Purpose: It is not always easy to diagnose early tendinosis in the rotator cuff using ultrasonography. Therefore, the aim of our study was to show the usefulness of sonoelastography in diagnosing early tendinosis of the supraspinatus tendon.
Materials and Methods: A total of 25 consecutive patients (age range, 26-68 years) with shoulder pain were examined with sonoelastography of the supraspinatus tendon and 3T shoulder MRI with a T2* mapping sequence. The elasticity was estimated by the strain ratio of the supraspinatus tendon to the deltoid muscle (strain ratio S/D). T2* mapping images were analyzed via an independent external workstation. Correlation analysis was performed for strain ratio S/D, and the mean (T2*bulk) and standard deviation (T2*h) of T2* values. Linear and non-linear regression analyses were performed to find the best functions to fit each parameter.
Results: The mean strain ratio S/D was 0.65 ± 0.33 on sonoelastography. T2*bulk and T2*h in the supraspinatus tendons were 21.8 ± 5.4 and 6.3 ± 3.4, respectively. The strain ratio S/D and T2*bulk in the supraspinatus tendon had a significant negative correlation (ρ = - 0.518, p=0.008). The strain ratio S/D and T2*h in the supraspinatus tendon also had a significant negative correlation (ρ = - 0.537, p=0.006). The non-linear power function is best fit for the correlation between strain ratio and T2* values.
Conclusion: Strain ratio S/D showed significant negative correlations with T2*bulk and T2*h in the supraspinatus tendon. In other words, the elasticity found in sonoelastography is well-correlated with the signal intensity of the T2* map and topographical heterogeneity of T2* values at the supraspinatus tendon on MR imaging. Therefore, sonoelastography may have a promising role in the diagnosis of early tendinosis in the shoulder joint. Further studies are needed in order to confirm these findings.
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