Detection of partial-thickness supraspinatus tendon tears: is a single direct MR arthrography series in ABER position as accurate as conventional MR arthrography?

Schreinemachers, Saskia A.; Hulst, Victor P. M. van der; Willems, W. Jaap; Bipat, Shandra; Woude, Henk-Jan van der

doi:10.1007/s00256-009-0680-3

Cited by 35 publications

(37 citation statements)

References 40 publications

(45 reference statements)

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“…Upon inclusion of the abduction external rotation view in routine sequences of MR arthrography, there is an increase in the sensitivity of detection articular-sided partial-thickness tears of the rotator cuff tendon (13, 14). Some patients may not be tolerant of the abduction external rotation positioning due to the provocation of instability or pain.…”

Section: Discussionmentioning

confidence: 99%

Comparisons of the Various Partial-Thickness Rotator Cuff Tears on MR Arthrography and Arthroscopic Correlation

Chun

Kim

2010

Korean J Radiol

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ObjectiveTo assess the diagnostic performance of MR arthrography in the diagnosis of the various types of partial-thickness rotator cuff tears by comparing the MR imaging findings with the arthroscopic findings.Materials and MethodsThe series of MR arthrography studies included 202 patients consisting of 100 patients with partial-thickness rotator cuff tears proved by arthroscopy and a control group of 102 patients with arthroscopically intact rotator cuffs, which were reviewed in random order. At arthroscopy, 54 articular-sided, 26 bursal-sided, 20 both articular- and bursal-sided partial-thickness tears were diagnosed. The MR arthrographies were analyzed by two radiologists for articular-sided tears, bursal-sided tears, and both articular- and bursal-sided tears of the rotator cuff. The sensitivity and specificity of each type of partial-thickness tears were determined. Kappa statistics was calculated to determine the inter- and intra-observer agreement of the diagnosis of partial-thickness rotator cuff tears.ResultsThe sensitivity and specificity of the various types of rotator cuff tears were 85% and 90%, respectively for articular-sided tears, 62% and 95% for bursal-sided tears, as well as 45% and 99% for both articular- and bursal-sided tears. False-negative assessments were primarily observed in the diagnosis of bursal-sided tears. Conversely, both articular- and bursal-sided tears were overestimated as full-thickness tears. Inter-observer agreement was excellent for the diagnosis of articular-sided tears (k = 0.70), moderate (k = 0.59) for bursal-sided tears, and fair (k = 0.34) for both articular- and bursal-sided tears, respectively. Intra-observer agreement for the interpretation of articular- and bursal-sided tears was excellent and good, respectively, whereas intra-observer agreement for both articular- and bursal-sided tears was moderate.ConclusionMR arthrography is a useful diagnostic tool for partial-thickness rotator cuff tears, but has limitations in that it has low sensitivity in bursal- and both articular- and bursal-sided tears. In addition, it shows only fair inter-observer agreement when it comes to predicting both articular- and bursal-sided tears.

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Section: Discussionmentioning

confidence: 99%

Comparisons of the Various Partial-Thickness Rotator Cuff Tears on MR Arthrography and Arthroscopic Correlation

Chun

Kim

2010

Korean J Radiol

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“…Most of these are articularsided tears [10,11]. These tears may be simple abrasions of the surface of the tendon or may be more complex delaminating or flap tears, which have a horizontal component and retraction of the affected fibers [12].…”

Section: Partial-thickness Rotator Cuff Tearsmentioning

confidence: 99%

“…full-thickness tears [10,11]. Delaminating partial-thickness tears may be treated differently, such as with layer-to-layer suturing or resection of the flap; thus, detecting these lesions is important for preoperative planning [12].…”

Section: Polster and Schickendantzmentioning

confidence: 99%

Shoulder MRI: What Do We Miss?

Polster

Schickendantz

2010

American Journal of Roentgenology

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“…This reduced scan protocol will save scan time, and, besides the detection of labral-ligamentous lesions, it is reliable in diagnosing (partial thickness) rotator cuff lesions and Hill Sachs lesions as well [17,23,24].…”

Section: Discussionmentioning

confidence: 99%

Is a single direct MR arthrography series in ABER position as accurate in detecting anteroinferior labroligamentous lesions as conventional MR arthography?

et al. 2009

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Purpose The purpose of this study is to retrospectively compare accuracy of single magnetic resonance (MR) arthrography series in Abduction External Rotation (ABER) with conventional MR arthrography for detection and characterisation of anteroinferior labroligamentous lesions, with arthroscopy as reference standard. Interobserver variability of both protocols was determined. Methods and materials Institutional review board approval was obtained; informed consent was waived. MR arthrograms, including oblique axial fat suppressed T1-weighted images in ABER position and conventional imaging directions of 250 patients (170 men, 80 women; mean age, 36 years), were retrospectively and independently evaluated by three reviewers. Reviewers were blinded to clinical information and arthroscopic results. Labroligamentous lesions were registered in both ABER and MRa. The lesions were sub-classified (Bankart, Perthes, anterior labrum periosteal sleeve avulsion (ALPSA) or lesions not otherwise specified). Inter-observer agreement was assessed by Kappa statistics for all 250 patients. Ninety-two of 250 patients underwent arthroscopy. Sensitivity, specificity and accuracy of ABER versus conventional MR arthrography were calculated and compared using paired McNemar test.Results Kappa values of the ABER and conventional MR arthrography ranged from 0.44 to 0.56 and 0.44 to 0.62, respectively. According to arthroscopy, 45 of 92 patients had an intact anteroinferior labrum, and in 44 patients, a labroligamentous lesion (eight Bankart, seven Perthes, 29 ALPSA and three lesions not otherwise specified) was diagnosed. There were no statistically significant differences between ABER and conventional MR arthrography regarding sensitivity (85-89%, 89-96%), specificity (82-91%, 84-89%) and overall accuracy (50-62%, 53-63%). Conclusion The results of a single MR arthrography series in ABER position are comparable with those of conventional MR arthrography for detecting anteroinferior labroligamentous lesions.

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Detection of partial-thickness supraspinatus tendon tears: is a single direct MR arthrography series in ABER position as accurate as conventional MR arthrography?

Cited by 35 publications

References 40 publications

Comparisons of the Various Partial-Thickness Rotator Cuff Tears on MR Arthrography and Arthroscopic Correlation

Comparisons of the Various Partial-Thickness Rotator Cuff Tears on MR Arthrography and Arthroscopic Correlation

Shoulder MRI: What Do We Miss?

Is a single direct MR arthrography series in ABER position as accurate in detecting anteroinferior labroligamentous lesions as conventional MR arthography?

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