Abstract

BackgroundFatty Degeneration (FD) of the rotator cuff muscles influences functional and anatomical outcome after rotator cuff repair. The MRI based estimation of fatty degeneration is the gold standard. There is some evidence that Ultrasound elastography (EUS) can detect local differences of tissue stiffness in muscles and tendons. Shear-wave elastography (SWE) was evaluated to determine the extent to which shear wave velocity was associated with measures of fatty degeneration. MRI-spectroscopic fat measurement was used as a reference to quantify the amount of fat in the muscle belly.MethodsForty-two patients underwent SWE of the supraspinatus muscles at its thickest diameter. After ultrasound evaluation an MRI-spectroscopic fat measurement of the supraspinatus muscle was performed using the SPLASH-technique. A gel filled capsule was used to locate the measured area in the MRI. The values of shear wave velocity (SWV) measured with SWE and spectroscopic fat measurement were correlated statistically using Pearson’s correlation test.ResultsCorrelation of the fat amount measured with MRI-spectroscopy and the SWV measured with SWE was ρ =0.82. Spectroscopic measured fat ratio of the supraspinatus muscle ranged from 0% to 77.41% and SWV from 1.59 m/s to 5.32 m/s. In 4 patients no sufficient SWE could be performed, these individuals showed a larger diameter of the overlying soft tissue. SWV measured with SWE showed a good correlation with MRI spectroscopic fat amount of the supraspinatus muscle.ConclusionThese preliminary data suggest that SWE may be a sufficient tool in detecting and estimating the amount of fatty degeneration in the supraspinatus muscle in real time. Large overlying soft tissue may be a limitation in performing sufficient EUS.Ethical Committee Approval: Nr: 156/14 Date 12th August 2014.Level of Evidence: III.

Highlights

  • Fatty Degeneration (FD) of the rotator cuff muscles influences functional and anatomical outcome after rotator cuff repair

  • These preliminary data suggest that Shear-wave elastography (SWE) may be a sufficient tool in detecting and estimating the amount of fatty degeneration in the supraspinatus muscle in real time

  • Large overlying soft tissue may be a limitation in performing sufficient Ultrasound elastography (EUS)

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Summary

Introduction

Fatty Degeneration (FD) of the rotator cuff muscles influences functional and anatomical outcome after rotator cuff repair. The MRI based estimation of fatty degeneration is the gold standard. There is some evidence that Ultrasound elastography (EUS) can detect local differences of tissue stiffness in muscles and tendons. Fatty degeneration (FD) of the rotator cuff occurs after tendon rupture or nerve damage and affects the functional and anatomical outcome after rotator cuff repair [10, 31]. Preoperative detection and classification of FD is an essential part of planning operative rotator cuff repair. Conventional ultrasound has lately become a standard diagnostic tool for detecting rotator cuff tears due to its high sensitivity [11, 14, 21]. Conventional ultrasound techniques only allow a semi-quantitative grading of FD and is still considered an experimental modality [30]

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