The prevalence of neovascularity in rotator cuff tendinopathy: comparing conventional Doppler with superb microvascular imaging
To determine the prevalence of neovascularity in the supraspinatus tendon of patients presenting with clinically painful unilateral rotator cuff tendinopathy (RCT) using conventional colour Doppler ultrasound (CDU), power Doppler ultrasound (PDU), and superb microvascular imaging (SMI). The associat...
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| Veröffentlicht in: | Clinical radiology 2022-06, Vol.77 (6), p.e442-e448 |
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| creator | Ooi, C.C. Wong, S.K. Ma, V.C. Tan, G.M. Teng, K.Q. Mohamed, S.N. Png, M.A. |
| description | To determine the prevalence of neovascularity in the supraspinatus tendon of patients presenting with clinically painful unilateral rotator cuff tendinopathy (RCT) using conventional colour Doppler ultrasound (CDU), power Doppler ultrasound (PDU), and superb microvascular imaging (SMI). The association between Doppler findings and clinical scores was also assessed.
The bilateral supraspinatus of consecutive patients presented with unilateral RCT clinically were evaluated with grey-scale ultrasound (tendon thickening, heterogeneous echotexture, and hypoechogenicity), CDU, PDU, and SMI. The prevalence of neovascularity and grey-scale changes on duplex imaging techniques were analysed. The relationship between neovascularity on CDU, PDU, SMI, and pain/disability as determined using a visual analogue scale (VAS) and the Oxford Shoulder Score (OSS) were assessed.
Fifty-nine patients (mean age 53 years, 39 women) were recruited. Of the symptomatic supraspinatus tendons, 42.4% (25/59) demonstrated neovascularity on SMI, compared to 6.8% (4/59) on PDU and 5.1% (3/59) on CDU. Of the asymptomatic supraspinatus tendons, 5.1% (3/59) depicted neovascularity on SMI but not on conventional Doppler techniques. SMI showed a significant correlation with the VAS (r2 = 0.560, p |
| doi_str_mv | 10.1016/j.crad.2022.03.003 |
| format | Article |
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The bilateral supraspinatus of consecutive patients presented with unilateral RCT clinically were evaluated with grey-scale ultrasound (tendon thickening, heterogeneous echotexture, and hypoechogenicity), CDU, PDU, and SMI. The prevalence of neovascularity and grey-scale changes on duplex imaging techniques were analysed. The relationship between neovascularity on CDU, PDU, SMI, and pain/disability as determined using a visual analogue scale (VAS) and the Oxford Shoulder Score (OSS) were assessed.
Fifty-nine patients (mean age 53 years, 39 women) were recruited. Of the symptomatic supraspinatus tendons, 42.4% (25/59) demonstrated neovascularity on SMI, compared to 6.8% (4/59) on PDU and 5.1% (3/59) on CDU. Of the asymptomatic supraspinatus tendons, 5.1% (3/59) depicted neovascularity on SMI but not on conventional Doppler techniques. SMI showed a significant correlation with the VAS (r2 = 0.560, p<0.001) and OSS (r2 = 0.62, p<0.001). PDU weakly correlated with the VAS and OSS (r2 = 0.312, p=0.016; r2 = 0.260, p=0.047, respectively) while CDU did not show a significant relationship.
SMI is superior in demonstrating neovascularity and shows better correlation with pain and functional deficit compared to conventional Doppler in patients with painful RCT. SMI also showed vascularity to a lesser degree in the asymptomatic tendon. Further large-scale studies are needed to prove the diagnostic value of SMI in the assessment of RCT.
•Superb microvascular imaging (SMI) correlated well with clinical symptoms.•SMI can potentially guide therapeutic intervention of rotator cuff tendinopathy.•SMI is superior in detecting neovascularity in patients with rotator cuff symptoms.•Subclinical grey scale and vascular changes were observed in asymptomatic tendons.•Clinicians should be aware of subclinical ultrasound changes in pain free tendons.</description><identifier>ISSN: 0009-9260</identifier><identifier>EISSN: 1365-229X</identifier><identifier>DOI: 10.1016/j.crad.2022.03.003</identifier><identifier>PMID: 35428470</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Female ; Humans ; Male ; Middle Aged ; Neovascularization, Pathologic - diagnostic imaging ; Neovascularization, Pathologic - epidemiology ; Pain ; Prevalence ; Rotator Cuff - diagnostic imaging ; Tendinopathy - diagnostic imaging ; Tendinopathy - epidemiology ; Ultrasonography, Doppler, Color</subject><ispartof>Clinical radiology, 2022-06, Vol.77 (6), p.e442-e448</ispartof><rights>2022 The Royal College of Radiologists</rights><rights>Copyright © 2022 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-3b42bcb90a15824798a7a135eb990dfdae5e94dcc396df5cd6afee14ed83cbce3</citedby><cites>FETCH-LOGICAL-c356t-3b42bcb90a15824798a7a135eb990dfdae5e94dcc396df5cd6afee14ed83cbce3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.crad.2022.03.003$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35428470$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ooi, C.C.</creatorcontrib><creatorcontrib>Wong, S.K.</creatorcontrib><creatorcontrib>Ma, V.C.</creatorcontrib><creatorcontrib>Tan, G.M.</creatorcontrib><creatorcontrib>Teng, K.Q.</creatorcontrib><creatorcontrib>Mohamed, S.N.</creatorcontrib><creatorcontrib>Png, M.A.</creatorcontrib><title>The prevalence of neovascularity in rotator cuff tendinopathy: comparing conventional Doppler with superb microvascular imaging</title><title>Clinical radiology</title><addtitle>Clin Radiol</addtitle><description>To determine the prevalence of neovascularity in the supraspinatus tendon of patients presenting with clinically painful unilateral rotator cuff tendinopathy (RCT) using conventional colour Doppler ultrasound (CDU), power Doppler ultrasound (PDU), and superb microvascular imaging (SMI). The association between Doppler findings and clinical scores was also assessed.
The bilateral supraspinatus of consecutive patients presented with unilateral RCT clinically were evaluated with grey-scale ultrasound (tendon thickening, heterogeneous echotexture, and hypoechogenicity), CDU, PDU, and SMI. The prevalence of neovascularity and grey-scale changes on duplex imaging techniques were analysed. The relationship between neovascularity on CDU, PDU, SMI, and pain/disability as determined using a visual analogue scale (VAS) and the Oxford Shoulder Score (OSS) were assessed.
Fifty-nine patients (mean age 53 years, 39 women) were recruited. Of the symptomatic supraspinatus tendons, 42.4% (25/59) demonstrated neovascularity on SMI, compared to 6.8% (4/59) on PDU and 5.1% (3/59) on CDU. Of the asymptomatic supraspinatus tendons, 5.1% (3/59) depicted neovascularity on SMI but not on conventional Doppler techniques. SMI showed a significant correlation with the VAS (r2 = 0.560, p<0.001) and OSS (r2 = 0.62, p<0.001). PDU weakly correlated with the VAS and OSS (r2 = 0.312, p=0.016; r2 = 0.260, p=0.047, respectively) while CDU did not show a significant relationship.
SMI is superior in demonstrating neovascularity and shows better correlation with pain and functional deficit compared to conventional Doppler in patients with painful RCT. SMI also showed vascularity to a lesser degree in the asymptomatic tendon. Further large-scale studies are needed to prove the diagnostic value of SMI in the assessment of RCT.
•Superb microvascular imaging (SMI) correlated well with clinical symptoms.•SMI can potentially guide therapeutic intervention of rotator cuff tendinopathy.•SMI is superior in detecting neovascularity in patients with rotator cuff symptoms.•Subclinical grey scale and vascular changes were observed in asymptomatic tendons.•Clinicians should be aware of subclinical ultrasound changes in pain free tendons.</description><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neovascularization, Pathologic - diagnostic imaging</subject><subject>Neovascularization, Pathologic - epidemiology</subject><subject>Pain</subject><subject>Prevalence</subject><subject>Rotator Cuff - diagnostic imaging</subject><subject>Tendinopathy - diagnostic imaging</subject><subject>Tendinopathy - epidemiology</subject><subject>Ultrasonography, Doppler, Color</subject><issn>0009-9260</issn><issn>1365-229X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM1q3DAUhUVpSSZpXqCLomU3dvRje6zSTclvIdBNAt0JWbrOaLAlR5InzKqvHplJssxKV_Cdw70fQt8oKSmhzfm21EGZkhHGSsJLQvgntKK8qQvGxL_PaEUIEYVgDTlGJzFul2_FqiN0zOuKtdWarND_-w3gKcBODeA0YN9jB36nop4HFWzaY-tw8EklH7Ce-x4ncMY6P6m02f_E2o9T5txjntwOXLLeqQFf-mkaIOBnmzY4zhOEDo9Wh_dmbEf1mGNf0ZdeDRHOXt9T9HB9dX9xW9z9vflz8fuu0LxuUsG7inW6E0TRumXVWrRqrSivoROCmN4oqEFURmsuGtPX2jSqB6AVmJbrTgM_RT8OvVPwTzPEJEcbNQyDyufOUbKmpk0raLvOKDuged0YA_RyCnnbsJeUyEW83MpFvFzES8JlFp9D31_7524E8x55M52BXwcA8pU7C0FGbRflxgbQSRpvP-p_ASkkmUM</recordid><startdate>202206</startdate><enddate>202206</enddate><creator>Ooi, C.C.</creator><creator>Wong, S.K.</creator><creator>Ma, V.C.</creator><creator>Tan, G.M.</creator><creator>Teng, K.Q.</creator><creator>Mohamed, S.N.</creator><creator>Png, M.A.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202206</creationdate><title>The prevalence of neovascularity in rotator cuff tendinopathy: comparing conventional Doppler with superb microvascular imaging</title><author>Ooi, C.C. ; Wong, S.K. ; Ma, V.C. ; Tan, G.M. ; Teng, K.Q. ; Mohamed, S.N. ; Png, M.A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-3b42bcb90a15824798a7a135eb990dfdae5e94dcc396df5cd6afee14ed83cbce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neovascularization, Pathologic - diagnostic imaging</topic><topic>Neovascularization, Pathologic - epidemiology</topic><topic>Pain</topic><topic>Prevalence</topic><topic>Rotator Cuff - diagnostic imaging</topic><topic>Tendinopathy - diagnostic imaging</topic><topic>Tendinopathy - epidemiology</topic><topic>Ultrasonography, Doppler, Color</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ooi, C.C.</creatorcontrib><creatorcontrib>Wong, S.K.</creatorcontrib><creatorcontrib>Ma, V.C.</creatorcontrib><creatorcontrib>Tan, G.M.</creatorcontrib><creatorcontrib>Teng, K.Q.</creatorcontrib><creatorcontrib>Mohamed, S.N.</creatorcontrib><creatorcontrib>Png, M.A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ooi, C.C.</au><au>Wong, S.K.</au><au>Ma, V.C.</au><au>Tan, G.M.</au><au>Teng, K.Q.</au><au>Mohamed, S.N.</au><au>Png, M.A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The prevalence of neovascularity in rotator cuff tendinopathy: comparing conventional Doppler with superb microvascular imaging</atitle><jtitle>Clinical radiology</jtitle><addtitle>Clin Radiol</addtitle><date>2022-06</date><risdate>2022</risdate><volume>77</volume><issue>6</issue><spage>e442</spage><epage>e448</epage><pages>e442-e448</pages><issn>0009-9260</issn><eissn>1365-229X</eissn><abstract>To determine the prevalence of neovascularity in the supraspinatus tendon of patients presenting with clinically painful unilateral rotator cuff tendinopathy (RCT) using conventional colour Doppler ultrasound (CDU), power Doppler ultrasound (PDU), and superb microvascular imaging (SMI). The association between Doppler findings and clinical scores was also assessed.
The bilateral supraspinatus of consecutive patients presented with unilateral RCT clinically were evaluated with grey-scale ultrasound (tendon thickening, heterogeneous echotexture, and hypoechogenicity), CDU, PDU, and SMI. The prevalence of neovascularity and grey-scale changes on duplex imaging techniques were analysed. The relationship between neovascularity on CDU, PDU, SMI, and pain/disability as determined using a visual analogue scale (VAS) and the Oxford Shoulder Score (OSS) were assessed.
Fifty-nine patients (mean age 53 years, 39 women) were recruited. Of the symptomatic supraspinatus tendons, 42.4% (25/59) demonstrated neovascularity on SMI, compared to 6.8% (4/59) on PDU and 5.1% (3/59) on CDU. Of the asymptomatic supraspinatus tendons, 5.1% (3/59) depicted neovascularity on SMI but not on conventional Doppler techniques. SMI showed a significant correlation with the VAS (r2 = 0.560, p<0.001) and OSS (r2 = 0.62, p<0.001). PDU weakly correlated with the VAS and OSS (r2 = 0.312, p=0.016; r2 = 0.260, p=0.047, respectively) while CDU did not show a significant relationship.
SMI is superior in demonstrating neovascularity and shows better correlation with pain and functional deficit compared to conventional Doppler in patients with painful RCT. SMI also showed vascularity to a lesser degree in the asymptomatic tendon. Further large-scale studies are needed to prove the diagnostic value of SMI in the assessment of RCT.
•Superb microvascular imaging (SMI) correlated well with clinical symptoms.•SMI can potentially guide therapeutic intervention of rotator cuff tendinopathy.•SMI is superior in detecting neovascularity in patients with rotator cuff symptoms.•Subclinical grey scale and vascular changes were observed in asymptomatic tendons.•Clinicians should be aware of subclinical ultrasound changes in pain free tendons.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>35428470</pmid><doi>10.1016/j.crad.2022.03.003</doi></addata></record> |
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| subjects | Female Humans Male Middle Aged Neovascularization, Pathologic - diagnostic imaging Neovascularization, Pathologic - epidemiology Pain Prevalence Rotator Cuff - diagnostic imaging Tendinopathy - diagnostic imaging Tendinopathy - epidemiology Ultrasonography, Doppler, Color |
| title | The prevalence of neovascularity in rotator cuff tendinopathy: comparing conventional Doppler with superb microvascular imaging |
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