| Part 1 Study on the evaluation of normal supraspinatus tendon stiffness by acoustic radiation force impulse imagingObjective: To detect and assess shear wave velocity of supraspinatus tendon in normal people by Virtual Touch imaging quantification(VTIQ)elastography of Acoustic Radiation Force Impulse(ARFI)elastography,analyze the influencing factors,and discuss the application value of ARFI imaging in the evaluation of tendon stiffness.Methods: Left and right supraspinatus tendons of 130 healthy volunteers were examined with two-dimensional ultrasound and VTIQ,then were measured its maximum thickness and shear wave velocity(SWV),respectively.They were divided into 3 groups according to age: Group 1(≤30 years),Group 2(31~50 years),Group 3(>50 years).According to BMI(Body Mass Index),they were divided into 2 groups: normal(BMI <24kg/m2),overweight(BMI 24kg/m2).According to the thickness of supraspinatus tendon,they were divided into 2 groups: thin group(thickness<5.5mm),thick group(thickness≥5.5mm).Compared the difference of SWV of supraspinatus tendon on the left and right sides in different ages,BMI and thickness of supraspinatus tendon.Results: 1.Comparison of SWV of left and right supraspinatus tendons in different age groups In group 1,the SWV of left and right supraspinatus tendon was 7.65 0.42m/s,7.63 0.39m/s,respectively.In group 2,the SWV of left and right supraspinatus tendon was 7.56 0.49m/s,7.54 0.43m/s,respectively.There were no significant differences in the SWV of left and right supraspinatus tendons within group 1 and group 2(P>0.05).In group 3,the SWV of left supraspinatus tendon(7.19 0.52m/s)is greater than the SWV of right supraspinatus tendon(7.09 0.52m/s),and there was significant difference in the SWV of left and right supraspinatus tendons within group 3(P<0.05).2.Comparison of SWV of left and right supraspinatus tendon among different age groups Age was negatively correlated with the SWV of left and right supraspinatus tendon(the left rs was-0.38,the right rs was-0.46),and the correlation had significant difference(P<0.05).The SWV of left and right supraspinatus tendon in group 3(7.19 0.52m/s,7.09 0.52m/s)was less than group 1(7.65 0.42m/s,7.63 0.39m/s)and Group 2(7.56 0.49m/s,7.54 0.43m/s),respectively.There were significant differences in the SWV of left and right supraspinatus tendon between group 1 and group 3,group 2 and group 3(P<0.05).The SWV showed a slight downward trend between group 1 and group 2,but the difference was not significant(P>0.05).3.Comparison of SWV of left and right supraspinatus tendon between different BMI groups The correlation was statistically significant between BMI and the SWV of left and right supraspinatus tendon(P<0.05).The SWV of right supraspinatus tendon in group normal and overweight was 7.47 0.51m/s,7.24 0.52m/s,respectively.And the SWV of the left supraspinatus tendon was 7.47 0.51m/s,7.36 0.54m/s,respectively.There was significant difference in the SWV of right supraspinatus tendon between two BMI groups(P<0.05).There was no significant differences in the SWV of left supraspinatus tendon between two BMI groups(P>0.05).4.Comparison of SWV of left and right supraspinatus tendon between different supraspinatus tendon thickness groups There was no significant correlation between the thickness of supraspinatus tendon and the SWV of left and right supraspinatus tendon(P>0.05).The SWV of left supraspinatus tendon in thin and thick groups was 7.46 0.54m/s,7.38 0.46m/s,respectively.And the SWV of right supraspinatus tendon was 7.43 0.50m/s,7.30 0.53m/s,respectively.There was no significant differences in the SWV of left and right supraspinatus tendons between two supraspinatus thickness groups,respectively(P>0.05).Conclusion: Age and BMI have effect on the SWV of supraspinatus tendon,and age has a greater influence.As the age or BMI increases,the SWV of the tendon gradually decreases,the tendon softens.ARFI elastography can reflect the change of supraspinatus tendon stiffness,and has high clinical value in evaluating the biological characteristics of tendon,and can be used as a supplementary examination method for two-dimensional ultrasound imaging.Part 2 Study on the evaluation of injured supraspinatus tendon stiffness by acoustic radiation force impulse imagingObjective: To detect and assess shear wave velocity of the injured supraspinatus tendon by Virtual Touch imaging quantification(VTIQ)elastography of Acoustic Radiation Force Impulse(ARFI)elastography.Study the change of the supraspinatus tendon stiffness during injury,and explore the value of ARFI elastography in the diagnosis of supraspinatus tendon injury.Methods: the affected side supraspinatus tendon of 51 patients with rotator cuff injury was examined with two-dimensional ultrasound and VTIQ,observed their shape and internal echo,then were measured its maximum thickness and shear wave velocity(SWV).(1)Compare the thickness of supraspinatus tendon: take all healthy volunteers in part 1 as the normal control group,and compare the affected side tendon of the injured group with the corresponding ipsilateral healthy tendon.(2)Compare the SWV of supraspinatus tendon: According to age,the injured group is divided into 2 groups: group 1(age ≤50 years old),group 2(age> 50 years old).The SWV of the supraspinatus tendon in left and right sides of the normal group in whom is≤50 years old was not statistically significant,so the average SWV of the bilateral supraspinatus tendon was used as the control group,which compare with the injured group 1;The SWV of the supraspinatus tendon in left and right sides of the normal group in whom is>50 years old were different,so the same healthy tendon corresponding to the affected side in the injured group 2 was taken as a control.Result: 1.The sonogram echogram of injured group All echogram showed tendon thickness increased,tendon fibers were unclear,and uneven echo was maldistribution.Acute tendon injury showed hyperechoic performance, chronic tendon injury showed uneven echo.2.Comparison of thickness of supraspinatus tendon between the injured and the control group The thickness of left supraspinatus tendon in the injured group and the control group was 5.40 0.91 mm,4.98 0.62 mm,respectively,and the thickness of the right supraspinatus tendon was 5.70 0.98 mm,5.15 0.58 mm,respectively.The thickness of the injured supraspinatus tendon in the injured group was thicker than that in the control group,and there was significant difference between them(P <0.05).3.Comparison of SWV of supraspinatus tendon between injured group and control group in different age groups In group 1(age ≤50 years),the SWV of supraspinatus tendon in the injured group and control group was 6.84 1.23m/s,7.60 0.37m/s,respectively,and there was significant difference between them(P<0.05).In group 2(age> 50 years),the SWV of left supraspinatus tendon in the injury group and the control group was 7.09 0.92m/s、7.18 0.52m/s,respectively.And the SWV of right supraspinatus tendon was 7.39 1.09m/s、7.09 0.52m/s,respectively.There were no significant difference in the SWV value of left and right supraspinatus tendon between the injured group and the control group in group 2(P>0.05).Conclusion: When supraspinatus tendon is injured,it may show increased thickness and variational SWV.Different age groups have different changes in stiffness when the supraspinatus tendon is injured.VTIQ imaging is helpful for the diagnosis of supraspinatus tendon injury,and can be used as an effective auxiliary examination method for early diagnosis,early intervention treatment and monitoring and follow-up of patients with asymptomatic supraspinatus tendon injury. |
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