Quantitative assessment of fatty infiltration of the supraspinatus by shear-wave ultrasound elastography in cases of suspected rotator cuff injury: Correlation with the Goutallier imaging classification and its potential applicability in the assessment of athletes

Abstract

Objective: To evaluate the accuracy of shear wave elastography (SWE) ultrasound in the assessment and quantification of fatty infiltration (FI) of the supraspinatus (SSP) muscle with the Goutallier classification on CT as the reference standard. Materials and Methods: Prospective study of 90 patients from December 2020 to August 2022 who had undergone shoulder US including SWE for the assessment of rotator cuff disease and had a previous CT with the shoulder included. Shear modulus (in meters per second) was estimated using ultrasound SWE in three regions of the SSP (myotendinous junction, anterior and posterior muscle bundle). Data collected included age, sex, and fatty muscle infiltration on CT (Goutallier stages 0–IV). Pearson correlation between CT Goutallier stage of the FI of the supraspinatus and SWE value in each region of the supraspinatus muscle was determined. Bland-Altman indexes were used to assess agreement between readers. Results: There were statistically significant differences in the SWE and the different Goutallier groups in the SWE of anterior bundle muscle, posterior bundle muscle, and myotendinous junction (p = < 0.001, 0.008, 0.031, respectively). The differences were significant for SWE of the anterior bundle muscle among the different subgroups of Goutallier stage (I-IV, p = < 0.001). Conclusion: SWE shows an excellent correlation with the Goutallier stage on CT in detecting, qualifying, and quantifying fatty infiltration of the supraspinatus. SWE may be useful in quantifying supraspinatus muscle quality in athletes competing in racquet sports and in other sports with overhead motions such as swimming, volleyball and javelin.

Keywords

• Shear wave
• Elastography
• Shoulder
• Rotator cuff
• Fatty infiltration