Ning Ziwen, Shi Zhengliang, Yang Guang, Zhong Ruiying, Yu Hong, Wang Yang, Wang Guoliang, Li Yanlin
Department of Sports Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650032, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2022 Sep 15;36(9):1172-1177. doi: 10.7507/1002-1892.202206054.
To summarize the evaluation methods of postoperative healing of supraspinatus tendon tear in recent years, in order to provide reference for clinic.
CNKI, Wanfang, PubMed, and Foreign Medical Literature Retrieval Service (FMRS) databases were used to search the literatures between 2005 and 2022. The literature related to the diagnosis and postoperative healing of supraspinatus tendon tear was included. Finally, 50 articles were reviewed.
Supraspinatus tendon tear is a common shoulder disease. Physical examination, clinical score, and imaging examination are used to predict and evaluate the postoperative healing. Among them, physical examination and clinical score are non-invasive and the most economical methods, but their accuracy and sensitivity are lower than imaging examination, so they can only be used as auxiliary methods. The acromio-humeral distance (AHD) and upward migration index (UMI) measured by X-ray films can directly reflect the change of supraspinatus tendon thickness, but they are impossible to distinguish whether there is tear or not. Ultrasound and MRI are the main methods for the clinical diagnosis of supraspinatus tendon tear, but the commonly used MRI sequence can not accurately judge the internal healing of the tendon. Shear wave elastrography (SWE) and ultrashort-echo-time (UTE) techniques are the latest research directions in recent years, but different studies have shown opposite conclusions on the application of SWE technique. This conclusion shows that the principle of SWE technique and its relationship with tendons need to be further studied. UTE technique has good clinical effect, and the T2* value obtained by UTE technique is more accurate than that of traditional Sugaya typing, but there are still few research samples.
AHD and UMI measured by X-ray film and T2* value measured by UTE technique can be used as effective methods for evaluating the healing of supraspinatus tendon tear after repairing, and can be used as a follow-up evaluation method combined with physical examination and clinical score for patients with supraspinatus tendon tear.
总结近年来肩袖肌腱撕裂术后愈合情况的评估方法，为临床提供参考。
通过中国知网、万方、PubMed及外文医学文献检索服务系统（FMRS）数据库检索2005年至2022年的文献，纳入与肩袖肌腱撕裂诊断及术后愈合相关的文献，最终纳入50篇进行综述。
肩袖肌腱撕裂是一种常见的肩部疾病，体格检查、临床评分及影像学检查用于预测和评估术后愈合情况。其中，体格检查和临床评分是非侵入性且最经济的方法，但准确性和敏感性低于影像学检查，仅可作为辅助方法。X线片测量的肩峰下间隙（AHD）和上移指数（UMI）可直接反映肩袖肌腱厚度变化，但无法区分是否存在撕裂。超声和磁共振成像（MRI）是肩袖肌腱撕裂临床诊断的主要方法，但常用的MRI序列无法准确判断肌腱内部愈合情况。剪切波弹性成像（SWE）和超短回波时间（UTE）技术是近年来最新的研究方向，但不同研究对SWE技术的应用得出了相反结论，这表明SWE技术的原理及其与肌腱的关系有待进一步研究。UTE技术临床效果良好，UTE技术获得的T2*值比传统的 Sugaya分型更准确，但研究样本仍较少。
X线片测量的AHD和UMI以及UTE技术测量的T2*值可作为评估肩袖肌腱撕裂修复术后愈合情况的有效方法，可与体格检查和临床评分相结合，作为肩袖肌腱撕裂患者的随访评估方法。
