Extensibility of Rotator Cuff Muscle with Tendon Rupture Determined Using SWE

项目总结/摘要 肩袖撕裂是肩痛和相关残疾的最常见原因。可能性 损伤随着年龄的增长而急剧增加。随着受伤时间的推移，肌腱会收缩， 留下大的缺陷。然而，不仅组织间隙是一个问题，而且组织的性质也是一个问题。 肌肉变化，最终结果是顺应性降低和僵硬度增加。虽然它是 显然，修复所需的张力随着受伤后时间的推移而增加， 变化量因此，对旋转体伸展性进行个性化的术前预测至关重要 袖带肌肉有助于术前计划和整个康复过程中的恢复监测 过程我们的长期目标是开发一种非侵入性的工具来获取这些信息， 改善计划，从而改善治疗效果。本研究的目的是启动 通过采用一种新的技术，即剪切波弹性成像（SWE）的发展。SWE 通过评估剪切波，提供组织硬度和粘度的定量体内测量 传播速度，其固有地与组织机械特性相关。我们建议 独特和创新的方法，结合B型超声成像（评估肌肉 几何和形态学特性）与SWE（评估肌肉材料特性）进行量化 肌肉结构特性，然后将其用于预测肩袖肌肉的伸展性 （通常为冈上肌）。本研究的目标将在以下方面实现 使用体外尸体肩关节标本的三个具体目的：具体目的1：获得材料 以及冈上肌的几何特性， 分别具体目标2：测量肌肉的伸展性和结构特性， 冈上肌力学测试。具体目标3：建立关系 体外冈上肌的结构刚度（在特定目标2中测量）与 使用SWE测量的肌肉模量和基于b模式的几何/形态学特性 通过回归分析进行成像（目标1中的测量）。贡献将是巨大的 因为它将提供对整个组织延展性的必要的、非侵入性的评估， 直接有助于肩袖修复术的预后、术前计划和术后评估， 骨科最常见和最具挑战性的手术。

PROJECT SUMMARY/ABSTRACT Rotator cuff tears are the most common cause of shoulder pain and related disability. Likelihood of injury increases dramatically with advancing age. Over time following injury, the tendon retracts, leaving a large defect. However, not only is the tissue gap a problem, but also the nature of the muscle changes, with an end result of decreased compliance and increased stiffness. Though it is clear that the tension required for repair increases with time after injury, there is much individual variation. Thus, it is critical to have an individualized pre-surgical prediction of extensibility of rotator cuff muscles assist in pre-surgical planning and monitoring of recovery throughout the rehabilitation process. Our long-term goal is to develop a non-invasive tool for acquiring such information to improve the planning, and thus, the outcome of treatment. The purpose of this study is to initiate the development by adopting a novel technology, namely, Shear Wave Elastography (SWE). The SWE provides quantitative in vivo measurements of tissue stiffness and viscosity by evaluating shear wave propagation speed, which is inherently related to tissue mechanical properties. We propose this unique and innovative approach which combines b-mode ultrasound imaging (to assess muscle geometric and morphological properties) with SWE (to assess muscle material properties) to quantify muscle structural properties which will then be used to predict the extensibility of rotator cuff muscles (typically supraspinatus muscle). The objective of this study will be accomplished in the following three specific aims using cadaver shoulder specimens in vitro: Specific Aim 1: To obtain the material and geometric properties of the supraspinatus muscles using SWE and b-mode ultrasound imaging, respectively. Specific Aim 2: To measure muscle extensibility and structural properties of the supraspinatus muscles through mechanical testing. Specific Aim 3: To establish the relationship between structural stiffness of in vitro supraspinatus muscles (measured in Specific Aim 2) with muscle modulus measured with SWE and geometric/morphological properties based on b-mode imaging (measurements in aim 1) via regression analyses. The contribution will be significant because it will provide a necessary, non-invasive assessment of whole-tissue extensibility that will directly aid in prognosis, pre-surgical planning, and post-surgical evaluation of rotator cuff repair, one of the most common and challenging procedures in orthopedics.