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首页> 外文期刊>Journal of shoulder and elbow surgery >Contrast-enhanced ultrasound characterization of the vascularity of the rotator cuff tendon: age- and activity-related changes in the intact asymptomatic rotator cuff.
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Contrast-enhanced ultrasound characterization of the vascularity of the rotator cuff tendon: age- and activity-related changes in the intact asymptomatic rotator cuff.

机译：肩袖肌腱血管造影的超声增强特征：无症状肩袖完整与年龄和活动相关的变化。

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摘要

The natural history of the blood supply to the rotator cuff and its role in the etiology of rotator cuff disease has not been definitively established. To date, there has not been an in-vivo dynamic assessment of the baseline vascularity of the asymptomatic rotator cuff. This study was designed to test the hypothesis that regional variations in supraspinatus tendon vascularity exist with an age-dependent decrease in asymptomatic individuals with intact rotator cuffs. Lipid microsphere, contrast-enhanced ultrasound shoulder examinations were done in 31 patients with a mean age of 41.5 years (range, 22-65 years). Images were obtained at baseline, after contrast administration at rest, and after contrast administration following exercise to visualize the intratendinous blood flow to the supraspinatus tendon. Qualitative and quantitative analysis was performed by determining 4 regions of interest (bursal medial, articular medial, bursal lateral, and articular lateral) with quantification and analysis software (QLAB Philips, Andover, MA) to examine each region of interest and normalize data for interpretation of the mean intensity per pixel. A statistically significant decrease in blood flow to the supraspinatus tendon with age was observed in a comparative analysis of patients aged younger than 40 and older than 40, (P < .05 for all 4 zones after exercise and for the bursal medial, articular medial, and bursal lateral zones after exercise; P = .07 for the articular lateral zone after exercise). A statistically significant increase in blood flow with exercise was observed in an analysis of all patients (P < .001). The age-related decrease in the vascular supply of the tendon observed in this study is consistent with published reports demonstrating an increasing prevalence of rotator cuff pathology with age and may predispose to the development of rotator cuff tendinopathy and, ultimately, attritional tears.
机译：尚未明确确定肩袖供血的自然史及其在肩袖疾病病因中的作用。迄今为止，尚未对无症状肩袖的基线血管进行体内动态评估。这项研究旨在检验以下假设：在无完整肩袖的无症状个体中，存在棘上肌腱血管的区域性变化，并随年龄而减少。对31名平均年龄为41.5岁（范围为22-65岁）的患者进行了脂质微球造影对比超声检查。在基线时，静止给予对比剂之后以及运动后对比剂给予后获得图像，以使流向棘上肌腱的肌内血流可视化。定性和定量分析是通过使用量化和分析软件（QLAB Philips，Andover，MA）确定4个感兴趣区域（法氏囊内侧，关节内侧，法氏囊外侧和关节外侧）进行的，以检查每个感兴趣的区域并标准化数据以进行解释每个像素的平均强度。在对年龄小于40岁且年龄大于40岁的患者进行的比较分析中，观察到随着年龄的增长，流到脊椎上肌腱的血流量有统计学上的显着下降（运动后所有4个区域以及法氏囊内侧，关节内侧，以及运动后的法氏囊外侧区;运动后的关节外侧区P = .07）。在对所有患者的分析中，观察到运动引起的血流量统计学上显着增加（P <.001）。在这项研究中观察到的与年龄有关的肌腱血管供应减少与已发表的报道相符，该报道表明随着年龄的增长，肩袖病理学的患病率增加，并且可能导致肩袖肌腱病的发展，并最终导致磨损。

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