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剪切波弹性成像在诊断部分分层肩袖全层撕裂中的作用。

The effect of shear wave elastography in the diagnosis of delaminated partial-thickness rotator cuff tears.

机构信息

Department of Orthopedics, the Second Affiliated Hospital of Xi'an Jiaotong University, 710004 Xi'an, China;.

Department of Ultrasound, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

出版信息

Med Ultrason. 2023 Dec 27;25(4):390-397. doi: 10.11152/mu-4251.

Abstract

AIM

To assess the effectiveness of shear wave elastography (SWE) in diagnosing delaminated partial-thickness rotator cuff tears (DPT-RCT).

MATERIAL AND METHODS

A retrospective study was carried out on 137 patients with DPT-RCT. The study included complete clinical data, including the images of conventional ultrasound (US), SWE, Magnetic Resonance Imaging (MRI) and shoulder arthroscopic surgery. The features of US, SWE, and MRI were evaluated. The study analysed the Shear-Wave Velocity (SWV) among three types of DPT-RCT, and between the regions of tears, normal contralateral, and affected unilateral supraspinatus tendon. Furthermore, receiver operating characteristic (ROC) curves were evaluated.

RESULTS

The SWE detection rate was significantly higher (91.2%) compared to US (73.7%) and MRI (87.6%) for the overall diagnosis of DPT-RCT. Similarly, SWE yielded higher rates of detection for types 1 (89.5%) and 2 (92.3%) of DPT-RCT as compared to US (71.7%, 69.2%) and MRI (81.6%, 94.9%), respectively. However, there was no significant difference in the accuracy of diagnosing type 3 among the three methods. The SWV of the 137 supraspinatus tendon tears was 3.64±0.60 m/s, which was higher than that of the normal supraspinatus tendon (2.43±0.47 m/s, p<0.01) as well as the region of tears (1.61±0.54 m/s, p<0.01). Nevertheless, there was no significant difference in SWV among the three types of DPT-RCT. The cutoff thresholds of SWV for identifying normal tendon from DPT-RCT and for identifying DPT-RCT from the region of tears were 2.96m/s and 2.39m/s, respectively.

CONCLUSIONS

SWE with SWV can provide both quantitative and qualitative diagnostic information for DPT-RCT, which can be used as a crucial supplement imaging method.

摘要

目的

评估剪切波弹性成像(SWE)诊断部分层裂性肩袖全层撕裂(DPT-RCT)的有效性。

材料与方法

对 137 例 DPT-RCT 患者进行回顾性研究。该研究包括完整的临床资料,包括常规超声(US)、SWE、磁共振成像(MRI)和肩关节镜手术图像。评估 US、SWE 和 MRI 的特征。分析三种类型的 DPT-RCT 之间以及撕裂区、正常对侧和患侧冈上肌腱之间的剪切波速度(SWV)。此外,还评估了受试者工作特征(ROC)曲线。

结果

SWE 对 DPT-RCT 的整体诊断的检出率明显高于 US(73.7%)和 MRI(87.6%)(91.2%)。同样,SWE 对 DPT-RCT 1 型(89.5%)和 2 型(92.3%)的检出率也高于 US(71.7%,69.2%)和 MRI(81.6%,94.9%)。然而,三种方法对 3 型 DPT-RCT 的诊断准确性无显著差异。137 例冈上肌腱撕裂的 SWV 为 3.64±0.60 m/s,高于正常冈上肌腱(2.43±0.47 m/s,p<0.01)和撕裂区(1.61±0.54 m/s,p<0.01)。然而,三种类型的 DPT-RCT 之间的 SWV 无显著差异。SWV 鉴别正常肌腱与 DPT-RCT 的截断阈值为 2.96m/s,鉴别 DPT-RCT 与撕裂区的截断阈值为 2.39m/s。

结论

SWV 的 SWE 可为 DPT-RCT 提供定量和定性的诊断信息,可作为一种重要的补充成像方法。

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