Brage Karen, Hjarbaek John, Boyle Eleanor, Ingwersen Kim Gordon, Kjaer Per, Juul-Kristensen Birgit
Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Health Sciences Research Centre, UCL University College, Odense, Denmark.
JSES Int. 2020 Feb 24;4(2):310-317. doi: 10.1016/j.jseint.2019.12.008. eCollection 2020 Jun.
We aimed to explore the discriminative validity of ultrasound strain elastography (SEL) between patients with painful supraspinatus tendinopathy and healthy control shoulders, as well as the associations between SEL and magnetic resonance imaging (MRI), conventional ultrasound (tendon thickness), and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH).
Thirty patients with shoulder pain and MRI-verified supraspinatus tendinopathy and 30 healthy control shoulders (no pain) were examined using SEL, MRI, and conventional ultrasound of the supraspinatus tendon. SEL variables included raw data, ratios between the deltoid muscle and supraspinatus tendon (deltoid ratio), color rating, and presence of red/yellow lesions (middle, worst part, and total tendon).
Statistically significant increases in odds ratios for being symptomatic (increased softening) were seen for all raw data variables, corresponding to 3.978 (95% confidence interval [CI], 1.414-11.197) for middle, 4.602 (95% CI, 1.536-13.788) for worst, and 4.865 (95% CI, 1.406-16.836) for total tendon, and 1.260 (95% CI, 1.027-1.545) for the deltoid ratio (worst), adjusted for sex and body mass index (BMI). Tendon thickness was not associated with SEL; however, significantly positive associations were found between raw data variables and MRI (β ≥ 0.58, < .01), and positive associations were found between raw data variables and the DASH score (β = 0.01, ≤ .04), adjusted for sex and BMI.
Raw data variables and the deltoid ratio (worst) discriminated between patients with painful supraspinatus tendinopathy and healthy control shoulders when adjusted for sex and BMI. Associations were statistically significant for raw data variables and MRI or DASH score when adjusted for sex and BMI. Further studies are needed to understand SEL and the role of sex and BMI, including the responsiveness of SEL.
我们旨在探讨超声应变弹性成像（SEL）在疼痛性冈上肌腱病患者与健康对照肩部之间的鉴别效度，以及SEL与磁共振成像（MRI）、传统超声（肌腱厚度）和上肢、肩部和手部功能障碍问卷（DASH）之间的关联。
对30例肩部疼痛且经MRI证实为冈上肌腱病的患者以及30个健康对照肩部（无疼痛）进行SEL、MRI和冈上肌腱的传统超声检查。SEL变量包括原始数据、三角肌与冈上肌腱的比值（三角肌比值）、颜色分级以及红色/黄色病变的存在情况（中间、最严重部位和整个肌腱）。
所有原始数据变量出现症状（软化增加）的比值比均有统计学显著升高，调整性别和体重指数（BMI）后，中间部位为3.978（95%置信区间[CI]，1.414 - 11.197），最严重部位为4.602（95% CI，1.536 - 13.788），整个肌腱为4.865（95% CI，1.406 - 16.836），三角肌比值（最严重部位）为1.260（95% CI，1.027 - 1.545）。肌腱厚度与SEL无关；然而，调整性别和BMI后，原始数据变量与MRI之间存在显著正相关（β≥0.58，P <.01），原始数据变量与DASH评分之间存在正相关（β = 0.01，P≤.04）。
调整性别和BMI后，原始数据变量和三角肌比值（最严重部位）可区分疼痛性冈上肌腱病患者与健康对照肩部。调整性别和BMI后，原始数据变量与MRI或DASH评分之间的关联具有统计学意义。需要进一步研究以了解SEL以及性别和BMI的作用，包括SEL的反应性。
