Objective To discuss the ultrasound elastography of supraspinatus tendon with real-time virtual sonography (RVS). Methods Twenty-four patients with shoulder ache were diagnosed chronic supraspinatus tendinitis with MRI. Sonography and MR images were fused with RVS, and then ultrasound elastography was performed. Supraspinatus tendons in the suffered and healthy sides were assessed according to the colors on elastography images. Scored 1: More than 90% of the image was green, and the other could be purple or red. Scored 2: 50%-90% of the image was green, and less than 10% was red, the other was purple. Scored 3: More than 50% of the image was purple, and the other was green mixed with red, or more than 90% was red mixed with green. Scored 4: 50%-90% of the image was red, and less than 10% was green, the other was purple. Scored 5: More than 90% of the image was red, and the other could be purple or green. Results Grey-scale ultrasound did not show obvious abnormality in 14 of 24 patients with chronic supraspinatus tendinitis. All the sonography images could be lead according to MRI to find the lesions with the RVS. Three supraspinatus tendons scored 3, 13 scored 4 and 8 scored 5 in the suffered side. Five supraspinatus tendons scored 2, 16 scored 3 and 3 scored 4 in the healthy side. The score of suffered supraspinatus tendons were higher than that of healthy ones (P＜0. 05). Conclusion Ultrasound elastography is helpful for the diagnosis of the chronic supraspinatus tendinitis with the RVS.%目的 探讨实时虚拟超声(RVS)引导下弹性成像诊断冈上肌腱损伤的价值.方法 24例肩关节疼痛患者,均经常规MR检查明确为一侧慢性冈上肌腱损伤.在RVS下进行MRI与超声图像融合,然后行超声弹性成像,对患侧和健侧相应部位进行弹性成像评分和统计学分析.评分标准:1分:弹性图像90％以上为绿色,可伴有10％以下的紫色或红色；2分:弹性图像50％～90％为绿色,其余以紫色为主,可伴有10％以下的红色；3分:弹性图像50％以上为紫色,其余为绿色与红色相间；或弹性图像90％以上为红色、绿色相间；4分:弹性图像50％～90％为红色,其余以紫色为主,可伴有10％以下的绿色;5分:弹性图像90％以上为红色,可伴有10％以下的紫色或绿色.结果 24例患者中,14例灰阶超声未见明显异常.对所有患者均可进行有效的实时虚拟导航,通过MRI引导超声定位病变的冈上肌腱.超声弹性成像患侧冈上肌腱3分3例,4分13例,5分8例;健侧冈上肌腱2分5例,3分16例,4分3例；患侧弹性评分高于健侧(P＜0.05).结论 借助于RVS,超声弹性成像有助于诊断慢性冈上肌腱损伤.
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