Time-Dependent Ultrasound Echo Changes Occur in Tendon During Viscoelastic Testing

The viscoelastic behavior of tendons has been extensively studied in vitro. A noninvasive method by which to acquire mechanical data would be highly beneficial, as it could lead to the collection of viscoelastic data in vivo. Our lab has previously presented acoustoelasticity as an alternative ultrasound-based method of measuring tendon stress and strain by reporting a relationship between ultrasonic echo intensity (B mode ultrasound image brightness) and mechanical behavior of tendon under pseudoelastic in vitro conditions [Duenwald, S., Kobayashi, H., Frisch, K., Lakes, R., and Vanderby Jr, R., 2011, “Ultrasound Echo is Related to Stress and Strain in Tendon,” J. Biomech., 44(3), pp. 424–429]. Viscoelastic properties of the tendons were not examined in that study, so the presence of time-dependent echo intensity changes has not been verified. In this study, porcine flexor tendons were subjected to relaxation and cyclic testing while ultrasonic echo response was recorded. We report that time- and strain history-dependent mechanical properties during viscoelastic testing are manifested in ultrasonic echo intensity changes. We also report that the patterns of the echo intensity changes do not directly mimic the patterns of viscoelastic load changes, but the intensity changed in a repeatable (and therefore predictable) fashion. Although mechanisms need further elucidation, viscoelastic behavior can be anticipated from echo intensity changes. This phenomenon could potentially lead to a more extensive characterization of in vivo tissue behavior.