使用CT亨氏单位对肱骨外上髁炎中桡侧腕短伸肌肌腱退变进行定量评估：与组织学和MRI结果的相关性

Quantitative assessment of ECRB tendon degeneration in lateral epicondylitis using CT hounsfield units: correlation with histological and MRI findings.

作者信息

Ishibashi Shigeki, Kodama Akira, Tokumoto Maya, Yokomachi Kazushi, Shinomiya Rikuo, Adachi Nobuo

机构信息

Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan.

Division of Regenerative Medicine for Musculoskeletal System Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan.

出版信息

BMC Musculoskelet Disord. 2025 Apr 16;26(1):367. doi: 10.1186/s12891-025-08346-z.

DOI:10.1186/s12891-025-08346-z

PMID:40241023

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12001386/

Abstract

BACKGROUND

Lateral epicondylitis (LE) is characterized by enthesopathy and tendon degeneration of the extensor carpi radialis brevis (ECRB) attachment. Although magnetic resonance imaging (MRI) can reveal pathological changes, quantitative evaluation methods remain limited. This study aimed to quantify ECRB tendon degeneration on computed tomography (CT) using Hounsfield unit (HU) values.

METHODS

We analyzed 24 elbows (12 males, 12 females; mean age: 53.7 years) in the LE group and 25 control elbows (16 males and 9 females; mean age: 56.7 years). All the patients in the study group underwent preoperative CT, MRI, and subsequent ECRB tendon resection. The tendon was divided into proximal, middle, and distal regions. The mean HU values were measured on reconstructed coronal CT images and analyzed in relation to the control group measurements, MRI findings, and histological evaluations.

RESULTS

The mean HU values were significantly lower in the LE group than in the controls in the proximal (49.7 vs. 65.4 HU, P < .0001) and middle regions (58.9 vs. 67.1 HU, P = 0.024) but not in the distal region (66.1 vs. 70.8 HU, P = 0.192). The ECRB tendon showed the greatest histological degeneration proximally, demonstrating a strong negative correlation with HU values (Spearman ρ = -0.612, P < .0001). Proximal region HU values showed a moderate negative correlation with MRI grades (Spearman ρ = -0.517, P = 0.020).

CONCLUSION

HU values provide a quantitative method for evaluating ECRB tendon degeneration in LE, correlating well with histological and MRI findings. This technique offers an objective measure of tendon pathology that may complement the current diagnostic approaches.

EVIDENCE FROM THE STUDY

Level III.

摘要

背景

外侧上髁炎（LE）的特征是桡侧腕短伸肌（ECRB）附着处的附着点病和肌腱退变。尽管磁共振成像（MRI）能够揭示病理变化，但定量评估方法仍然有限。本研究旨在使用亨氏单位（HU）值在计算机断层扫描（CT）上对ECRB肌腱退变进行量化。

方法

我们分析了LE组的24个肘部（12名男性，12名女性；平均年龄：53.7岁）和25个对照肘部（16名男性和9名女性；平均年龄：56.7岁）。研究组的所有患者均接受了术前CT、MRI检查以及随后的ECRB肌腱切除术。将肌腱分为近端、中间和远端区域。在重建的冠状位CT图像上测量平均HU值，并与对照组测量值、MRI结果和组织学评估结果进行分析。

结果

LE组近端（49.7对65.4 HU，P <.0001）和中间区域（58.9对67.1 HU，P = 0.024）的平均HU值显著低于对照组，但远端区域（66.1对70.8 HU，P = 0.192）并非如此。ECRB肌腱近端的组织学退变最为严重，与HU值呈强负相关（Spearman ρ = -0.612，P <.0001）。近端区域的HU值与MRI分级呈中度负相关（Spearman ρ = -0.517，P = 0.020）。