Objective To evaluate the feasibility of shear wave elastography in evaluating the anterior talofibular ligament and to determine the in vivo mechanical properties of the ATFL in healthy person. Methods Forty-two (21 volunteers with bilateral ATFL) healthy ATFL represented as shear wave velocities as well as conventional ultrasound were obtained for the ATFL in neutral and plantar flexor varus ankle position and compared the differences. For SWE tissue elasticity(m/s) was measured at Location 1: central position of ligament; Location 2: 5mm distal of the fibula attachment;and location 3: 5mm distal of the talus attachment

intra class correlation coefficient (ICC) was used to evaluate interobserver consistency.Compression elastography (CE) was performed on ATFL in the non-signal region under SWE conditions and compare the elasticity of the ATFL in neutral and plantiar flexion pronator varus ankle position. Results The SWVs of 42 ATFL in different positions (neutral vs plantar flexor varus) were significantly different（P＜0.01）. Different sites ( L1

L2

L3 ) ( P =0.288 )，different genders ( P >0.05 )

and bilateral comparison showed no significant difference in SWVs（P>0.05 ) . In compression elastography

the elastic ratio of ATFL and guide pad in different positions was significantly different ( P < 0.01 ). The interobserver reliability revealed an ICC of 0.750~0.969. Conclusion SWE is a valuable diagnostic modality with high reliability in assessing the mechanical properties of ATFL tissue

and can provide in vivo mechanical properties for ATFL damage and recovery.