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Supraspinatus muscle shear wave elastography (SWE): detection of biomechanical differences with varying tendon quality prior to gray-scale morphologic changes

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Abstract

Objective

The purpose of this study was to determine whether SWE can detect biomechanical changes in the supraspinatus muscle that occur with increasing supraspinatus tendon abnormality prior to morphologic gray-scale changes.

Materials and methods

An IRB approved, HIPAA compliant retrospective study of shoulder ultrasounds from 2013–2018 was performed. The cohort consisted of 88 patients (mean age 55 ± 15 years old) with 110 ultrasounds. Images were acquired in longitudinal orientation to the supraspinatus muscle with shear wave velocity (SWV) point quantification. The tendon and muscle were graded in order of increasing tendinosis/tear (1–4 scale) and increasing fatty infiltration (0–3 scale). Mixed model analysis of variance, analysis of covariance, and Spearman rank correlation were used for statistical analysis.

Results

There was no statistically significant age or sex dependence for supraspinatus muscle SWV (p = 0.314, 0.118, respectively). There was no significant correlation between muscle SWV and muscle or tendon grade (p = 0.317, 0.691, respectively). In patients with morphologically normal muscle on gray-scale ultrasound, there were significant differences in muscle SWV when comparing tendon grade 3 with grades 1, 2, and 4 (p = 0.018, 0.025, 0.014, respectively), even when adjusting for gender and age (p = 0.044, 0.028, 0.018, respectively). Pairwise comparison of tendon grades other than those mentioned did not achieve statistical significance (p > 0.05).

Conclusion

SWE can detect biomechanical differences within the supraspinatus muscle that are not morphologically evident on gray-scale ultrasound. Specifically, supraspinatus tendon partial tears with moderate to severe tendinosis may correspond to biomechanically distinct muscle properties compared to both lower grades of tendon abnormality and full-thickness tears.

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Abbreviations

US:

Ultrasound

MRI:

Magnetic resonance imaging

SWE:

Shear wave elastography

SWV:

Shear wave velocity

ARFI:

Acoustic radiation force impulse

ROI:

Region of interest

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Authors and Affiliations

  1. Department of Radiology, Division of Musculoskeletal Radiology, NYU Langone Health, 301 East 17th Street, 6th Floor, New York, NY, 10003, USA

    Dana J. Lin, Christopher J. Burke, Benjamin Abiri, James S. Babb & Ronald S. Adler

Authors
  1. Dana J. Lin
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  2. Christopher J. Burke
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  3. Benjamin Abiri
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  4. James S. Babb
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  5. Ronald S. Adler
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Correspondence to Ronald S. Adler.

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“All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.”

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Lin, D.J., Burke, C.J., Abiri, B. et al. Supraspinatus muscle shear wave elastography (SWE): detection of biomechanical differences with varying tendon quality prior to gray-scale morphologic changes. Skeletal Radiol 49, 731–738 (2020). https://doi.org/10.1007/s00256-019-03334-6

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  • DOI: https://doi.org/10.1007/s00256-019-03334-6

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