Diagnosis of rotator cuff tears using 3-Tesla MRI versus 3-Tesla MRA: a systematic review and meta-analysis

McGarvey, Ciaran; Harb, Ziad; Smith, Christian; Houghton, Russell; Corbett, Steven A; Ajuied, Adil

doi:10.1007/s00256-015-2299-x

Cited by 32 publications

(30 citation statements)

References 26 publications

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“…In some cases however, it could fail to diagnose the presence of SSC tears [28], indirect signs, as LHBT subluxation must be analysed ( Figure 5). Diagnostic accuracy could be improved with MR arthrography in assessing rotator cuff tendon tears [29], essentially in the evaluation of SSC tears [30]. Lee recently reported that T1 SPIR is a more sensitive and accurate imaging sequence compared to T2 TSE in detecting SSC tendon tear on 3 T MRA [31].…”

Section: Radiographic Imagingmentioning

confidence: 99%

Subscapularis Tendon Tears: Classification, Diagnosis and Repair

Baverel¹

2018

Recent Advances in Arthroscopic Surgery

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Rotator cuff tears include a panel of tendon lesions, and superior cuff tears are often combined with subscapularis lesions that are more difficult to repair. We propose in this chapter to describe the Lafosse subscapularis tears classification and to describe the arthroscopic repair that can be performed easily with a needle as shuttle. The advantages of these surgical techniques are simplicity, safety and quickness. The procedure is performed under general anaesthesia with the patient in beach chair position. A classic arthroscopic posterior portal is used to perform glenohumeral exploration, and cuff tendons are analysed. Once subscapularis tear is confirmed, the tendon must be released after repair with anterolateral portal. Then, a triple-loaded anchor is positioned at the edge of the bicipital groove to perform both biceps tenodesis and subscapularis repair.

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Section: Radiographic Imagingmentioning

confidence: 99%

Subscapularis Tendon Tears: Classification, Diagnosis and Repair

Baverel¹

2018

Recent Advances in Arthroscopic Surgery

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“…44 However, the combination of patient characteristics, history, and clinical shoulder tests for the diagnosis of FT tears could improve the ability of MRI, 171 and a meta-analysis confirmed that 3.0-T MRI appeared equivalent to 3.0-T MRA. 96 In recent years, technological advances in arthroscopic shoulder surgery have made the surgical management of partial-thickness (PT) tears much less invasive and thereby more cost-effective. Consequently, the identification of a PT tear has become more meaningful.…”

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confidence: 99%

Detecting Rotator Cuff Tears: A Network Meta-analysis of 144 Diagnostic Studies

Liu

Dong

Shen³

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Many imaging techniques have been developed for the detection of rotator cuff tears (RCTs). Despite numerous quantitative diagnostic studies, their relative accuracy remains inconclusive.Purpose: To determine which of 3 commonly used imaging modalities is optimal for the diagnosis of RCTs.Study Design: Systematic review; Level of evidence, 4.Methods: Studies evaluating the performance of magnetic resonance imaging (MRI), magnetic resonance arthrography (MRA), and ultrasound (US) used in the detection of RCTs were retrieved from the PubMed/MEDLINE and Embase databases. Diagnostic data were extracted from articles that met the inclusion/exclusion criteria. A network meta-analysis was performed using an armbased model to pool the absolute sensitivity and specificity, relative sensitivity and specificity, and diagnostic odds ratio as well as the superiority index for ranking the probability of these techniques.Results: A total of 144 studies involving 14,059 patients (14,212 shoulders) were included in this network meta-analysis. For the detection of full-thickness (FT) tears, partial-thickness (PT) tears, or any tear, MRA had the highest sensitivity, specificity, and superiority index. For the detection of any tear, MRI had better performance than US (sensitivity: 0.84 vs 0.81, specificity: 0.86 vs 0.82, and superiority index: 0.98 vs 0.22, respectively). With regard to FT tears, MRI had a higher sensitivity and superiority index than US (0.91 vs 0.87 and 0.67 vs 0.28, respectively) and a similar specificity (0.88 vs 0.88, respectively). The results for PT tears were similar to the detection of FT tears. A sensitivity analysis was performed by removing studies involving only 1 arm for FT tears, PT tears, or any tear, and the results remained stable.Conclusion: This network meta-analysis of diagnostic tests revealed that high-field MRA had the highest diagnostic value for detecting any tear, followed by low-field MRA, high-field MRI, high-frequency US, low-field MRI, and low-frequency US. These findings can help guide clinicians in deciding on the appropriate imaging modality.

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“…So far, the diagnostic accuracy of 7-T shoulder MRI is inferior to the results of 3 T studies published in the literature. In the detection of supraspinatus tears at 3 T, Mc Garvey et al [34] reported in their meta-analysis sensitivities of 85.7% and 80.5% and specificities of 99% and 100% for full-and partial-thickness tears, respectively. However, a high number of false positive results was reported in patients with adhesive capsulitis, where MRI predicted a rotator cuff pathology in 57.9 % while arthroscopy revealed an incidence of only 13.2% [35].…”

Section: Discussionmentioning

confidence: 99%

7-T clinical MRI of the shoulder in patients with suspected lesions of the rotator cuff

et al. 2020

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Background: To evaluate feasibility and diagnostic performance of clinical 7-T magnetic resonance imaging (MRI) of the shoulder.Methods: Eight patients with suspected lesions of the rotator cuff underwent 7-T MRI before arthroscopy. Image quality was scored for artifacts, B 1 + inhomogeneities, and assessability of anatomical structures. A structured radiological report was compared to arthroscopy. In four patients, a visual comparison with pre-existing 1.5-T examinations was performed. Results: Regarding image quality, the majority of the sequences reached values above the middle of each scoring scale. Fat-saturated proton density sequences showed least artifacts and best structure assessability. The most homogenous B 1 + field was reached with gradient-echo sequences. Arthroscopy did not confirm tendinopathy/ partial tear of supraspinatus in 5/8 patients, of subscapularis in 5/6, and of infraspinatus in one patient; only a partial lesion of the subscapularis tendon was missed. Pathologic findings of long bicipital tendon, acromioclavicular joint, glenohumeral cartilage, labrum, and subacromial subdeltoideal bursa were mainly confirmed; exceptions were one lesion of the long bicipital tendon, one subacromial bursitis, and one superior glenoid labrum anterior-to-posterior lesion, missed on 7-T MRI. Evaluating all structures together, sensitivity was 86%, and specificity 74%. A better contrast and higher image resolution was noted in comparison to previous 1.5-T examinations. Conclusions: 7-T MRI of the shoulder with diagnostic image quality is feasible. Overrating of tendon signal alterations was the main limitation. Although the diagnostic performance did not reach the current results of 3-T MRI, our study marks the way to implement clinical 7-T MRI of the shoulder.

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Diagnosis of rotator cuff tears using 3-Tesla MRI versus 3-Tesla MRA: a systematic review and meta-analysis

Cited by 32 publications

References 26 publications

Subscapularis Tendon Tears: Classification, Diagnosis and Repair

Subscapularis Tendon Tears: Classification, Diagnosis and Repair

Detecting Rotator Cuff Tears: A Network Meta-analysis of 144 Diagnostic Studies

7-T clinical MRI of the shoulder in patients with suspected lesions of the rotator cuff

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