| Part oneObjective:To analyze the ultrasonic image characteristics of High frequency ultrasound(HFUS)in the diagnosis of frozen shoulder,and to explore the clinical application value of HFUS in the evaluation of frozen shoulder.Materials and Methods:From September 2020 to February 2023,30 patients with unilateral frozen shoulder were selected,including 10 males and 20 females,with an average age of 53.5±11.26 years.The affected shoulder joint of patients with frozen shoulder was selected as the experimental group,and the healthy shoulder joint was selected as the control group.The HFUS images of the experimental group and the control group were compared and analyzed.The study parameters mainly included the thickness of the glenohumeral joint capsule and coracohumeral ligament,the thickness,echo and blood flow signal of the biceps dolichocephaly tendon sheath,and the thickness of the subacromial subdeltoid bursa.The clinical application value of HFUS in the diagnosis of frozen shoulder was analyzed.The relevant measurement data were statistically analyzed by student’s t test,and the count data were analyzed by chi-square test.P<0.05 indicated that the difference was statistically significant.Results:The glenohumeral joint capsule and coracohumeral ligament were significantly thicker in the experimental group than those in the control group.The average thickness of glenohumeral joint capsule and coracohumeral ligament were 6.99mm and 1.77mm in the experimental group,2.24mm and 1.09mm in the control group.There was significant difference between the two groups(P<0.01).Abnormalities of the biceps dolichocephaly tendon were found in 23 of 30 shoulders in the experimental group,and associated signs included:The biceps dolichocephaly tendon sheath had thickened sheath,decreased echo and increased blood flow.At the same time,there were 23 shoulder joints with subacromial subdeltoid bursa thickening.In the control group,there were 1 abnormal biceps dolichocephaly tendon and 1 abnormal subacromial subdeltoid bursa.And the difference was statistically significant(P<0.01).Conclusion:HFUS can accurately evaluate the changes of the glenohumeral joint capsule,coracohumeral ligament,biceps dolichocephaly tendon and subacromial subdeltoid bursa in patients with frozen shoulder,and has good diagnostic value for the diagnosis of frozen shoulder.Part twoObjective:To investigate the clinical application value of Shear wave elastography(SWE)in the diagnosis of frozen shoulder.Materials and Methods:From September 2020 to February 2023,we selected about 32 patients who were diagnosed with unilateral frozen shoulder by clinician,including 10 males and 22 females,with an average age of 51.5±11.31 years.The affected shoulder joint of patients with frozen shoulder was used as the experimental group,and the healthy shoulder joint was used as the control group.The main study parameters included the mean elasticity value(Emean)and mean shear wave velocity(SWVmean)of the supraspinatus tendon,infraspinatus tendon,biceps dolichocephaly tendon,subscapularis tendon and glenohumeral joint capsule of the experimental and control groups.At the same time,the receiver operating characteristic curve(ROC)was drawn to obtain the diagnostic cut-off value of related parameters,so as to obtain the diagnostic sensitivity and specificity.The clinical application value of SWE in the diagnosis of frozen shoulder was analyzed.The relevant measurement data were statistically analyzed by student’s t test,P<0.05,indicating that the difference was statistically significant.Results:1.The Emean and SWVmean of the supraspinatus tendon,infraspinatus tendon,biceps dolichocephaly tendon,subscapularis tendon and glenohumeral joint capsule in the experimental group were higher than those in the control group,and there were significant differences between the two groups(P<0.01).The average Emean and average SWVmean of the supraspinatus tendon,infraspinatus tendon,biceps dolichocephaly tendon,subscapularis tendon and glenohumeral joint capsule in the experimental group were 65.31kpa,56.56kpa,79.06kpa,29.60kpa,51.35kpa,and 4.56m/s,4.23m/s,5.05m/s,3.02m/s,4.02m/s.In the control group,the average Emean and average SWVmean of supraspinatus tendon,infraspinatus tendon,biceps dolichocephaly tendon,subscapularis tendon and glenohumeral joint capsule were 34.25kpa,31.98kpa,48.33kpa,14.50kpa,25.72kpa and 3.28m/s,3.21m/s,3.90m/s,2.16m/s,2.82m/s.2.Draw the ROC curve,the results showed that Emean and SWVmean of supraspinatus tendon,infraspinatus tendon,biceps dolichocephaly tendon,subscapularis tendon and glenohumeral joint capsule had good diagnostic value for frozen shoulder.The areas under the Emean curve of the associated tendon were AUC(supraspinatus tendon)=0.955,AUC(infraspinatus tendon)=0.908,AUC(biceps dolichocephaly tendon)=0.867,AUC(subscapularis tendon)=0.918,AUC(glenohumeral joint capsule)=0.885 respectively.The area under the curve of SWVmean of the associated tendon were respectively AUC(supraspinatus tendon)=0.954,AUC(infraspinatus tendon)=0.913,AUC(biceps dolichocephaly tendon)=0.873,AUC(subscapularis tendon)=0.913,AUC(glenohumeral joint capsule)=0.886.When we set the Emean of the supraspinatus tendon was 46.55kpa and the SWVmean was 3.91m/s,the sensitivity was 0.906 and the specificity was 0.906.When we set the Emean of the infraspinatus tendon was 38.35kpa and SWVmean was 3.53m/s,the sensitivity was 0.906 and the specificity was 0.812.When we set the Emean of biceps dolichocephaly tendon was 59.8kpa and the SWVmean was 4.44m/s,the sensitivity was 0.875 and the specificity was 0.75.When we set the Emean of subscapular tendon was 17.7kpa and the SWVmean was 2.42m/s,the sensitivity was 0.867 and the specificity was 0.80.When we set the Emean and SWVmean of subglenohumeral capsule were set as 30.25kpa and 3.16m/s,the sensitivity was 0.906 and specificity was 0.812.Conclusion:The stiffness of supraspinatus tendon,infraspinatus tendon,biceps dolichocephaly tendon,subscapularis tendon and glenohumeral joint capsule increased in patients with frozen shoulder.SWE has a good diagnostic value in the diagnosis of frozen shoulder and can be used as an auxiliary examination method. |
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