The effect of shear wave elastography in the diagnosis of delaminated partial-thickness rotator cuff tears.

AIM: To assess the effectiveness of shear wave elastography (SWE) in diagnosing delaminated partial-thickness rotator cuff tears (DPT-RCT). MATERIAL AND METHODS: A retrospective study was carried out on 137 patients with DPT-RCT. The study included complete clinical data, including the images of conventional ultrasound (US), SWE, Magnetic Resonance Imaging (MRI) and shoulder arthroscopic surgery. The features of US, SWE, and MRI were evaluated. The study analysed the Shear-Wave Velocity (SWV) among three types of DPT-RCT, and between the regions of tears, normal contralateral, and affected unilateral supraspinatus tendon. Furthermore, receiver operating characteristic (ROC) curves were evaluated. RESULTS:  The SWE detection rate was significantly higher (91.2%) compared to US (73.7%) and MRI (87.6%) for the overall diagnosis of DPT-RCT. Similarly, SWE yielded higher rates of detection for types 1 (89.5%) and 2 (92.3%) of DPT-RCT as compared to US (71.7%, 69.2%) and MRI (81.6%, 94.9%), respectively. However, there was no significant difference in the accuracy of diagnosing type 3 among the three methods. The SWV of the 137 supraspinatus tendon tears was 3.64±0.60 m/s, which was higher than that of the normal supraspinatus tendon (2.43±0.47 m/s, p<0.01) as well as the region of tears (1.61±0.54 m/s, p<0.01). Nevertheless, there was no significant difference in SWV among the three types of DPT-RCT. The cutoff thresholds of SWV for identifying normal tendon from DPT-RCT and for identifying DPT-RCT from the region of tears were 2.96m/s and 2.39m/s, respectively. CONCLUSIONS: SWE with SWV can provide both quantitative and qualitative diagnostic information for DPT-RCT, which can be used as a crucial supplement imaging method.

The value of percutaneous ultrasound-guided subacromial bursography in the diagnosis of rotator cuff tears.

AbstractPurpose To determine the feasibility and diagnostic value of percutaneous ultrasound-guided subacromial bursography (PUSB) in the diagnosis of rotator cuff tears.Methods Between July 2019 to October 2021, 78 patients who had suspected rotator cuff injury and who were admitted to the Second Affiliated Hospital of Xi'an Jiaotong University were selected, including 32 males and 46 females, aged 31-70 years (mean age 53.9±9.1 years), with a course of 1D-2 years. The MRI, US and PUSB images of patients were retrospectively analyzed to obtain the diagnostic and predictive indexes (sensitivity, specificity, positive predictive value，negative predictive value and accuracy) of these three methods for different rotator cuff tears types (full-thickness tears, partial-thickness tears and no tears of rotator cuff ). With the results of shoulder arthroscopy serving as the standard, PUSB results were compared with MRI and US results using the X2 -test (a=0.05, two-sided).Results In all 78 patients, the overall accuracy of MRI, US, and PUSB in diagnosing rotator cuff tears was 82.1% (64/78), 75.6% (59/78) and 96.2% (75/78), respectively (P < 0.001). Among 21 patients with full-thickness tears, the numbers of cases correctly diagnosed by MRI, US and PUSB were 19, 19 and 21, respectively. The sensitivity and specificity of MRI, US and PUSB in diagnosing full-thickness tears were 90.5%, 90.5%, 100% and 98.2%, 93.0%, 100%, respectively. The diagnostic accuracies of full-thickness rotator cuff tears were 90.5%, 90.5% and 100%, respectively, with no statistical difference (P = 0.344). Among 42 patients with partial-thickness tears, the numbers of patients whose cases were correctly diagnosed on MRI, US and PUSB were 32, 27 and 40, respectively. The sensitivity and specificity of MRI, US and PUSB in diagnosing partial-thickness tears were 76.2%, 64.3%, and 95.2% and 88.9%, 88.9%, and 97.2%, respectively. The diagnostic accuracies of partial-thickness rotator cuff tears were 76.2% (32/42), 64.3% (27/42) and 95.2% (40/42), respectively (P＜0.05). Among the 15 patients without tears, the numbers of misdiagnosed cases by MRI, US and PUSB were 2, 2, and 1, respectively, and they were all misdiagnosed as partial-thickness tears. The sensitivity and specificity of MRI, US and PUSB in the diagnosis of complete rotator cuff were 86.7%, 86.7%, and 93.3% and 85.7%, 82.5% and 96.8%, respectively, and the accuracies in diagnosing no tears were 86.7% (13/15), 86.7% (13/15) and 87.5% (14/15), respectively (P = 0.997).Conclusions It is feasible to diagnose rotator cuff tears by PUSB, which can be used as an important supplement imaging method to evaluate rotator cuff tears.