Zhang Lei, Chen Hua, Yang Qi, Ding Zhichao, Zhang Laizhi, Gu Yifeng
Department of Ultrasound Medicine, Zhejiang Provincial People's Hospital, Hangzhou, China.
Department of Orthopedics II, Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
J Back Musculoskelet Rehabil. 2025 Mar;38(2):253-264. doi: 10.1177/10538127241298533. Epub 2024 Dec 18.
BackgroundFrozen shoulder (FS) is a common musculoskeletal disease. Imaging plays an active role in the clinical diagnosis and staging of FS.ObjectiveThis study is undertaken to assess the application value of high-frequency ultrasound (HFU) combined with magnetic resonance (MR) in clinical staging diagnosis of FS.MethodsThis was a retrospective cohort study. The medical records of FS patients (from January 2021 to February 2022, n = 100) were collected. Patients were categorized into stage I (n = 30), stage II (n = 35) and stage III (n = 35) groups. The diagnostic value of HFU-related and MR-related indicators was assessed by the receiver operating characteristic (ROC) curve. The correlation between HFU/MR indicator and passive range of motion-related indicators was analyzed by Spearman rank method.ResultsThere were no statistically significant differences in gender, age, height, weight, and affected shoulder (left: right) among the three groups at different stages (> 0.05). HFU and MR in combination had a higher diagnostic coincidence rate when compared to their single use (96.00% vs. 91.00% or 93.00%). There was high diagnostic value for inferior capsule thickness (ICT) (area under the curve (AUC) = 0.914, < 0.001, 95% (0.836-0.992)), glenohumeral distance (GHD) (AUC = 0.999, < 0.001, 95% (0.996-1.000)) and articular capsule thickness (ACT) (AUC = 1.000, < 0.001, 95% (0.998-1.000)) in stage I FS, for ICT (AUC = 0.947, < 0.001, 95% (0.885-1.000)) and GHD (AUC = 0.974, < 0.001, 95% (0.949-0.999)) in stage II FS, and for ACT (AUC = 0.989, < 0.001, 95% (0.975-1.000)) in stage III FS. ICT/ACT positively correlated with internal rotation (IR), and negatively correlated with external rotation (ER)/extension (EX)/flexion (FL)/abduction (AB). GHD had a negative correlation with IR, and a positive correlation with ER/EX/FL/AB.ConclusionHigh-frequency ultrasound combined with magnetic resonance can improve the accuracy in clinical diagnosis of FS, promote better staging of FS, and provide a more reliable basis for clinical diagnosis and treatment of FS.
背景
肩周炎（FS）是一种常见的肌肉骨骼疾病。影像学在FS的临床诊断和分期中发挥着积极作用。
目的
本研究旨在评估高频超声（HFU）联合磁共振成像（MR）在FS临床分期诊断中的应用价值。
方法
这是一项回顾性队列研究。收集了FS患者（2021年1月至2022年2月，n = 100）的病历。患者被分为I期（n = 30）、II期（n = 35）和III期（n = 35）组。通过受试者工作特征（ROC）曲线评估HFU相关指标和MR相关指标的诊断价值。采用Spearman秩相关法分析HFU/MR指标与被动活动范围相关指标之间的相关性。
结果
不同阶段的三组患者在性别、年龄、身高、体重和患侧肩部（左：右）方面差异均无统计学意义（> 0.05）。与单独使用相比，HFU和MR联合使用具有更高的诊断符合率（96.00%对91.00%或93.00%）。I期FS中，下囊厚度（ICT）（曲线下面积（AUC）= 0.914，< 0.001，95%（0.836 - 0.992））、肱盂距离（GHD）（AUC = 0.999，< 0.001，95%（0.996 - 1.000））和关节囊厚度（ACT）（AUC = 1.000，< 0.001，95%（0.998 - 1.000））具有较高诊断价值；II期FS中，ICT（AUC = 0.947，< 0.001，95%（0.885 - 1.000））和GHD（AUC = 0.974，< 0.001，95%（0.949 - 0.999））具有较高诊断价值；III期FS中，ACT（AUC = 0.989，< 0.001，95%（0.975 - 1.000））具有较高诊断价值。ICT/ACT与内旋（IR）呈正相关，与外旋（ER）/伸展（EX）/屈曲（FL）/外展（AB）呈负相关。GHD与IR呈负相关，与ER/EX/FL/AB呈正相关。
结论
高频超声联合磁共振成像可提高FS临床诊断的准确性，促进FS更好地分期，为FS的临床诊断和治疗提供更可靠的依据。
