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Sonoelastography findings of supraspinatus tendon in rotator cuff tendinopathy without tear: comparison with magnetic resonance images and conventional ultrasonography

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Abstract

Background and purpose

Sonoelastography (SE) is a new technique that can assess differences in tissue stiffness. This study investigated the performance of SE for the differentiation of supraspinatus (SSP) tendon alterations of tendinopathy compared to magnetic resonance imaging (MRI) and conventional ultrasonography (US).

Methods

One hundred and eighteen consecutively registered patients with symptoms and MRI findings of SSP tendinopathy were assessed with US and SE. Coronal images of the SSP tendon were obtained using US and SE. Increased signal intensity on T2-weighted images in the coronal planes were graded according to the extent of the signal changes from ventral to dorsal. SE images were evaluated by reviewers using an experimentally proven color grading system.

Results

Using SE, 7.6 % of the SSP tendons were categorized as grade 0, 30.5 % as grade 1, 19.5 % as grade 2, and 42.4 % as grade 3. Evaluation of the interobserver reliability of the SE findings showed “almost perfect agreement”, with a weighted kappa coefficient of 0.83. By comparing the MRI findings with the SE findings, grades of MRI and SE had a positive correlation (r = 0.829, p = <0.001). Furthermore, grades of US and SE also had a positive correlation (r = 0.723, p = <0.001).

Conclusions

SE is valuable in the detection of the intratendinous and peritendinous alterations of the SSP tendon and has excellent interobserver reliability and excellent correlation with MRI findings and conventional ultrasonography findings.

Riassunto

Obiettivi

La sonoelastografia (SE) è una nuova tecnica in grado di valutare le differenze di rigidità dei tessuti. Questo studio ha valutato le capacità della SE nella differenziazione delle alterazioni tendinee da tendinopatia del sovraspinato (SSP) rispetto a risonanza magnetica (MRI) ed ecografia convenzionale (US).

Materiali e Metodi

Centoventuno pazienti con sintomi e reperti MRI di tendinopatia del SSP sono stati valutati con US e SE. Si sono realizzate immagini coronali del tendine SSP utilizzando US e SE. Sono state valutate immagini T2-pesate, per la maggiore intensità del segnale, nei piani coronali, da ventrale a dorsale. Immagini di SE sono state valutate da revisori che utilizzavano un sistema di grading di colore sperimentale.

Risultati

Utilizzando la SE, 7,4 % dei tendini SSP sono stati classificati come di grado 0, 29,8 % di grado 1, 19,8 % di grado 2, e 43,0 % di grado 3. La valutazione inter-osservatori dei risultati SE ha mostrato “accordo quasi perfetto”, con un coefficiente kappa pesato di 0,83. Confrontando i risultati della risonanza magnetica con i risultati della SE, risonanza magnetica e SE hanno avuto una correlazione positiva (r = 0,849, p = < 0.001). Inoltre, anche US e SE hanno avuto una correlazione positiva (r = 0,706, p = < 0,001).

Conclusioni

La SE è valida nella rilevazione delle alterazioni intra-tendinee e peri-tendinee del tendine SSP e ha un’ottima affidabilità inter-osservatori e un’eccellente correlazione con RM e reperti di ecografia convenzionale.

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Conflict of interest

The authors (Joong-Bae Seo, Jae-Sung Yoo, and Jee-Won Ryu) have no conflict of interest.

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). All patients provided written informed consent to enrolment in the study and to the inclusion in this article of information that could potentially lead to their identification.

Human and animal studies

The study conducted in accordance with all institutional and national guidelines for the care and use of laboratory animals.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Dankook University College of Medicine, 119, Dandae-ro Dongnam-gu, Cheonan-Si, Chungnam, 330-715, Republic of Korea

    Joong-Bae Seo, Jae-Sung Yoo & Jee-Won Ryu

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  1. Joong-Bae Seo
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  2. Jae-Sung Yoo
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  3. Jee-Won Ryu
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Correspondence to Jae-Sung Yoo.

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Seo, JB., Yoo, JS. & Ryu, JW. Sonoelastography findings of supraspinatus tendon in rotator cuff tendinopathy without tear: comparison with magnetic resonance images and conventional ultrasonography. J Ultrasound 18, 143–149 (2015). https://doi.org/10.1007/s40477-014-0148-8

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  • DOI: https://doi.org/10.1007/s40477-014-0148-8

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