HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text AVI Movies All Versions of this Article: 2483071400v1 248/3/954    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Adler, R. S. Articles by Warren, R. F. PubMed PubMed Citation Articles by Adler, R. S. Articles by Warren, R. F.

Rotator Cuff in Asymptomatic Volunteers: Contrast-enhanced US Depiction of Intratendinous and Peritendinous Vascularity¹

¹ From Weill Medical College of Cornell University, New York, NY (R.S.A.); Department of Radiology and Imaging, Division of Ultrasound and Body Imaging (R.S.A.), Sports Service at Department of Orthopaedics (S.F., A.P., R.F.W., W.K.), and Epidemiology and Biostatistics Division (S.L.), Hospital for Special Surgery, 535 E 70th St, New York, NY 10021; Washington Orthopaedics and Sports Medicine, Washington, DC (J.R.R.); and Midwest Orthopaedics at Rush, Chicago, Ill (N.N.V.). Received August 8, 2007; revision requested October 5; revision received January 2, 2008; accepted January 30; final version accepted March 28. Supported in part by research grants provided by Major League Baseball (grant 3135400), the Soft Tissue Research Fund of the Hospital for Special Surgery, and Philips Medical Systems. Address correspondence to R.S.A. (e-mail: adlerr{at}hss.edu).

Purpose: To test the hypothesis that regional variations in supraspinatus tendon vascularity exist and can be imaged and quantified in asymptomatic individuals by using contrast material–enhanced ultrasonography (US).

Materials and Methods: After institutional review board approval and informed consent were obtained, 31 volunteers aged 22–65 years (mean age, 41.5 years) underwent lipid microsphere contrast-enhanced shoulder US performed with an L8-4 transducer operating in contrast harmonic mode and a mechanical index of 0.07 in a HIPAA-compliant protocol. Images were obtained in the volunteers at rest and after exercise. Quantitative analysis was performed by using the time-enhancement postcontrast data derived from four regions of interest (ROIs): bursal medial, articular medial, bursal lateral, and articular lateral. Two 2-minute acquisitions were performed after each contrast material bolus. Baseline enhancement and peak enhancement for each ROI were estimated from these acquisitions. Baseline gray-scale and power Doppler US images of the supraspinatus tendon were obtained by using an L12-5 transducer. The Mann-Whitney nonparametric test was used to test for significant differences between ROIs in all volunteers.

Results: In the volunteers at rest before exercise, significant variations in regional enhancement between the articular medial zone and both the bursal medial zone (P = .002) and the bursal lateral zone (P = .003) were observed. Differences in enhancement between the articular medial and articular lateral zones approached significance. Greater differentiation (P < .001) was observed after exercise, with a significant increase in apparent enhancement in each ROI in all volunteers.

Conclusion: This study revealed the spatial distribution of the blood supply to the supraspinatus tendon in asymptomatic individuals. The addition of exercise to the protocol resulted in a significantly increased level of enhancement compared with that at rest and enabled more sensitive assessment of intratendinous and peritendinous vascularity.

Supplemental material: http://radiology.rsnajnls.org/cgi/content/full/2483071400/DC1

© RSNA, 2008