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Wang W, Peng L, He L, Chen Y, Jiang M, Luo X, Gao G. Applicability of combined high-frequency and contrast-enhanced ultrasound in finger extensor tendon injuries: three case reports. Ultrasound J 2024; 16:36. [PMID: 39017903 PMCID: PMC11254872 DOI: 10.1186/s13089-024-00376-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 05/04/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND By combining high-frequency and contrast-enhanced ultrasound (CEUS), the position of the severed end of a finger extensor tendon injury and the injury classification can be determined as part of a comprehensive preoperative evaluation in clinical practice. However, there have been no reports of high-frequency ultrasound combined with CEUS for the preoperative diagnosis of human finger extensor tendon injury. CASES PRESENTATION One case of complete rupture of the extensor tendon was diagnosed by ultrasound, which was completely consistent with the surgery; one case of incomplete rupture was ultimately confirmed clinically; and one case of distal phalangeal bone base avulsion fracture with tendon contusion and missed diagnosis on the first radiographic examination was confirmed by follow-up radiographic examination. CONCLUSIONS Different types of finger extensor tendon injuries exhibit distinctive contrast-enhanced ultrasonography findings. Combined high-frequency and contrast-enhanced ultrasound can accurately locate the position of the severed end of the finger extensor tendon injury before surgery while observing the contrast agent filling area to clarify injury classification, providing a reliable imaging basis for clinical practice and ultimately developing personalized diagnosis and treatment plans for patients to ensure minimal trauma and pain, as well as optimal treatment effects.
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Affiliation(s)
- Wenying Wang
- Department of Ultrasound, West China Longquan Hospital Sichuan University (The First People's Hospital Of Longquanyi District), Chengdu, 610100, China
| | - Li Peng
- Department of Ultrasound, West China Longquan Hospital Sichuan University (The First People's Hospital Of Longquanyi District), Chengdu, 610100, China.
| | - Lian He
- Department of Ultrasound, West China Longquan Hospital Sichuan University (The First People's Hospital Of Longquanyi District), Chengdu, 610100, China
| | - Yan Chen
- Department of Ultrasound, West China Longquan Hospital Sichuan University (The First People's Hospital Of Longquanyi District), Chengdu, 610100, China
| | - Mingshan Jiang
- Department of Ultrasound, West China Longquan Hospital Sichuan University (The First People's Hospital Of Longquanyi District), Chengdu, 610100, China
| | - Xue Luo
- Department of Ultrasound, West China Longquan Hospital Sichuan University (The First People's Hospital Of Longquanyi District), Chengdu, 610100, China
| | - Guoqiang Gao
- Department of Ultrasound, West China Longquan Hospital Sichuan University (The First People's Hospital Of Longquanyi District), Chengdu, 610100, China
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Wang Y, Zhu Y, Zhang F, Chen X, Chen J, Jiang W, Chen S, Yang J, Zhang Q. The value of combined ultrasound contrast arthrography and subacromial-subdeltoid bursography for detecting and differentiating the rotator cuff tear subtypes in patients with the uncertain rotator cuff tear. Eur Radiol 2024; 34:3503-3512. [PMID: 37855852 DOI: 10.1007/s00330-023-10183-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 07/14/2023] [Accepted: 07/30/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVES In this study, ultrasound (US) contrast arthrography and subacromial-subdeltoid bursography with the contrast agent of SonoVue were performed to evaluate their value for detecting and differentiating the rotator cuff tear (RCT) subtypes in patients with the uncertain RCT. METHODS A total of 102 patients with the clinically suspected RCTs in the orthopedic clinic were prospectively recruited and underwent conventional high-frequency US for the category of undoubted full-thickness RCT, uncertain RCT, and intact rotator cuff. Among these patients, the patients with uncertain RCT underwent the subsequent US contrast arthrography and subacromial-subdeltoid bursography. The arthroscopic findings were used as the gold standard in this study. RESULTS After the conventional US screening, 62 patients with uncertain RCT underwent the subsequent US contrast arthrography and subacromial-subdeltoid bursography. All the US contrast arthrography and subacromial-subdeltoid bursography were successfully performed and no severe side effects were observed in all the patients. For full-thickness tears, the sensitivity and specificity of the combined US contrast arthrography and subacromial-subdeltoid bursography were 94.7% (CI: 0.72-1.0) and 81.4% (CI: 0.66-0.91), respectively, and for articular-side tears 100% (CI: 0.51-1) and 100% (CI: 0.92-1), respectively, and for the bursal-side tears 84.6% (CI: 0.54-0.97) and 97.9% (CI: 0.88-1.0), respectively. The main inconsistency between the contrast-enhanced US and arthroscopy was that 7 patients with arthroscopic proved concurrent articular- and bursal-side tears were indicated as full-thickness RCTs on contrast-enhanced US. CONCLUSIONS Combined US contrast arthrography and subacromial-subdeltoid bursography are useful for detecting the RCT subtypes in patients with the uncertain RCTs. CLINICAL RELEVANCE STATEMENT When conventional high-frequency US has some difficulty in differentiating the full-thickness from partial-thickness RCTs, combined US contrast arthrography and subacromial-subdeltoid bursography could be used to improve the detection accuracy of RCT subtypes. KEY POINTS • This is the first study by injection of the US contrast agent SonoVue into the shoulder joint cavity and subacromial-subdeltoid bursa for the detection and differentiation of the RCT subtypes among the people with the uncertain RCT by conventional US screening. • The SonoVue was injected into the glenohumeral joint cavity under US guidance to differentiate the full-thickness RCTs from partial-thickness RCTs. • Combined US contrast arthrography and subacromial-subdeltoid bursography are useful for detecting the RCT subtypes in patients with the uncertain RCTs.
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Affiliation(s)
- Yuexiang Wang
- Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Yaqiong Zhu
- Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Fei Zhang
- Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, 100048, China
| | - Xianghui Chen
- Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Jian Chen
- Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Wenli Jiang
- Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Siming Chen
- Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Jing Yang
- Department of Pain Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China.
| | - Qiang Zhang
- Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, 100048, China.
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Liu B, Ge D, Shan Y, Li Y, Lv J, Gan S. The Value of Percutaneous Ultrasound-Guided Subacromial Bursography for Rotator Cuff Tear in Elderly Patients with Shoulder Pain. J Pain Res 2023; 16:1895-1906. [PMID: 37287825 PMCID: PMC10243717 DOI: 10.2147/jpr.s392833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 04/03/2023] [Indexed: 06/09/2023] Open
Abstract
Objective Based on the analysis of the images of acromial slide, we explored the application of percutaneous ultrasound-guided subacromial bursography (PUSB) on rotator cuff tear (RCT) in diagnosing elderly patients with shoulder pain. Methods Eighty-five patients who were clinically diagnosed with RCT and underwent PUSB examination in the department of ultrasound in our hospital were enrolled as the subjects. Independent samples t-test was used to analyze the general characteristics. Based on the gold standard of shoulder arthroscopy, the diagnostic efficacy of ultrasound, magnetic resonance imaging (MRI), and PUSB was evaluated. The sensitivity, specificity, positive and negative predictive values, and accuracy were calculated as well. The consistency of these techniques with shoulder arthroscopy in diagnosing the RCT stage was additionally compared using Kappa test. Results In patients with large full-thickness RCT, the 100% detection rate was achieved by the techniques of ultrasound, MRI, and PUSB. For patients with small full-thickness RCT, the detection rate of PUSB (100%) was evidently higher than those of ultrasound and MRI. Similar results were shown in the detection rates of patients with bursal-side partial-thickness RCT (90.5%) and articular-side partial-thickness RCT (86.9%). More importantly, the sensitivity, specificity, and accuracy of PUSB in patients with both full-thickness RCT and partial-thickness RCT were significantly better than those of ultrasound and MRI. Conclusion PUSB has a better efficacy in the detection of RCT than ultrasound and MRI, showing its feasibility as an important imaging method to evaluate the degree of RCT.
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Affiliation(s)
- Bili Liu
- Department of Ultrasound, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, 310007, People’s Republic of China
| | - Dan Ge
- Department of Ultrasound, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, 310007, People’s Republic of China
| | - Yue Shan
- Department of Ultrasound, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, 310007, People’s Republic of China
| | - Yanping Li
- Department of Ultrasound, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, 310007, People’s Republic of China
| | - Juan Lv
- Department of Ultrasound, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, 310007, People’s Republic of China
| | - Shuzhi Gan
- Department of Ultrasound, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, 310007, People’s Republic of China
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Chen SY, Wang YW, Chen WS, Hsiao MY. Update of Contrast-enhanced Ultrasound in Musculoskeletal Medicine: Clinical Perspectives - A Review. J Med Ultrasound 2023; 31:92-100. [PMID: 37576422 PMCID: PMC10413398 DOI: 10.4103/jmu.jmu_94_22] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/03/2022] [Accepted: 10/07/2022] [Indexed: 08/15/2023] Open
Abstract
Contrast-enhanced ultrasound (CEUS) uses an intravascular contrast agent to enhance blood flow signals and assess microcirculation in different parts of the human body. Over the past decade, CEUS has become more widely applied in musculoskeletal (MSK) medicine, and the current review aims to systematically summarize current research on the application of CEUS in the MSK field, focusing on 67 articles published between January 2001 and June 2021 in online databases including PubMed, Scopus, and Embase. CEUS has been widely used for the clinical assessment of muscle microcirculation, tendinopathy, fracture nonunions, sports-related injuries, arthritis, peripheral nerves, and tumors, and can serve as an objective and quantitative evaluation tool for prognosis and outcome prediction. Optimal CEUS parameters and diagnostic cut off values for each disease category remain to be confirmed.
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Affiliation(s)
- Shao-Yu Chen
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Yao-Wei Wang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Wen-Shiang Chen
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ming-Yen Hsiao
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei, Taiwan
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Sun Q, Huang R, Fu S, Wu C, Guo X, Li T, Hou Y, Wang F, Xi R, Li S. Relationship between left ventricular mechanical synchrony and left ventricular systolic function: a CZT-SPECT analysis. BMC Cardiovasc Disord 2022; 22:420. [PMID: 36138379 PMCID: PMC9494855 DOI: 10.1186/s12872-022-02863-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 09/13/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND CZT-SPECT has good agreement in the evaluation of mechanical synchronization compared with conventional SPECT. The aim of this study was to evaluate the correlation between left ventricular mechanical contraction synchrony and left ventricular systolic function by gated myocardial perfusion imaging (GMPI) using cadmium-zine-telluride (CZT) single photon emission computed tomography (SPECT). METHODS This retrospective study involved 371 patients (239 males and 132 females, mean age 61.06 ± 11.78 years old) who underwent GMPI at the Nuclear Medicine Department of Shanxi Cardiovascular Hospital from January 2020 to August 2020. Systolic synchrony parameters and left ventricular systolic function parameters were calculated via Emory Cardiac Toolbox, including PP, PSD, PHB, HS, HK, EDV, ESV, and LVEF. Based on LVEF value, patients were divided into the severe reduction group (group 1, 127 cases, EF < 35%), moderate reduction group (group 2, 47 cases, 35% ≤ EF < 45%), mild reduction group (group 3, 50 cases, 45% ≤ EF < 50%) and normal group (group 4, 147 cases, EF ≥ 50%). Differences in PP, PSD, PHB, HS and HK among the four groups were compared using one-way ANOVA. Differences between two groups were compared using LSD-t test. The correlation among functional and mechanical contraction synchrony factors were analyzed using Pearson test. RESULTS PP, PSD, PHB, HS and HK were significantly different among the four groups (F = 5.20, 188.72, 202.88, 171.05, 101.36, P < 0.001). Pairwise comparison tests showed significant differences in PSD and PHB in each two groups, and HS and HK in each two groups except for group 2 and 3 (t = 0.28 and 0.39, both P > 0.001). PP was significantly higher in group 1, relative to group 3 (t = 2.43, P < 0.001) and group 4 (t = 3.67, P < 0.001). Pearson correlation analysis revealed that LVEF negatively correlates with PP, PSD, PHB (r = 0.194, - 0.790, - 0.799, all P < 0.001). HS and HK showed positive correlation for LVEF (r = 0.778 and 0.795, P < 0.001), PSD, PHB and ESV were had good positive correlation (r = 0.778, 0.795, P < 0.001), PSD, PHB and EDV had good positive correlation (r = 0.722, 0.732, P < 0.001). However, PP had poor correlation with EDV (r = 0.095, P > 0.001). HS and HK were negatively correlated with EDV and ESV (r = - 0.700 to - 0.594, P < 0.001). CONCLUSION CZT SPECT GMPI provided left ventricular mechanical contraction synchrony parameters that correlated well with left ventricular systolic function. Worse left ventricular mechanical contraction synchrony lead to decreased LVEF, making the systolic synchrony parameters valuable in the prediction of left ventricular systolic function.
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Affiliation(s)
- Qiting Sun
- grid.452461.00000 0004 1762 8478Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Collaborative Innovation Center for Molecular Imaging of Precision Medicine, 85 Jiefang Nan Road, Taiyuan, 030001 Shanxi Province China
| | - Ruiliang Huang
- grid.477944.d0000 0005 0231 8693Department of Radiology, Shanxi Cardiovascular Hospital, Taiyuan, China
| | - Songhai Fu
- grid.477944.d0000 0005 0231 8693Department of Nuclear Medicine, Shanxi Cardiovascular Hospital, Taiyuan, China
| | - Chen Wu
- grid.477944.d0000 0005 0231 8693Department of Nuclear Medicine, Shanxi Cardiovascular Hospital, Taiyuan, China
| | - Xuliang Guo
- grid.477944.d0000 0005 0231 8693Department of Nuclear Medicine, Shanxi Cardiovascular Hospital, Taiyuan, China
| | - Tianliang Li
- grid.477944.d0000 0005 0231 8693Department of Ultrasound, Shanxi Cardiovascular Hospital, Taiyuan, China
| | - Yuehong Hou
- grid.477944.d0000 0005 0231 8693Department of Radiology, Shanxi Cardiovascular Hospital, Taiyuan, China
| | - Fei Wang
- grid.477944.d0000 0005 0231 8693Department of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan, China
| | - Rui Xi
- grid.452461.00000 0004 1762 8478Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Collaborative Innovation Center for Molecular Imaging of Precision Medicine, 85 Jiefang Nan Road, Taiyuan, 030001 Shanxi Province China
| | - Sijin Li
- grid.452461.00000 0004 1762 8478Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Collaborative Innovation Center for Molecular Imaging of Precision Medicine, 85 Jiefang Nan Road, Taiyuan, 030001 Shanxi Province China
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Babaei-Ghazani A, Boudier-Revéret M, Michaud J. Zebras in the Shoulder: a Review Article on Advanced Diagnostic Ultrasound of the Shoulder. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2021. [DOI: 10.1007/s40141-021-00331-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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