The Study Of High-frequency Ultrasound And MRI Assessment Of Rotator Cuff Tears Before Shoulder Arthroscopy

ObjectiveTo analyze the diagnostic capability of high-frequency ultrasound and magnetic resonance imaging(MRI)in different types of rotator cuff tears and provide the diagnostic basis for treatment strategies before shoulder arthroscopy.MethodsThis study analyzed 109 patients with suspected rotator cuff tear who underwent shoulder arthroscopic surgery in the Department of Sports Medicine of the First Affiliated Hospital of Jinan University from January 2020 to October 2021.High-frequency ultrasound and MRI examination were performed before the operation.The results of shoulder arthroscopy were regarded as the gold standard,the sensitivity,specificity,and accuracy of high-frequency ultrasound and MRI in detecting rotator cuff tears were analyzed;the value of high-frequency ultrasound and MRI in assessing the extent of rotator cuff tear was compared,and the effectiveness of three kinds of ultrasonographic features in the diagnosis of rotator cuff tear was explored.ResultsAmong the 109 cases with clinically suspected rotator cuff tears,98 patients(89.91%)were confirmed by shoulder arthroscopy,of which 95(87.16%)had supraspinatus tendon tears.Ultrasound and MRI had high sensitivity(87.30% vs 90.48%,respectively),specificity(97.82%vs 97.83%,respectively),and accuracy(91.74% vs 93.58%,respectively)for complete tear of the supraspinatus tendon.However,the sensitivity of ultrasound and MRI in detecting partial tear of the supraspinatus tendon was 62.63% and 53.13%,respectively,and there was no significant difference between them.33 patients(30.27%)had subscapular tendon tears.The sensitivity of partial subscapular tendon tear of ultrasound and MRI was 73.33% and 26.67%,respectively.The sensitivity and specificity of three ultrasonographic signs(the disappearance of beak-like structure at the humeral attachment of the subscapular tendon,the small tubercle of the humeral head irregularity,and thinning of the subscapular tendon)were 84.85% and 96.05%,66.67% and 89.47%,54.55% and 97.37%,respectively.ConclusionBoth high-frequency ultrasound and MRI had a high diagnostic value for evaluating supraspinatus tendon tear,but there are some limitations in partial supraspinatus tendon tear,and ultrasound dynamic scan can better detect the partial tear of subscapular tendon than MRI.Ultrasonography showed that the disappearance of beak-like structure at the humeral attachment of the subscapular tendon was a sign with high sensitivity and specificity in diagnosing tear.The signs of small tubercle of the humeral head irregularity and thinning of subscapular tendon had high specificity and low sensitivity.High-frequency ultrasound can be used as one of the optimal choice for preoperative evaluation of shoulder arthroscopy.