| Chapter1 Evaluation for Elastic characteristics of supraspinatus tendon using VTIQ in normal adultBackground Rotator cuff is a series of tendons attached to the surface of the humerus head.Rotator cuff injury is most often involved in supraspinatus tendon,which runs under acromion and adheres to humerus great tubercle.It is easy to cause supraspinatus tendon injury and even rotator cuff tear when shoulder joint adducts repeatedly for a long time.The histopathological changes after tendon injury may lead to the change of mechanical properties.How can we quantitatively evaluate this change?virtual Touch Tissue Imaging Quantification is a kind of ultrasonic elastic imaging technique with image quality monitoring.The evaluation of tendon elasticity by ultrasonic elastic imaging can be used to express the mechanical properties and mechanical characteristics of tendon to some extent.Objective To evaluate the elastic changes of supraspinatus tendon by VTIQ technique and analyze whether it is affected by age,sex,dominant hand and so on.Method Two-dimensional ultrasound and VTIQ were performed in 120 healthy volunteers.The patients were divided into three groups according to their age(group 1:16 males,16 females 40-59 years old)(group 2:20 males,26 females,? 60 years old)(group 3:14 males and 28 females).The maximum thickness of the long axial plane of supraspinatus tendon was measured by two-dimensional ultrasound.Then VTIQ technique was used to measure the superficial and deep shear Wave velocities of the tendon on the long axis of supraspinatus tendon at the end point of 1 cm from the greater tubercle of humerus(proximal end),three times for each site,and the average value was taken.Results1.Comparison of the thickness of supraspinatus tendonThere was no significant difference in the thickness of supraspinatus tendon between non-dominant hand and dominant hand,and different genders(P>0.05).In group 3,the thickness of superior tendon was 5.38 ±0.76 mm and 5.46 ± 1.00 mm,respectively,which was larger than that of group 1(P(non-dominant hand)= 0.005,?P(dominanthand)-0.002)and group 2(P(non-dominant hand-0.005,?P(dominant hand)=0.022).In group 1,the thickness of superior tendon was 4.67 ±0.93 mm and 4.46 ±0.67 mm respectively.In group 2,the thickness of superior hand was 4.70 ±0.60 mm and 4.79 ±0.44 mm,respectively.There was no significant difference in the thickness of superior tendon between group 1 and group 2.2.The comparison of S WV in the superficial and deep layers of supraspinatus tendon and supraspinatus tendon between non-dominant hand and dominant handThere was no significant difference in SWV between non-dominant hand and dominant hand in the three groups(P>0.05).The SWV in the superficial layer of bilateral supraspinatus tendon in each group was lower than that in deep layer(P<0.05).3.Comparison of SWV in supraspinatus tendon of different genders In group 3,the SWV of the superficial and deep layers of supraspinatus tendon in male was 5.40 ±1.32m/s,7.00±1.00m/s,respectively.The SWV of the superficial and deep layers of supraspinatus tendon in group 3 was 4.36±0.86m/s,5.46±0.93m/s,respectively.In group 3,the SWV of supraspinatus tendon in male was higher than that in female of the same age group.The difference was statistically significant(P(superficial)= 0.037,P(deep)=0.002).There was no significant difference in SWV of supraspinatus tendon between male and female in the other two groups(P>0.05).4.Comparison of MWV of supraspinatus tendon in different age groupsIn group 1,the SWV in the superficial and deep layers of supraspinatus tendon were 8.07 ± 1.37 m/s and 9.00 ± 1.03 m/s,respectively,and the SWV in the superficial and deep layers of supraspinatus tendon in group 2 were 7.20±1.24 m/s and 8.51±1.19 m/s,respectively.There was no significant difference between group 1 and group 2(P<0.05).In group 3,male was smaller than group 1 and group 2,the difference was statistically significant(P<0.05),and that of SWV of supraspinatus tendon was significantly higher in group 1 than in group 1,second in group 2 and lowest in group 3.5.Analysis of operator internal consistencyThere was no significant difference in intragroup variation among the three times of SWV repeated measurement of supraspinatus tendon(P>0.05),and the internal consistency of the operator was better than that of the control group(P>0.05).Conclusions The thickness of supraspinatus tendon increases when it is degenerative.The SWV of supraspinatus tendon decreases with age.VTIQ technique can indirectly evaluate the characteristics of elastic change of supraspinatus tendon.The biomechanical characteristics in addition to the morphological information on two-dimensional ultrasound are added.Chapter 2 Evaluation for elastic characteristics of supraspinatus tendon using VTIQ technique in Subacromial Impingement Syndrome in middle-aged and elderly patientsBackground Subacromial Impingement Syndrome is one of the important causes of shoulder pain,which often occurs repeatedly and causes a series of shoulder cuff diseases,such as subacromial bursitis,which affects the patient's quality of life.Supraspinatus tendinitis,rotator cuff tear,and a series of pathological changes are secondary,in which the loss of tissue structure has potentially destructive consequences for the patient,which is an important parameter for the tendency of tendon tear and the ability to heal and repair after injury.The mechanical properties of intact tendons may change correspondingly after injury.This study intends to evaluate the elastic changes of supraspinatus tendons in middle-aged and elderly patients with SIS by VTIQ technique,and to provide imaging reference for clinical evaluation of mechanical properties of supraspinatus tendons in SIS.Objective To evaluate the elasticity of supraspinatus tendon in unilateral SIS patients by using VTIQ technique,and to explore how the elasticity of supraspinatus tendon is affected by SIS in comparison with SWV of the same age control group.Methods 41 patients with unilateral SIS were included in this study,with an average age of 58.41 ±9.70 years and a range of 45-76 years.The average onset time was 4.75±3.2 months.There were 41 shoulder joints in 18 males and 23 females,of which 24 had superior shoulder joints and 17 had non-dominant shoulder joints.According to the age group of the first chapter,41 people were divided into 40 groups(n= 18,10 male,8 female,)60 years old),male 8,female 15.The dominant hand of the same age group in Chapter 1 was chosen to match age and sex.Finally,41 people were selected as control group.The maximum thickness on the long axis of supraspinatus tendon and the thickness of the saccular sac of the acromion were measured by two-dimensional ultrasound.Then VTIQ technique was used to measure the shear wave velocities of the superficial and deep layers of the tendon on the long axis of the supraspinatus tendon at the end point of 1 cm from the greater tubercle of the humerus(proximal end).The position of supraspinatus tendon in SIS group was compared with that in control group.Result1.Comparison of the thickness of subacromial bursa and tendon between SIS group and control groupIn the age group of 40 to 59 years old,the subacromial bursa in the SIS group and control group was about 2.02 10.73mm?1.47±0.33mm,respectively,which was significantly higher in the SIS group(P=0.007),and the thickness of supraspinatus tendon in the SIS group and control group was about 4.87±0.90mm,4.70±0.72mm,respectively.There was no significant difference in the thickness of supraspinatus tendon between the two groups(P =0.413).In the age group of more than 60 years old,the subacromial bursa in SIS group and control group were about(2.22 ±0.98)mm?(1.38 ±0.46)mm,respectively,and the difference was statistically significant.The thickness of supraspinatus tendon in control group and SIS group was about 6.11 ±1.24 mm?5.15±0.88 mm,respectively.which was significantly higher than that in control group(P<0.05).2.Comparison of SWV in supraspinatus tendon between SIS group and control groupThe superficial SWV of supraspinatus tendons in the control group and SIS group was(5.60±1.69)m/s?(7.09±1.88)m/s in the 40-59 age group,which was higher than that in the SIS group(P= 0.020),and the SWV in the deep layer of the supraspinatus tendon in the control group and SIS group was(6.50 ± 1.65)m/s?(8.14± 1.77)m/s,which was higher than that in the SIS group(P = 0.007).The superficial layer S WV of the supraspinatus tendon in the control group was(5.23 ± 1.68)m/s.(4.85 ± 1.29)m/s respectively in group more than 60 years old.There was no significant difference between the two groups(P=0.454),and the SWV in the deep layer of the supraspinatus tendon in the control group was(6.24 ± 1.43)m/s?(6.20 ± 1.28)m/s respectively.There was no significant difference between the two groups(P=0.940).3.Comparison of SWV between superficial and deep layer of supraspinatus tendon in SIS group and control groupThe superficial SWV of supraspinatus tendon in SIS group and control group were significantly lower than that in deep layer group(P<0,05).Conclusion The softening of supraspinatus tendon occurs in the aged 40-59 and over 60 years old,but the mechanism of softening of the two may be different.In the age group of 40-5 9,SIS may be the cause of tendon softening.In the age group of 60 years old,the effect of the first chapter on the degeneration of the supraspinatus tendon may include the degenerative guidance.Softening of the supraspinatus tendon.The softening of this tendon is the elastic characteristic of the tendon degeneration and the sub acromion syndrome,reflecting the mechanical and mechanical changes of the tendon,which can be used to indicate the clinical evaluation of the disease and the screening of the risk population. |
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