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肩袖修补术后评估的超声弹性成像系统评价。

A systematic review on sonoelastography for rotator-cuff post-repair assessment.

机构信息

Department of Physical Medicine and Rehabilitation, Lo-Hsu Medical Foundation, Inc., Lotung Poh-Ai Hospital, Yilan, Taiwan.

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan; Center for Regional Anesthesia and Pain Medicine, Wang-Fang Hospital, Taipei Medical University, Taipei, Taiwan.

出版信息

Asian J Surg. 2024 May;47(5):2097-2105. doi: 10.1016/j.asjsur.2024.02.094. Epub 2024 Feb 20.

Abstract

Surgical repair of rotator cuff tears is performed routinely; however, the risks of re-tears and the associated consequences are significant. Sonoelastography, an imaging modality that evaluates the mechanical properties of tissues, can examine the dynamic transitions in rotator cuff stiffness following retear and investigate the relationship between these changes and the occurrences of retears. This systematic review aimed to summarize the role of perioperative sonoelastography in repaired rotator cuffs. A comprehensive search of the PubMed, Embase, and Cochrane databases was conducted, covering studies published until June 19, 2023. The Newcastle-Ottawa scale was used for quality assessment. The key information extracted from each study included the injury/surgery type, follow-up duration, sonoelastography mode, and main sonoelastographic findings. Eleven eligible studies comprising 355 patients were included. All studies focused on supraspinatus muscles and tendons with previous arthroscopic repairs. During the postoperative 1st - 6th months, muscle stiffness increased in the supraspinatus and decreased in the ipsilateral deltoid. Failure to recover supraspinatus muscle elasticity might be indicative of potential tendon re-tear; however, it is imperative to first establish correlations with other imaging modalities. Conflicting findings have been observed regarding stiffening or softening of the supraspinatus tendon after surgical repair. The preoperative stiffness of the supraspinatus tendon did not correlate with postoperative tendon integrity or function.

摘要

肩袖撕裂的手术修复是常规进行的;然而,再次撕裂的风险及其相关后果是显著的。超声弹性成像作为一种评估组织力学特性的成像方式,可以检查肩袖撕裂后肩袖刚度的动态变化,并研究这些变化与再次撕裂发生之间的关系。本系统评价旨在总结围手术期超声弹性成像在修复肩袖中的作用。对 PubMed、Embase 和 Cochrane 数据库进行了全面检索,涵盖截至 2023 年 6 月 19 日发表的研究。使用纽卡斯尔-渥太华量表进行质量评估。从每项研究中提取的关键信息包括损伤/手术类型、随访时间、超声弹性成像模式和主要超声弹性成像发现。纳入了 11 项符合条件的研究,共 355 名患者。所有研究均聚焦于既往关节镜修复后的冈上肌和肌腱。在术后 1 至 6 个月期间,冈上肌的肌肉僵硬增加,而对侧三角肌的肌肉僵硬减少。冈上肌弹性未能恢复可能表明潜在的肌腱再次撕裂;然而,首先与其他成像方式建立相关性至关重要。关于术后冈上肌腱的僵硬或软化,观察到了相互矛盾的结果。冈上肌腱的术前僵硬与术后肌腱完整性或功能无关。

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