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In Vivo Vascularity Alterations in Repaired Rotator Cuffs Determined by Contrast-Enhanced Ultrasound

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Title: In Vivo Vascularity Alterations in Repaired Rotator Cuffs Determined by Contrast-Enhanced Ultrasound
Authors: Funakoshi, Tadanao Browse this author →KAKEN DB
Iwasaki, Norimasa Browse this author →KAKEN DB
Kamishima, Tamotsu Browse this author →KAKEN DB
Nishida, Mutsumi Browse this author
Ito, Yoichi Browse this author
Nishida, Kinya Browse this author
Motomiya, Makoto Browse this author
Suenaga, Naoki Browse this author
Minami, Akio Browse this author →KAKEN DB
Keywords: rotator cuff
contrast-enhanced ultrasound
subacromial bursa
Issue Date: Dec-2011
Publisher: SAGE Publications
Journal Title: American Journal of Sports Medicine
Volume: 39
Issue: 12
Start Page: 2640
End Page: 2646
Publisher DOI: 10.1177/0363546511420077
PMID: 21917614
Abstract: The alterations in blood flow after rotator cuff repair remain unclear. Visualization of vascular patterns could clarify basic and clinical investigations. Purpose: To assess longitudinal blood flow inside the repaired cuff and the surrounding tissue after rotator cuff repair, using contrast-enhanced ultrasonography. Study Design: Controlled laboratory study. Methods: Fifteen patients (7 men, 8 women, mean age 65.0 ± 9.8 years) consented to their participation. The patients underwent an ultrasound scan before and 1, 2, and 3 months after surgery. Enhanced ultrasound images were recorded for 1 min after intravenous injection of contrast reagent. Four regions of interest inside the cuff, and 2 regions in the anchor hole and subacromial bursa were superimposed on the obtained images. Calculated areas under the time-intensity curves were expressed in acoustic units (AU). Results: We found area-dependent differences in patterns of alteration and magnitude of blood flow inside the repaired cuff and peritendinous tissues. Vascularity in the articular distal and bursal distal region of the repaired cuff at 1 month postoperatively increased significantly compared with that at the preoperative baseline (76 vs. 5 AU, P = .0037, 92 vs. 7 AU, P = .043). The vascularity peaked at 1 month after surgery in the bursal area within the cuff, but at 2 months in the articular area. The vascularity in the articular proximal region of the repaired cuff was significantly lower than that in the bursal proximal (P = .0046), bursal distal (P = .0183), and articular distal regions (P = .0163) 1 month after surgery. Conclusions: Enhancement patterns in intratendinous tissue increased at 1 or 2 months postoperatively and decreased at 3 months. We found area-dependent differences in enhancement patterns inside the repaired cuff and peritendinous tissue. Clinical Relevance: Visualization of vascularization using contrast-enhanced ultrasound could help in deciding on appropriate repair technique or on the form of postoperative rehabilitation following rotator cuff repair.
Rights: The final, definitive version of this article has been published in the Journal, American Journal of Sports Medicine, 39(12), 2011 of publication, © American Orthopaedic Society for Sports Medicine, 2011 by SAGE Publications Ltd at the American Journal of Sports Medicine page: on SAGE Journals Online:
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 船越 忠直

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