Xu Weihua, Xu Jiayu, Zhou Yingying, Yang Weiwei, Huang Hui, Xue Jun, Zhang Jing
Ultrasound Medicine Department, Zhabei Central Hospital in Jing'an District, Shanghai, People's Republic of China.
Ultrasound Medicine Department, Daning Community Health Service Center in Jing'an District, Shanghai, People's Republic of China.
Int J Gen Med. 2024 Jul 10;17:3039-3046. doi: 10.2147/IJGM.S465952. eCollection 2024.
To explore the early diagnostic value of superb microvascular imaging (SMI) features within the rotator cuff gap for frozen shoulder.
This prospective study enrolled patients with acute early-stage frozen shoulder seeking treatment at Zhabei Central Hospital in Jing'an District, Shanghai, between July 2021 and December 2022 were enrolled in this study. Healthy controls were collected in a 1:1 ratio from the same hospital's physical examination center. All participants underwent SMI and power Doppler ultrasound (PDUS) of the rotator cuff gap.
The study included 79 patients with frozen shoulder and 77 healthy controls. Compared with the healthy control group, the patient group had a higher proportion of hypoechoic rotator cuff gap (81.0% vs 48.1%, P<0.001), a thicker coracohumeral ligament (2.60±1.01 vs 2.03±0.97, P<0.001), a thicker glenohumeral joint capsule (3.10±0.99 vs 2.46±1.17, P<0.001), and elevated blood grading using SMI (P<0.001) and PDUS (P=0.014). The highest area under the curve (AUC) was observed for SMI blood flow grading (AUC=0.824, 95% CI: 0.755-0.880, P<0.001), resulting in 82% sensitivity and 77% specificity when using a cutoff of 1. SMI blood flow grading was associated with external rotation <30° (P=0.007) and abduction <30° (P=0.013) but not with internal rotation <30° (P=0.630) or flexion <30° (P=0.562).
The grading of SMI blood flow may emerge as a valuable predictive indicator for the early stages of frozen shoulder. This simple ultrasound technique holds the potential to enhance the diagnostic process, enabling early initiation of treatment and potentially improving patient outcomes.
探讨肩袖间隙内超微血管成像（SMI）特征对肩周炎的早期诊断价值。
本前瞻性研究纳入了2021年7月至2022年12月期间在上海静安区闸北中心医院寻求治疗的急性早期肩周炎患者。从同一医院体检中心按1:1比例收集健康对照。所有参与者均接受了肩袖间隙的SMI和能量多普勒超声（PDUS）检查。
该研究纳入了79例肩周炎患者和77例健康对照。与健康对照组相比，患者组肩袖间隙低回声比例更高（81.0%对48.1%，P<0.001），喙肱韧带更厚（2.60±1.01对2.03±0.97，P<0.001），盂肱关节囊更厚（3.10±0.99对2.46±1.17，P<0.001），且SMI（P<0.001）和PDUS（P=0.014）的血流分级升高。SMI血流分级的曲线下面积（AUC）最高（AUC=0.824，95%CI：0.755 - 0.880，P<0.001），截断值为(1)时，敏感性为(82%)，特异性为(77%)。SMI血流分级与外旋<30°（P=0.007）和外展<30°（P=0.013）相关，但与内旋<30°（P=0.630）或屈曲<30°（P=0.562）无关。
SMI血流分级可能成为肩周炎早期有价值的预测指标。这种简单的超声技术有可能改进诊断过程，使治疗能够早期开始，并可能改善患者预后。
