Abstract
Objective
Sonolastography (SE) technique is one of the new functional ultrasonic imaging techniques, which was developed in the past few years and can obtain the distributions of elasticity in tissues. Using magnetic resonance imaging (MRI) as the standard of reference, the purpose of this study was to evaluate the ability of SE to assess the fatty degeneration of suprasupinatus (SSP) and to compare it to the MRI and the conventional ultrasonography (US) findings.
Materials and methods
The institutional review board approved the study, and a retrospective analysis between January 2013 and September 2013 was performed on 101 shoulders of 98 consecutive patients using MRI, US, and SE for the evaluation of shoulder lesion. Oblique sagittal images of SSP were obtained using SE. The SE images were evaluated by reviewers using an experimentally proven color grading system.
Results
When comparing SE to standard MRI findings, the mean sensitivity of SE was 95.6 %, the specificity 87.5 %, and the accuracy 91.1 %. The interobserver reliability of the SE findings was “almost perfect agreement” with a weighted kappa coefficient of 0.81. On comparing MRI with the SE findings, the grades of MRI and SE have a positive correlation (r = 0.855, P = <0.001). Furthermore, the grades of US and SE also have a positive correlation (r = 0.793, P = <0.001).
Conclusion
SE is valuable in the quantitative assessment of the severity of the fatty atrophy of the supraspinatus and has an excellent accuracy, an excellent correlation with MRI and the conventional US, and an excellent interobserver reliability.
Riassunto
Sfondo
La tecnica Sonoelastografia (SE) è una delle nuove tecniche di imaging funzionale ad ultrasuoni; sviluppato negli ultimi anni, e’ in grado di ottenere informazioni quantitative sulle distribuzioni di elasticità nei tessuti. Utilizzando la risonanza magnetica (MRI) come standard di riferimento, lo scopo di questo studio era di valutare la capacità di SE nel verificare la degenerazione grassa del sovraspinato (SSP) e di confrontarla con i risultati della risonanza magnetica MRI e dell'ecografia convenzionale (US)
Metodi
Il consiglio di revisione istituzionale ha approvato lo studio, ed è stata eseguita un'analisi retrospettiva fra il gennaio del 2013 e il settembre del 2013 in 101 spalle di 98 pazienti consecutivi ai quali sono stati eseguiti MRI, US, e SE per la valutazione delle lesioni della spalla. Le immagini sagittali oblique di SSP sono stati ottenuti utilizzando lo SE. Le immagini SE sono stati valutati da revisori che utilizzano un sistema di analisi del colore provata sperimentalmente.
Risultati
Quando si confrontano i risultati del SE e del MRI standard, la sensibilità media di SE era del 95.6 %, la specificità del 87.5 %, e l’accuratezza del 91.1 %. L'affidabilità interosservatore del SE è stato "un accordo quasi perfetto", con un coefficiente kappa pesata di 0.81. Confrontando i risultati del SE con il MRI, i gradi del MRI e del SE hanno una correlazione positiva (r = 0.855, P = < 0.001). Inoltre, le classi del US e del SE hanno anche una correlazione positiva (r = 0.793, P = <0.001).
Conclusione
SE è importante nella valutazione quantitativa della gravità della atrofia grassa del sovraspinoso e ha un'ottima precisione, una correlazione eccellente con MRI e US convenzionale, ed un'eccellente affidabilità inter-osservazione.
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Conflict of interest
Joongbae Seo, Jaesung Yoo, and Jeewon Ryu declare that they have no conflict of interest.
Informed consent
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (Dankook University Hospital Institutional Review Board). All patients provided written informed consent for enrollment in the study and for inclusion in this article of information that could potentially lead to their identification.
Human studies
The study was conducted in accordance with all institutional and national guidelines for the care.
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Seo, JB., Yoo, JS. & Ryu, JW. The accuracy of sonoelastography in fatty degeneration of the supraspinatus: a comparison of magnetic resonance imaging and conventional ultrasonography. J Ultrasound 17, 279–285 (2014). https://doi.org/10.1007/s40477-014-0064-y
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DOI: https://doi.org/10.1007/s40477-014-0064-y