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Suspected Rotator Cuff Lesions: Tissue Harmonic Imaging versus Conventional US of the Shoulder¹

¹ From the Departments of Radiology (K.S., M.Z., J.H.) and Orthopedic Surgery (L.N.), Orthopedic University Hospital Balgrist, Zurich, Switzerland. Received November 20, 2002; revision requested January 21, 2003; final revision received May 9; accepted June 16. Address correspondence to K.S., Radiologie, Kantonsspital Luzern, 6000 Luzern 16, Switzerland (e-mail: klaus.strobel@ksl.ch).

View larger version (132K): [in a new window]   Figure 1a. Long-axis (a) THI and (b) conventional US images of a partial tear of the SSP tendon. Visibility of the hypoechoic lesion (asterisks) in the articular portion of the tendon is slightly better with THI than with conventional US. (c) Findings on corresponding oblique-coronal intermediate-weighted fat-saturated MR arthrogram (3,300/14) obtained after injection of 10 mL of gadopentetate dimeglumine confirm the presence of a partial SSP tendon tear (arrow) on the articular side.

View larger version (137K): [in a new window]   Figure 1b. Long-axis (a) THI and (b) conventional US images of a partial tear of the SSP tendon. Visibility of the hypoechoic lesion (asterisks) in the articular portion of the tendon is slightly better with THI than with conventional US. (c) Findings on corresponding oblique-coronal intermediate-weighted fat-saturated MR arthrogram (3,300/14) obtained after injection of 10 mL of gadopentetate dimeglumine confirm the presence of a partial SSP tendon tear (arrow) on the articular side.

View larger version (146K): [in a new window]   Figure 1c. Long-axis (a) THI and (b) conventional US images of a partial tear of the SSP tendon. Visibility of the hypoechoic lesion (asterisks) in the articular portion of the tendon is slightly better with THI than with conventional US. (c) Findings on corresponding oblique-coronal intermediate-weighted fat-saturated MR arthrogram (3,300/14) obtained after injection of 10 mL of gadopentetate dimeglumine confirm the presence of a partial SSP tendon tear (arrow) on the articular side.

View larger version (134K): [in a new window]   Figure 2a. Long-axis (a) THI and (b) conventional US images of full-thickness tear of the SSP tendon. A hypoechoic defect (asterisks) of the distal SSP tendon is seen. The contour of the distal end (arrows) of the tendon is not clearly visible on either image. (d) Corresponding oblique-coronal intermediate-weighted fat-saturated MR image (3,300/14) shows the full-thickness tear (asterisk) of the SSP tendon and contrast material (arrowheads) in the bursa subdeltoidea. The distal part (arrow) of the tendon has altered signal intensity.

View larger version (131K): [in a new window]   Figure 2b. Long-axis (a) THI and (b) conventional US images of full-thickness tear of the SSP tendon. A hypoechoic defect (asterisks) of the distal SSP tendon is seen. The contour of the distal end (arrows) of the tendon is not clearly visible on either image. (d) Corresponding oblique-coronal intermediate-weighted fat-saturated MR image (3,300/14) shows the full-thickness tear (asterisk) of the SSP tendon and contrast material (arrowheads) in the bursa subdeltoidea. The distal part (arrow) of the tendon has altered signal intensity.

View larger version (126K): [in a new window]   Figure 2c. Long-axis (a) THI and (b) conventional US images of full-thickness tear of the SSP tendon. A hypoechoic defect (asterisks) of the distal SSP tendon is seen. The contour of the distal end (arrows) of the tendon is not clearly visible on either image. (d) Corresponding oblique-coronal intermediate-weighted fat-saturated MR image (3,300/14) shows the full-thickness tear (asterisk) of the SSP tendon and contrast material (arrowheads) in the bursa subdeltoidea. The distal part (arrow) of the tendon has altered signal intensity.

View larger version (152K): [in a new window]   Figure 3a. Short-axis (a) THI and (b) conventional US images of normal SSC tendon. The tendon substance with the different tendon bundles (asterisks) is more clearly visible with THI than with conventional US. (c) Corresponding oblique-sagittal T1-weighted MR image (600/12) shows normal SSC tendon substance with homogeneously hypointense signal (asterisks). The normal cranial (top arrowheads) and caudal (bottom arrowheads) contours of the tendon are visible on the THI, conventional US, and MR images.

View larger version (146K): [in a new window]   Figure 3b. Short-axis (a) THI and (b) conventional US images of normal SSC tendon. The tendon substance with the different tendon bundles (asterisks) is more clearly visible with THI than with conventional US. (c) Corresponding oblique-sagittal T1-weighted MR image (600/12) shows normal SSC tendon substance with homogeneously hypointense signal (asterisks). The normal cranial (top arrowheads) and caudal (bottom arrowheads) contours of the tendon are visible on the THI, conventional US, and MR images.

View larger version (112K): [in a new window]   Figure 3c. Short-axis (a) THI and (b) conventional US images of normal SSC tendon. The tendon substance with the different tendon bundles (asterisks) is more clearly visible with THI than with conventional US. (c) Corresponding oblique-sagittal T1-weighted MR image (600/12) shows normal SSC tendon substance with homogeneously hypointense signal (asterisks). The normal cranial (top arrowheads) and caudal (bottom arrowheads) contours of the tendon are visible on the THI, conventional US, and MR images.

View larger version (136K): [in a new window]   Figure 4a. Short-axis (a) THI and (b) conventional US images of an SSC tendon lesion. Only a few residual SSC tendon fibers (arrows) remain attached to the lesser tuberosity. A large defect (asterisk) of the cranial part of the tendon is seen. (c) Findings on corresponding oblique-sagittal T1-weighted MR image (600/12) confirm that a large part of the tendon is missing (asterisk). Some tendon fibers (arrows) remain attached to the lesser tuberosity.

View larger version (137K): [in a new window]   Figure 4b. Short-axis (a) THI and (b) conventional US images of an SSC tendon lesion. Only a few residual SSC tendon fibers (arrows) remain attached to the lesser tuberosity. A large defect (asterisk) of the cranial part of the tendon is seen. (c) Findings on corresponding oblique-sagittal T1-weighted MR image (600/12) confirm that a large part of the tendon is missing (asterisk). Some tendon fibers (arrows) remain attached to the lesser tuberosity.

View larger version (101K): [in a new window]   Figure 4c. Short-axis (a) THI and (b) conventional US images of an SSC tendon lesion. Only a few residual SSC tendon fibers (arrows) remain attached to the lesser tuberosity. A large defect (asterisk) of the cranial part of the tendon is seen. (c) Findings on corresponding oblique-sagittal T1-weighted MR image (600/12) confirm that a large part of the tendon is missing (asterisk). Some tendon fibers (arrows) remain attached to the lesser tuberosity.