The Clinical Application Value Of High Frequency Ultrasound And Shear Wave Elastography In Rotator Cuff

Chapter One:Research on the Value of High Frequency Ultrasound in the Diagnosis of Rotator Cuff InjuryObjective:To evaluate the value of high-frequency ultrasound for locating and qualitative diagnosis of rotator cuff injury,and to summarize the different ultrasound signs of rotator cuff injury,in order to provide a basis for the selection of reasonable imaging examination methods for patients with clinical rotator cuff injury.Methods:Thirty-four patients who were clinically suspected of rotator cuff injury and were admitted to the orthopedics department of our hospital and underwent shoulder arthroscopic surgery were selected.All patients underwent high-frequency ultrasound and magnetic resonance imaging examination within 2 weeks before surgery.The diagnostic efficiency of high-frequency ultrasound and magnetic resonance imaging in the diagnosis of rotator cuff tears was compared,and the consistency of the results of ultrasound and shoulder arthroscopy in the diagnosis of rotator cuff tears was checked.Results:There were 26 cases of rotator cuff injury confirmed by arthroscopy in 34 patients.Taking the results of shoulder arthroscopy as the gold standard,the positive predictive value(PPV),negative predictive value(NPV),sensitivity(Se),specificity(Sp)and accuracy(Acc)of high-frequency ultrasound for rotator cuff tears were 86.4%,41.7%,73.1%,62.5%and 70.6%,respectively.The PPV,NPV,Se,Sp,and Acc of rotator cuff tear on magnetic resonance imaging examination were 82.1%,50.0%,88.5%,37.5%and 76.5%,respectively.There was no significant difference between ultrasound and magnetic resonance imaging in the diagnosis of rotator cuff injury(P>0.05).The consistency of high-frequency ultrasound and arthroscopic surgery in the diagnosis of full-thickness tears is better than that of partial tears(κ=0.712,κ=0.478).Rotator cuff injury is usually accompanied by effusion around the shoulder joint,rough humeral skull cortex,thickened subacromial sac or synovial membrane,and positive acromion impingement test.Conclusion:High-frequency ultrasound has a good diagnostic accuracy for rotator cuff tears,especially for full-thickness rotator cuff tears.Accompanying ultrasound signs can also further assist in diagnosis.Therefore,it has high clinical application value.Moreover,it has the advantages of cheap,convenient,real-time dynamic imaging,etc.,and can be recommended as the preferred imaging examination method for patients with clinical rotator cuff injury.However,when the patient has a limited position or is clinically suspected of a labrum injury or the ultrasound diagnosis is not clear,it needs to be combined with magnetic resonance imaging.Chapter 2 Shear wave elastography technology evaluates the elastic changes of the supraspinatus tendon in healthy volunteers and analysis of influencing factorsObjective:To explore the elastic characteristics of the bilateral supraspinatus tendons in healthy adults,and analyze whether age,gender,dominant hand and non-dominant hand will affect the results.Methods:Fifty-one healthy volunteers without any shoulder symptoms were randomly selected,aged from 23 to 73 years old,with an average age of 50.43±14.86 years old.Divided into 3 groups by age:Group A:20-39 years old(6 males,9 females),group B:40-59 years old(10 males,9 females),group C:≥60 years old(9 males,8 females).A total of 102 cases of shoulder joints.Elastic parameter setting:set the size of the elastic sampling frame to 1.5x1.0cm,the range of SWV to 0.5～6.5m/s,and the diameter of the region of interest to 0.25cm.Results:The MSWV value of the supraspinatus tendon of healthy adults decreased with age.The MSWV value of the supraspinatus tendon of adult males is higher than that of females of the same age group,especially young females.There was no significant difference in the MSWV value of supraspinatus tendon between dominant hand and non-dominant hand.Conclusion:The MSWV of the supraspinatus tendon of healthy adults is related to age and gender,but has no obvious relationship with dominant hand and non-dominant hand.When one side of the rotator cuff-is suspected clinically,the opposite shoulder of the subject can be used as a normal reference.