Lee Sang-Uk, Joo Sun Young, Kim Sun Ki, Lee Sang-Ho, Park Sung-Ryeoll, Jeong Changhoon
Department of Orthopaedic Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
J Shoulder Elbow Surg. 2016 May;25(5):723-9. doi: 10.1016/j.jse.2015.10.019. Epub 2016 Jan 12.
Real-time sonoelastography can be used to assess tissue elasticity. The present study evaluated the relationship between tendon stiffness on sonoelastography and the magnetic resonance imaging (MRI) tendinosis grade in patients with rotator cuff tendinopathy.
The study included 39 patients with chronic pain and no history of trauma or rotator cuff tear. The supraspinatus tendons were graded according to MRI findings (grade 0, normal; grade 1, mild tendinosis; grade 2, moderate tendinosis; grade 3, marked tendinosis), and the subcutaneous fat-to-tendon (Fat/T) and gel pad-to-tendon (Pad/T) strain ratios were assessed. We used the trend test to analyze the relationship of the MRI grade with the Fat/T strain ratio and the Pad/T strain ratio.
Of the 39 patients, 9 had grade 0, 17 had grade 1, 12 had grade 2, and 1 had grade 3 tendinosis. The mean real-time elastography Fat/T and Pad/T strain ratios were 2.92 ± 2.13 and 20.77 ± 21.78 in patients with grade 0 tendinosis, 4.08 ± 4.09 and 21.78 ± 17.16 in patients with grade 1 tendinosis, 13.48 ± 10.19 and 83.00 ± 48.26 in patients with grade 2 tendinosis, and 12.3 ± 0.00 and 16.58 ± 0.00 in patients with grade 3 tendinosis, respectively. The Fat/T and Pad/T strain ratios were positively associated with the MRI grade (P <.001).
The MRI tendinosis grade is associated with stiffness assessed using sonoelastography in patients with rotator cuff tendinopathy. Therefore, sonoelastography might be a useful diagnostic tool for supraspinatus tendinopathy.
Level III; Diagnostic Study.
实时超声弹性成像可用于评估组织弹性。本研究评估了肩袖肌腱病患者超声弹性成像中肌腱硬度与磁共振成像（MRI）肌腱病变分级之间的关系。
该研究纳入了39例有慢性疼痛且无创伤或肩袖撕裂病史的患者。根据MRI结果对冈上肌腱进行分级（0级，正常；1级，轻度肌腱病变；2级，中度肌腱病变；3级，重度肌腱病变），并评估皮下脂肪与肌腱（Fat/T）以及凝胶垫与肌腱（Pad/T）的应变比。我们使用趋势检验分析MRI分级与Fat/T应变比和Pad/T应变比之间的关系。
39例患者中，9例为0级，17例为1级，12例为2级，1例为3级肌腱病变。0级肌腱病变患者的实时弹性成像Fat/T和Pad/T应变比的平均值分别为2.92±2.13和20.77±21.78；1级肌腱病变患者为4.08±4.09和21.78±17.16；2级肌腱病变患者为13.48±10.19和83.00±48.26；3级肌腱病变患者为12.3±0.00和16.58±0.00。Fat/T和Pad/T应变比与MRI分级呈正相关（P<.001）。
肩袖肌腱病患者的MRI肌腱病变分级与超声弹性成像评估的硬度相关。因此，超声弹性成像可能是冈上肌腱病的一种有用的诊断工具。
III级；诊断性研究。
