Quantitative Evaluation Of Mechanical Properties Of Structures Associated With Scapulohumeral Periarthritis By Shear Wave Elastography

【Objective】（1）Elastic values of subacromial-deltoid sliding bursae,supraspinatus tendon and deltoid muscle in patients with normal shoulder and perishoulder inflammation were measured by shear wave elastic imaging technology for statistical analysis,and compared with two-dimensional ultrasound to evaluate the diagnostic efficacy of shear wave elastic imaging technology.（2）To evaluate the correlation between the elasticity of subacromial-deltoid sliding bursae and deltoid muscle and patients’pain time,pain degree,mobility limitation degree and daily activity level.【Methods】A total of 37 patients with 56 shoulders were enrolled in the ultrasound department from December 2021 to August 2022,including32 shoulders from 20 patients in the diseased group and 24 shoulders from 16 patients in the control group.Two dimensional ultrasound and shear wave elastic imaging were performed on the long axis section and short axis section of supraspinatus tendon.The two dimensional ultrasound and shear wave elastic imaging parameters of subacromial-deltoid slide capsule,proximal supraspinatus tendon,distal supraspinatus tendon and deltoid muscle were recorded,and the differences between the affected group and the control group were evaluated.Shapiro-Wilk test,Independent Samples t test,Mann-Whitney U test,ROC curve and Spearman correlation were used for statistical analysis.【Results】The thickness of the subacromideus-deltoid slippage sac in patients with periarthritis of shoulder was statistically different between the two groups（p<0.01）.In shear wave elastic imaging,the shear wave velocity and Young’s modulus of subacromial deltoid sliding bursae,proximal supraspinatus tendon and deltoid muscle were statistically different from those of control group（p<0.001）.The diagnostic efficacy of shear-wave elastic imaging was better than that of traditional two-dimensional ultrasound(AUC_elasticity=0.939>AUC_ultrasound=0.727).The pain time and pain intensity were moderately correlated with the bursae and deltoid elasticity values（ρ≤0.8）,the degree of activity limitation was weakly correlated or moderately correlated with the bursae and deltoid elasticity values（0.3<ρ≤0.5 or 0.5<ρ≤0.8）,and the activity level was not correlated with the bursae and deltoid elasticity values（ρ≤0.3,p>0.05）.【Conclusion】（1）Shear wave elastography is feasible in the diagnosis of scapulohumeral periarthritis.Shear wave elastic imaging technique has good diagnostic efficiency,and is better than two-dimensional ultrasound,and has higher clinical value in the diagnosis of periarthritis of shoulder.（2）The pain time,pain degree and activity limitation were correlated with the shear wave elasticity parameters of subacromial-deltoid sliding bursae and deltoid muscle.