group (2.1 ± 1.7 vs. 0 [range, 0-0.8], p < 0.001, respectively). A strong positive correlation was found between the visual analog scale score and the VI (rho = 0.731, p < 0.001). The VI showed 89% specificity and 75% sensitivity in distinguishing de Quervain's disease according to receiver operating characteristics analysis (area under the curve: 0.862, 95% confidence interval: 0.756-0.967). Interobserver agreement in VI measurement was excellent (intraclass correlation coefficient: 0.880, 95% confidence interval: 0.741-0.945).

Conclusion: SMI for the detection of neovascularization and quantitative VI measurement may serve as a novel potential diagnostic tool in the clinical assessment of de Quervain's disease.