Shear Wave Elastography Can Predict Passive Stiffness of Supraspinatus Musculotendinous Unit During Arthroscopic Rotator Cuff Repair for Presurgical Planning
Shear Wave Elastography Can Predict Passive Stiffness of Supraspinatus Musculotendinous Unit During Arthroscopic Rotator Cuff Repair for Presurgical Planning
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DOI：
10.1016/j.arthro.2018.01.059
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发表时间：
2018-08-01
影响因子：
4.7
通讯作者：
Kaneko, Kazuo
中科院分区：
文献类型：
--
作者：
Itoigawa, Yoshiaki;Maruyama, Yuichiro;Kaneko, Kazuo
目的：确定B型超声剪切波弹性成像（SWE）在关节镜下肩袖修复术前预测肩袖肌肉僵硬度的可行性，以评估手术难度，并将SWE与磁共振成像（MRI）上的Goutallier分期进行比较。方法：38例冈上肌全层撕裂需要关节镜下肩袖修复的患者参与研究。术前在MRI上测量脂肪浸润的Goutallier分期，以及冈上肌前浅、前深、后浅和后深（PD）区域的SWE模量。为了测量手术过程中冈上肌腱单元的刚度，轴向拉伸冈上肌腱，直到达到解剖插入部位，并记录每次变形的力。确定冈上肌各区域或Goutallier分期的冈上肌刚度与SWE值之间的相关性。此外，将患者分为2组：（1）在完全足印覆盖组中，在刚度测量期间覆盖了超过50%的足印，以及（2）在不完全足印覆盖组中，在刚度测量期间覆盖了不到50%的足印。测量两组间SWE值和Goutallier分期的差异。结果如下：硬度与冈上肌PD肌SWE模量的最佳相关性为R=0.69，硬度与MRI上Goutallier分期的相关性为R=0.48。不完全足印覆盖组PD区域的SWE值大于完全足印覆盖组，尽管Goutallier分期没有显著差异。结论：与其他区域的SWE评估或MRI上的Goutallier分期相比，与冈上肌肌腱单位的刚度相关性最高的是PD肌肉的SWE模量。超声SWE可以最好地预测冈上肌腱单元的僵硬度。
Purpose: To determine the feasibility of shear wave elastography (SWE) with B-mode ultrasound in predicting the stiffness of the rotator cuff muscle before arthroscopic rotator cuff repair to evaluate the difficulty of the surgical procedure, as well as to compare SWE with the Goutallier stage on magnetic resonance imaging (MRI). Methods: Thirty-eight patients with a full-thickness supraspinatus tear requiring arthroscopic rotator cuff repair participated. The Goutallier stage of fatty infiltration on MRI was measured before surgery, as was the SWE modulus of the anterior superficial, anterior deep, posterior superficial, and posterior deep (PD) regions of the supraspinatus muscle. To measure the stiffness of the supraspinatus musculotendinous unit during surgery, the supraspinatus tendon was axially stretched until the anatomic insertion site was reached, and force per deformation was recorded. The correlation between stiffness of the supraspinatus and SWE value in each region of the supraspinatus muscle or Goutallier stage was determined. In addition, patients were divided into 2 groups: (1) In the complete footprint coverage group, greater than 50% of the footprint was covered during the stiffness measurement, and (2) in the incomplete footprint coverage group, less than 50% of the footprint was covered during the stiffness measurement. Differences in SWE value and Goutallier stage were measured between the 2 groups. Results: The best correlation of stiffness with the SWE modulus of the PD muscle of the supraspinatus was R=0.69, and the correlation of stiffness with the Goutallier stage on MRI was R=0.48. The SWE value of the PD region was greater in the incomplete footprint coverage group than in the complete footprint coverage group, although the Goutallier stage was not significantly different. Conclusions: The highest correlation with stiffness of the supraspinatus musculotendinous unit was with the SWE modulus of the PD muscle, as compared with SWE evaluation of the other regions or the Goutallier stage on MRI. Ultrasound SWE can predict the stiffness of the supraspinatus musculotendinous unit best.