机构:[1]Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.四川大学华西医院[2]Ultrasound Medical Center, Sichuan Cancer Hospital & Research Institute, Cancer Hospital Affiliated to School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.四川省肿瘤医院[3]Function Department of Sichuan Integrative Medicine Hospital, Chengdu, China.
Capsule-preserving hydrodilatation is a common treatment for adhesive capsulitis (AC), and ultrasound (US) has recently become the most popular adjuvant tool for image-guided glenohumeral joint injection. However, traditional US is hardly adequate to assess extracapsular fluid leakage, which may decide the treatment outcomes. In this study, we explored the value of contrast-enhanced ultrasound (CEUS) guided capsule-preserving hydrodilatation with steroids and ultrasonic contrast agents for treatment of AC.A total of 40 consecutive patients with AC were prospectively enrolled and received CEUS-guided capsule-preserving hydrodilatation. The number of injection attempts, injection volume, and fluid leakage were recorded, and the correlations with clinical features were analyzed by Pearson or Spearman correlation coefficients. Outcome measures including visual analog scale (VAS) score, passive range of motion (ROM), and shoulder pain and disability index (SPADI) score were evaluated at baseline and 4 weeks after treatment. Comparisons between patients with good and poor clinical outcomes were performed with independent t-test, Mann-Whitney U test, and chi-square test. Logistic regression was used to identify predictors of good clinical outcomes. A P value <0.05 defined significance.Access to the glenohumeral joint was successful in 87.5% patients on the first attempt. The infused fluid volume was 21.0±3.40 mL. Longer symptom duration (r=-0.676, P<0.001), greater SPADI (r=-0.148, P=0.007), and decreased ROM in abduction (r=0.38, P=0.016) were associated with a decreased volume of infused fluid. CEUS detected massive fluid leakage in 5 (12.5%) patients, with 4 capsule ruptures confirmed by magnetic resonance imaging (MRI). Longer symptom duration (r=0.485, P=0.001), decreased ROM in the direction of abduction (r=-0.33, P=0.037), and external rotation (r=-0.34, P=0.032) were correlated with an increased incidence of massive fluid leakage. Moreover, patients with good outcomes had significantly shorter symptom duration (5.7±2.09 vs. 11.2±3.89 months, P=0.002) and greater initial VAS score (6.9±1.04 vs. 6.3±0.50, P=0.022) than those with poor outcomes. Absence of massive fluid leakage was an independent predictor of clinical good outcomes at 4 weeks after treatment [odd ratio (OR) =0.05, 95% confidential interval (CI): 0.003-0.882, P=0.041].CEUS-guided capsule-preserving hydrodilatation allows real-time visualization of capsule dilatation, accurate detection of extracapsular fluid leakage, and identification of risks for capsule rupture. It provides an effective treatment for AC, and is useful to predict patients' clinical outcomes.2024 Quantitative Imaging in Medicine and Surgery. All rights reserved.
基金:
This work was supported by the Natural
Science Foundation of Sichuan (Youth Fund) (No.
2024NSFSC1790); the China Postdoctoral Science
Foundation (No. 2023M732436); the Postdoctoral
Foundation of West China Hospital of Sichuan University
(No. 2023HXBH003); and the Key Program of the Science
and Technology Bureau of Sichuan (No. 2022YFS0218).
第一作者机构:[1]Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.[2]Ultrasound Medical Center, Sichuan Cancer Hospital & Research Institute, Cancer Hospital Affiliated to School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
通讯作者:
通讯机构:[2]Ultrasound Medical Center, Sichuan Cancer Hospital & Research Institute, Cancer Hospital Affiliated to School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.[*1]Ultrasound Medical Center, Sichuan Cancer Hospital & Research Institute, Cancer Hospital Affiliated to School of Medicine, University of Electronic Science and Technology of China, No. 55 Section 4 of South Renmin Road, Chengdu 610041, China
推荐引用方式(GB/T 7714):
Cheng Xueqing,Zhang Zhenqi,Wu Minggang,et al.A preliminary study of contrast-enhanced ultrasound guided capsule-preserving hydrodilatation in shoulder adhesive capsulitis[J].Quantitative Imaging In Medicine And Surgery.2024,14(7):4804-4814.doi:10.21037/qims-24-39.
APA:
Cheng Xueqing,Zhang Zhenqi,Wu Minggang,Qiao Lang,Xu Jinshun&Lu Man.(2024).A preliminary study of contrast-enhanced ultrasound guided capsule-preserving hydrodilatation in shoulder adhesive capsulitis.Quantitative Imaging In Medicine And Surgery,14,(7)
MLA:
Cheng Xueqing,et al."A preliminary study of contrast-enhanced ultrasound guided capsule-preserving hydrodilatation in shoulder adhesive capsulitis".Quantitative Imaging In Medicine And Surgery 14..7(2024):4804-4814