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The three-dimensional ultrasound evaluation of the rotator cuff--an experimental study
T A Wallny1, I Theuerkauf, R L Schild
1University of Bonn, Department of Orthopaedics, Bonn, Germany. wallny@uni-bonn.de
Objective:
An accurate sonographic diagnosis of rotator cuff lesions significantly depends on image quality and on the experience of the operator. The present study was performed to determine whether the use of three dimensional (3D) sonography further increases the diagnostic yield of ultrasound.
Methods:
In an experimental study 22 artificial rotator cuff lesions (seven full thickness and 15 partial thickness tears) of cadaveric shoulder joints were evaluated by ultrasound with two and three dimensional imaging in a water basin.
Results:
With 3D ultrasound, rotator cuff lesions were more often correctly diagnosed (sensitivity of 77%) than with conventional 2D sonography (sensitivity of 64%). Specificity was 85 and 69%, respectively. In partial thickness tears in particular, 3D imaging was the superior method reaching a sensitivity and specificity of 73 and 77%, respectively, compared to 53 and 61%, respectively, with 2D ultrasound. With 2D and 3D ultrasound eight and 11 out of 13 tendons, respectively, were correctly diagnosed as intact confirmed by histopathological examination.
Conclusion:
Although the results of an experimental study may not reflect the clinical situation, 3D ultrasound appears to facilitate diagnosis of partial thickness rotator cuff tears.