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MEDICINA DELLO SPORT
A Journal on Sports Medicine
Official Journal of the Italian Sports Medicine Federation
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,163
Medicina dello Sport 2012 December;65(4):513-25
language: English, Italian
Evaluation of focal lesions of the supraspinatus tendon with elastosonography: comparison with B-mode ultrasound and magnetic resonance imaging: our experience
Francavilla G. 1, Sutera R. 2, Iovane A. 2, Candela F. 2, La Tona G. 2, Peritore G. 4, Sanfilippo A. 3, Francavilla V. C. 3, D’arienzo M. 3, Midiri M. 2 ✉
1 Department of Clinical Medicine, Cardiovascular and Nephro-Urological Diseases, , University of Palermo, Palermo, Italy;
2 DIBIMEF - Section of Radiological Sciences, University of Palermo, Palermo, Italy;
3 Clinic of Orthopedic and Trauma, , University of Palermo, Palermo, Italy;
4 Department of Radiology, , San Raffaele-Giglio Hospital, Cefalù, Palermo, Italy
Aim. The aim of the study was to assess the elasticity of the tendon of the supraspinatus in the symptomatic shoulder of patients with clinical suspicion of unilateral focal lesion of the supraspinatus tendon, and to compare the findings with those observed in conventional B-mode ultrasonography (US) and magnetic resonance imaging (MRI).
Methods. Between January and December 2009 both shoulders of 58 patients (mean age 46 years, range 32-58 years) were evaluated by a radiologist. Both shoulders were analyzed with real-time elastosonography and also with US using the same ultrasound machine (EUB - Hitachi 7500) with a high frequency (13 MHz) linear probe. The elasticity of the supraspinatus tendon fibers was evaluated by a semiquantitative score of different colors representing hard tissue (blue) and progressively more elastic tissue (green, yellow, red). Elastosonographic and US findings were evaluated separately by a second radiologist, and those of the affected shoulder compared with those seen after an MRI performed in a period between 2 and 4 weeks after the ultrasound examination. The MRI was evaluated by a third radiologist blinded to the result of elastosonographic and US findings.
Results. Using MRI as the gold standard, the elastosonography correctly diagnosed in seven patients a partial-thickness tear detected by US as simple tendinosis, probably due to the presence of intralesional granulation tissue with echostructure similar to that of the surrounding tendon. Moreover, three cases of intrasubstance partial-thickness tear reported by US proved to be, both with elastosonography and MRI, a full-thickness tear. In all cases (58/58) MRI findings confirmed those of elastosonography, although in some cases the extent of injury appeared greater in MRI, presumably due to the additional high signal given by perilesional edema
Conclusion. Elastosonography is a sensitive method for diagnosis of focal lesions of the supraspinatus tendon, in particular degenerative partial and full thickness tears.