Diagnosis of Rotator Cuff Tears with Non-Arthrographic MR Imaging: 3D Fat-Suppressed Isotropic Intermediate-Weighted Turbo Spin-Echo Sequence versus Conventional 2D Sequences at 3T

Partial-Thickness Tear of Supraspinatus and Infraspinatus Tendon Revisited: Based on MR Findings

“…위음성의 경우는 관절경 소견에서 점액낭 측(bursal-sided) 부분 파열인 경우가 많았다고 한다( 12 ). 주로 점액낭 측의 표재성(superficial) 파열이나 갈라진 틈새 같은(slit-like) 파열이었고, 이럴 경우 자기공명영상에서는 점액낭 측 표면에 뚜렷한 불연속성(discontinuity) 없이 약간의 불규칙성(focal irregularity)이나 마모(fraying)의 소견이 있을 수 있다( 12 ).…”

3D MRI of the Shoulder

“…52,53 A 2018 study comparing 3D FSE and 2D FSE sequences in 74 patients with arthroscopic correlation showed 3D sequences to be 95% sensitive, 100% specific, and 95% accurate in identifying supraspinatus-infraspinatus tendon tears compared with 99%, 93%, and 98% on 2D sequences. 26 However, that same study showed 3D FSE to be slightly less reliable and less specific in identifying subscapularis tears, which was thought to be due to blurring and motion. Correlation of imaging and arthroscopic evaluation of the subscapularis tendon is difficult because the middle to distal tendon footprints are challenging to evaluate arthroscopically without a dedicated evaluation and a high suspicion for pathology.…”

“…3D FSE sequences have demonstrated similar performance to 2D sequences in identifying rotator cuff tears in non-arthrographic MRIs. 26,51 As mentioned previously, 3D sequences have the added benefit of the ability to be reformatted in nonstandard imaging planes, including into an angled oblique sagittal plane oriented perpendicular to the distal supraspinatus tendon. This plane was shown to be helpful in identifying distal partial-thickness rotator cuff tears and is commonly performed at some institutions.…”

“…[22][23][24] Currently, all major vendors offer 3D FSE sequences that can be performed with any desired image-weighting and with or without arthrography. [24][25][26][27] Although these sequences have shown promising results in evaluating the shoulder, adaption into routine clinical practice has been slow. This is likely due to the relatively long acquisition time, often between 7 and 8 minutes at 1.5 T for the shoulder, which makes these sequences susceptible to patient motion and difficult to repeat, if necessary, while remaining within a scheduled time slot.…”

“…27,28 Imaging at 3 T has the potential to shorten sequence acquisition times, although published acquisition times are still between 6 and 8 minutes. 22,25,26 Another commonly cited concern with using 3D acquisitions is image blurring, causing structural edges to become indistinct. 29 Newer imaging techniques, such as controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA), may help overcome some of these difficulties, but data are limited on its use in the shoulder.…”