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. 2014 Nov 20;9(11):e113803.
doi: 10.1371/journal.pone.0113803. eCollection 2014.

Quantitative ultrasound facilitates the exploration of morphological association of the long head biceps tendon with supraspinatus tendon full thickness tear

Ke-Vin Chang  1 , Wen-Shiang Chen  2 , Tyng-Guey Wang  2 , Chen-Yu Hung  3 , Kuo-Liong Chien  4
Affiliations

Quantitative ultrasound facilitates the exploration of morphological association of the long head biceps tendon with supraspinatus tendon full thickness tear

Ke-Vin Chang et al. PLoS One. .

Abstract

Backgrounds: Pathology of the long head biceps tendon (LHBT) is associated with rotator cuff tears but whether the LHBT texture changes following supraspinatus tendon full thickness tear (SSFT) can be detected at the extra-articular segment remains unknown. This cross-sectional study aimed to explore the morphological differences of the LHBT in shoulders with and without deficient rotator cuffs by using quantitative ultrasound.

Materials and methods: We selected 145 cases with SSFT and 145 age-and- gender-matched controls. The width, thickness, flattening ratio, cross-sectional area, and echogenicity ratio of the LHBT were measured and a general linear model was used to clarify the relationship between rotator cuff pathology and LHBT morphology. The receiver operating characteristic curves of each parameter were constructed for SSFT discrimination and the maximal Youden indexes were used to define the best cut-off points.

Results: We found increased thickness and cross-sectional area but decreased flattening ratio in shoulders with SSFT, and no between-group differences in the width and echogenicity ratio. The LHBT appearance was modified by biceps peritendinous effusion and medial subluxation, but not by the size of SSFT. The flattening ratio was the best discriminator for SSFT with an area under curve of 0.81 (95% confidence interval, 0.76-0.86). The cut-off values to differentiate between the non-tear and tear groups were 2.00 mm of the thickness, 1.73 of the flattening ratio and 10.53 mm(2) of the cross-sectional area.

Conclusion: Quantitative ultrasound facilitated the detection of the LHBT morphological changes following SSFT and demonstrated its potential utility in discriminating rotator cuff deficiency.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Common pathology of the long head biceps tendons associated with rotator cuff tears: (A) biceps tendinopathy (B) biceps tendon medial subluxation (C) biceps tendon dislocation and (D) biceps tendon tear with an empty bicipital groove.
Figure 2
Figure 2. Illustration of how to measure (A) the width (yellow dash line), (B) thickness (white dash line), (C) cross-sectional area, and (D) mean pixel intensity of the long head biceps tendon as well as the mean pixel intensity of the overlying deltoid muscle.
Figure 3
Figure 3. The receiver operating characteristics (ROC) curve of (A) the flattening ratio versus the thickness and (B) the flattening ratio versus the cross-sectional area of the long head biceps tendon in discriminating supraspinatus tendon full thickness tear.
See this image and copyright information in PMC

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