Observational Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2020; 8(14): 2977-2987
Published online Jul 26, 2020. doi: 10.12998/wjcc.v8.i14.2977
Role of shear wave elastography in the evaluation of the treatment and prognosis of supraspinatus tendinitis
Jie Zhou, De-Bin Yang, Jing Wang, Hui-Zhang Li, Ying-Chun Wang
Jie Zhou, De-Bin Yang, Jing Wang, Ying-Chun Wang, Department of Ultrasonic Imaging, Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences, Shanghai 201800, China
Hui-Zhang Li, Department of Orthopaedics, Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences, Shanghai 201800, China
Author contributions: Zhou J and Yang DB contributed equally to this study; Wang YC was the guarantor and designed the study; Zhou J, Yang DB and Wang YC designed the research; Zhou J, Yang DB, Wang J and Li HZ performed the research; Wang J and Li HZ contributed new analytic tools; Zhou J, Yang DB, Wang J and Li HZ analyzed data; Zhou J, Yang DB and Wang YC wrote the paper and revised the article critically for important intellectual content.
Supported by Medical Guidance Project of Shanghai Science and Technology Commission, No. 134119b2300; and Key Medical Discipline of Jiading District, Shanghai, No. 2017ZD04.
Institutional review board statement: The study was approved by the ethics committee of Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences.
Informed consent statement: All patients gave informed consent.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement, and the manuscript was prepared and revised according to the STROBE Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ying-Chun Wang, MD, Chief Doctor, Department of Ultrasonic Imaging, Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences, No. 1, Chengbei Road, Shanghai 201800, China. wangyingchun4478@163.com
Received: April 1, 2020
Peer-review started: April 1, 2020
First decision: April 22, 2020
Revised: April 24, 2020
Accepted: July 4, 2020
Article in press: July 4, 2020
Published online: July 26, 2020
Abstract
BACKGROUND

Supraspinatus tendinitis recurs easily after treatment. One of the main reasons is the lack of objective tools for the efficacy evaluation. Shear wave elastography (SWE) can quantitatively analyze the tissue elasticity of region of interest by measuring the Young’s modulus (YM) value.

AIM

To explore the role of SWE in the efficacy and prognostic evaluation of supraspinatus tendinitis.

METHODS

Eighty-seven patients with supraspinatus tendinitis treated in Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences were recruited. Another 30 healthy volunteers were enrolled as the control group. The visual analogue scale (VAS) and Constant-Murley Score (CMS) were recorded before treatment. All participants were scanned by SWE scan, and the YM value of the region of interest were recorded. Spearman correlation analysis was performed on YM values with VAS and CMS. Univariate repeated measures analysis of variance was used to calculate the changing trend of VAS, CMS and SWE under different treatment courses. After treatment, the patients were further grouped based on who achieved significantly effective and curative treatment. The patients in the continued treatment group continued to receive treatment according to the YM value, and the remaining patients who stopped receiving treatment were included in the stopped treatment group. All patients were followed up for 1 year, and the difference in recurrence rates between the continued treatment group and the stopped treatment group were compared.

RESULTS

The SWE images of supraspinatus muscle in healthy volunteers were mainly blue, while those of patients with supraspinatus tendinitis showed regional red and green areas. The average YM value of the supraspinatus muscle in healthy volunteers was 26.12 ± 4.03 kPa. The average YM value of patients with supraspinatus muscle was greater than that of healthy volunteers (average YM = 60.61 ± 11.53 kPa, t = 26.344, P < 0.001). The YM value was positively correlated with VAS (r = 0.564, P < 0.001) and negatively correlated with CMS (r = -0.411, P < 0.001). The changes of VAS and CMS were the most obvious in course 1 and then decreased gradually. The degree of change in YM values was similar in different courses. After a 1-year follow-up, the cumulative relapse-free rate in the continued treatment group was 91.43%, which was significantly higher than that in the stopped treatment group (64.71%, X2 = 7.379, P = 0.007).

CONCLUSION

SWE can objectively indicate the severity of supraspinatus tendinitis. Using the YM value as a criterion for curative effect may reduce the recurrence rate.

Keywords: Supraspinatus tendinitis, Shear wave elastography, Young’s modulus value, Visual analog score, Constant-Murley score, Recurrence

Core tip: Supraspinatus tendinitis is a common disease. Due to the lack of objective assessment methods, it is easy to relapse after treatment. Shear wave elastography can quantitatively analyze the tissue elasticity by measuring the Young’s modulus value. This study explored the role of shear wave elastography in the efficacy and prognostic evaluation of supraspinatus tendinitis. It revealed that shear wave elastography can objectively indicate the severity of the supraspinatus tendinitis. Using the Young’s modulus value as the criterion for determining the efficacy of the treatment is more thorough, and it is expected to reduce the recurrence rate.