{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:19:13Z","timestamp":1777389553558,"version":"3.51.4"},"reference-count":57,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2018,8,6]],"date-time":"2018-08-06T00:00:00Z","timestamp":1533513600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Muscle degeneration as a consequence of rotator cuff tears is mainly assessed by magnetic resonance imaging. Contrast-enhanced ultrasound (CEUS) is a new functional imaging method to assess microvascular perfusion as a fundamental parameter of muscle tissue vitality. In this cross-sectional study, the authors evaluated supraspinatus muscle perfusion after cuff repair and analyzed its association with functional shoulder outcome and the grade of echogenicity in B-mode ultrasound indicating fatty infiltration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Hypothesis:<\/jats:title>\n                    <jats:p>The authors expected reduced microperfusion of the operated versus the contralateral supraspinatus muscle and a correlation of the muscular microperfusion with functional shoulder outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cross-sectional study; Level of evidence, 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients who received unilateral repair of the supraspinatus tendon between 2009 and 2014 were invited for a single follow-up examination. Functional scores were assessed, including the Constant-Murley score and American Shoulder and Elbow Surgeons score. CEUS examination was performed bilaterally in an oblique sagittal plane of the supraspinatus fossa. Perfusion was quantified by the parameters wash-in perfusion index (WiPI) and peak enhancement via VueBox quantification software. The results of the Constant-Murley score, American Shoulder and Elbow Surgeons score, and perfusion parameters were referenced to the contralateral shoulder. Echogenicity of the supraspinatus muscle was classified with a 3-point scale as compared with the trapezius muscle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Sixty-seven patients were available, with a mean follow-up of 38.0 \u00b1 18.5 months. Functional assessment showed impaired shoulder function on the operated shoulder as compared with the contralateral side (relative Constant Score [CS], 80% \u00b1 19%). CEUS revealed diminished perfusion on the operated shoulder (WiPI, 55.1% \u00b1 40.2%, P &lt; .001). A strong correlation could be demonstrated between the perfusion deficit and functional impairment (relative WiPI and CS: r\n                      <jats:sub>s<\/jats:sub>\n                      = .644, P &lt; .001). Higher grade of echogenicity in B-mode ultrasound was associated with reduced perfusion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>CEUS could visualize impaired supraspinatus muscle perfusion after rotator cuff repair as compared with the contralateral, healthy shoulder. With its ability to quantify microvascular perfusion as a surrogate parameter for muscle vitality and function, CEUS may serve as a quantitative method to evaluate rotator cuff muscles.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0363546518787266","type":"journal-article","created":{"date-parts":[[2018,8,6]],"date-time":"2018-08-06T12:05:33Z","timestamp":1533557133000},"page":"2735-2742","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":35,"title":["Contrast-Enhanced Ultrasound Determines Supraspinatus Muscle Atrophy After Cuff Repair and Correlates to Functional Shoulder Outcome"],"prefix":"10.1177","volume":"46","author":[{"given":"Christian","family":"Fischer","sequence":"first","affiliation":[{"name":"Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, HTRG\u2013Heidelberg Trauma Research Group, Heidelberg University Hospital, Heidelberg, 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Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc-Andr\u00e9","family":"Weber","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, University Medical Center Rostock, Rostock, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Kunz","sequence":"additional","affiliation":[{"name":"Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, HTRG\u2013Heidelberg Trauma Research Group, Heidelberg University Hospital, Heidelberg, Germany"},{"name":"Shoulder and Elbow Surgery, Catholic Hospital Mainz, Mainz, 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