Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Effect of Patient's Positioning on the Grade of Tendinosis and Visible Range of Infraspinatus Tendon on Ultrasound

초음파 영상에서 극하근 힘줄병의 단계와 관찰가능 범위에 환자의 자세가 미치는 영향

  • Jee Won Chai (Department of Radiology, SMG-SNU Boramae Medical Center) ;
  • Joo-ho Lee (Department of Urology, Seoul National University Hospital) ;
  • Dong Hyun Kim (Department of Radiology, SMG-SNU Boramae Medical Center) ;
  • Jina Park (Department of Radiology, SMG-SNU Boramae Medical Center) ;
  • So-Hee Oh (Department of Biostatistics, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine) ;
  • Su-Mi Shin (Department of Radiology, SMG-SNU Boramae Medical Center)
  • 채지원 (서울대학교병원운영 서울특별시보라매병원 영상의학과) ;
  • 이주호 (서울대학교병원 비뇨의학과) ;
  • 김동현 (서울대학교병원운영 서울특별시보라매병원 영상의학과) ;
  • 박진아 (서울대학교병원운영 서울특별시보라매병원 영상의학과) ;
  • 오소희 (서울대학교 의과대학 서울대학교병원운영 서울특별시보라매병원 의학통계지원실) ;
  • 신수미 (서울대학교병원운영 서울특별시보라매병원 영상의학과)
  • Received : 2022.10.12
  • Accepted : 2022.12.27
  • Published : 2023.05.01
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Abstract

Purpose To investigate the effect of patient positioning on tendinosis grade, visible range, and infraspinatus tendon (IST) thickness, and to determine the feasibility of internal rotation (IR) position to assess IST on ultrasound (US). Materials and Methods This study included 52 shoulders of 48 subjects who were evaluated for IST in three different positions: neutral position (N), IR, and position with the ipsilateral hand on the contralateral shoulder (HC). Two radiologists retrospectively graded IST tendinosis from grade 0 to grade 3 and the visible range from grade 1 to grade 4. The thickness of the IST was measured by another radiologist with a short-axis view. A generalized estimating equation was used for statistical analysis. Results The tendinosis grades were higher in the HC position than in the IR position, with a cumulative odds ratio of 2.087 (p = 0.004, 95% confidence interval [CI]: 1.268-3.433). The tendinosis grades in the HC position (p = 0.370) and IR position (p = 0.146) were not significantly different from those in the N position. The overall difference in IST thickness was significant (p < 0.001), but the visible range (p = 0.530) was not significantly different according to position. Conclusion Patient positioning significantly affected the grade of tendinosis and thickness but not the visible range of the IST. The IR position is a feasible position for assessing the IST on US.

목적 환자의 자세가 극하근의 힘줄병의 단계, 두께와 관찰가능 범위에 영향을 주는지 알아보고자 하였으며, 이로써 내전자세에서 초음파로 극하근을 평가하는 것이 가능한지 알고자 하였다. 대상과 방법 이 연구는 극하근을 세 가지 다른 자세(중립자세, 내전자세, 반대쪽 어깨에 손을 얹은 자세)로 평가한 48명의 환자의 52개의 어깨를 대상으로 하였다. 두 명의 영상의학과 전문의가 후향적으로 극하근의 힘줄병의 단계를 grade 0에서 grade 3까지, 관찰가능 범위를 grade 1에서 grade 4까지 판정하였다. 극하근의 두께는 다른 영상의학과 전문의가 단축 영상에서 측정하였다. 일반화추정방정식을 통계적 기법으로 사용하였다. 결과 반대쪽 어깨에 손을 얹은 자세에서 힘줄병의 단계는 내전자세보다 누적승산비가 2.087(p = 0.004, 95% 신뢰구간: 1.268-3.433)로 더 높았으나, 중립자세에서 힘줄병은 단계는 내전자세(p = 0.146)와 반대쪽 어깨에 손을 얹은 자세(p = 0.370)와 유의한 차이가 없었다. 극하근의 두께(p < 0.001)는 자세에 따라 유의한 차이가 있었으나, 관찰가능 범위(p = 0.530)는 유의한 차이가 없었다. 결론 환자의 자세는 극하근의 힘줄병의 단계와 두께에는 영향을 주었지만 관찰가능 범위에는 영향을 주지 않았다. 내전자세에서도 초음파로 극하근을 평가하는 것이 가능하다.

Keywords

Acknowledgement

We thank Dr. Hye Min Son for her measurements of tendon thickness.

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