Diagnostic Accuracy and Agreement between Magnetic Resonance Imaging and Ultrasound Finding for the Diagnosis of Rotator Cuff Tears

Abstract

Objective: To determine the diagnostic accuracy and agreement between ultrasound and magnetic resonance (MR) imaging in determining rotator cuff tears.
 Study Design: Cross-sectional study.
 Place and Duration of the Study: Armed Forces Institute of Radiology and Imaging, Pak Emirates Military Hospital,Rawalpindi Pakistan, from Jul 2018 to Jan 2019.
 Methodology: Patients of either gender with a traumatic shoulder injury duration of less than 15 days were consecutively included. Rotator cuff tear on ultrasonography was diagnosed on the presence of a hypoechoic discontinuity in the tendon and accentuation of cartilage shadow, giving a 'double cortex' view while on MRI, the hyper-intense signal area within the tendon on T2W, fat-suppressed and GRE sequences, corresponding to fluid signal seen.
 Results: Of 88 patients, the mean age was 54.022±5.19 years. Ultrasound diagnosed rotator cuff tears in 42(47.7%) patients, and MRI diagnosed rotator cuff tears in 44(50.0%) patients. Diagnostic accuracy of ultrasound taking MR imaging as the gold standard showed sensitivity as 81.82%, specificity as 77.27%, negative predicted value as 78.26%, positive predicted value as 80.95%, and overall diagnostic accuracy as 79.55%. A moderate agreement was found between ultrasound and MRI findings (p-value=0.591).
 Conclusion: The findings of the current study showed significant moderate agreement between ultrasound and MR imaging in the determination of rotator-cuff tears.