MR imaging diagnosis of rotator cuff tears

Evancho, Andrew M.; Stiles, R G; Fajman, William A.; Flower, S.; Macha, T; Brunner, Michael C.; Fleming, Lamar L.

doi:10.2214/ajr.151.4.751

Cited by 89 publications

(43 citation statements)

References 12 publications

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“…One patient falsely interpreted as rotator cuff tear on MRI, was found to be normal on arthroscopy. Isolated partial tears are difficult to detect on MRI because small area of increased signal intensity may be due to inflammation and oedema from early stages of impingement, which was described by Andrew et al [8] as being similar to our study.…”

Section: Clinical Findingssupporting

confidence: 89%

A clinical radiological and arthroscopic correlation in various shoulder pathologies: A prospective study

Srinivas¹,

Givvimani²,

Sekar³

et al. 2018

Int. J. Orthop. Sci.

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Shoulder pain is one of the most common complaint in medical practice and often leads to significant disabilities. Spectrum of etiologies that can give rise to shoulder pain are acute trauma to a gamut of degenerative disorders. Objective: To evaluate clinical, radiological and arthroscopic correlation in various shoulder pathologies. To compare clinical findings with MRI findings of symptomatic shoulder. To compare clinical and MRI findings with arthroscopy. Material and Methods: This is a prospective study, which includes patients with various intra articular shoulder disorders symptoms. 12 patients who were received between October 2013 and September 2015, who were clinically diagnosed to have general shoulder pathology based on a positive Dugas test and or rotator cuff pathology, were evaluated with MRI and subsequently with diagnostic arthroscopy on the symptomatic shoulder. Results: Clinical examination found sensitivity of 78%, specificity of 67% for rotator cuff tears and MRI showed sensitivity of 100% and specificity of 67% for the same. The sensitivity of MRI is higher when compared to clinical examination. But specificity was found to be same due to small sample size. Glenohumeral instability lesions were found in 6 patients. SLAP lesion were found in 2 patients, Bankart in 3 patients, Hill Sachs in one patient. Clinical examination found sensitivity of 80%, specificity of 71% for glenohumeral instability and MRI showed sensitivity of 100% and specificity of 86%. The sensitivity and specificity of MRI is higher when compared to clinical examination. Conclusion: The sensitivity and specificity for all pathologies is higher for arthroscopy in our study as compared to clinical and MRI examinations, as is the observation of most workers in this field.

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Section: Clinical Findingssupporting

confidence: 89%

A clinical radiological and arthroscopic correlation in various shoulder pathologies: A prospective study

Srinivas¹,

Givvimani²,

Sekar³

et al. 2018

Int. J. Orthop. Sci.

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“…Our sensitivities of 83â€"100%using the gradient echo technique are better than the 47% and 57% results reported by Parsaet al [26] for a similar sequence. Results of both the fat-sup pressed fast spin-echo and the gradient-echo sequences are also comparable with the 80â€" 97% sensitivities reported for conventional dual-echosequences [2,5,7]. In a study of MR imagesof 222 shouldersusinga mixture of conventional and fast spin-echo techniques without and with fat suppression, Balich et al [27] achieved sensitivities for full-thickness tears by five observersof 84â€"96%.…”

Section: Discussionsupporting

confidence: 57%

Gradient-echo versus fat-suppressed fast spin-echo MR imaging of rotator cuff tears.

Sahin-Akyar¹,

Miller²,

Staron³

et al. 1998

American Journal of Roentgenology

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OBJECTIVE. The purpose of thisstudyis to comparefat-suppressed T2-weightedfast spin-echosequences with T2-weighted multiplanargradient-echosequences in revealingro tator cuff disorders. MATERIALS AND METHODS. Obliquecoronal fat-suppressed fastspin-echo imagesand gradient-echo images of 39 patients who underwent surgery of the shoulder were retro spectively reviewed. Images from the two techniques were reviewed separately. Each set of images was interpreted twice by four musculoskeletal radiologists independently and with out knowledge of the surgical findings. Sensitivity and specificity for both sequenceswere determined. The kappa statistic was used to calculate intraobserver and interobserver agree ment of interpretations.RESULTS. Fordetecting anytear,thesensitivity of thefourreaders was71â€"96% using fast spin-echo and 58â€"100% using gradient-echo imaging. Confidence intervals showed no difference between the two sequences. Sensitivity of detecting full-thickness tears was 83â€" I00% for both sequences. Interobserver agreement was good. CONCLUSION. T2-weighted gradient-echo andfat-suppressed T2-weighted fastspinecho sequencesdepict rotator cuff tears equally well and take less time to acquire than con ventionaldual-echospin-echosequences. fat and fluid, increasedlesion conspicuity due to improved dynamic rangecharacteristics,re duced artifacts related to respiratory motion, and the elimination of chemical shift misregis tration artifacts [12,14,19,20]. Gradient-echo imaging allows significant reduction in image acquisition time by using gradient refocusing and reduced flip angles and provides higher contrast between the rotator cuff tendons and adjacent soft tissue than do conventional spin echo proton densityâ€"and T2-weighted se quencesI161,The purpose of our study is to compare the sensitivity and specificity of T2-weighted gradient-echo images and fat-suppressed T2-weighted fast spin-echo images for the detec tion of rotator cuff disorders. Materials and MethodsFrom October 1993 through March 1996, we obtained MR images of 329shoulders usingbothob lique coronal fat-suppressed fast spin-echo T2-weighted images and T2-weighted gradient-echo images u.spartof @ur standard imagingprotocol. All

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“…As a panoramic image of the supraspinatus tendon can be shown in an oblique coronal MRI, oblique coronal MRI images were used for guiding the process of US-MRI virtual navigation. Because a number of images were captured at different degrees of injury in different MRI sequence images, we selected the most representative images in our study [13][14][15]. The process of US-MRI virtual navigation provides a good platform for subsequent UE.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound elastography of the supraspinatus tendon guided by US-MRI virtual navigation

Liu¹,

Zhan²,

Zhou³

et al. 2015

THC

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Abstract. BACKGROUND: A virtual navigation system (VNS) can combine two imaging modalities for synchronous observation and can be beneficial for diagnosis and treatment. Ultrasound elastography (UE) can distinguish between soft and hard tissues. However, the application of UE to musculoskeletal structures is rare. OBJECTIVE: To evaluate UE of the supraspinatus tendon using ultrasound-magnetic resonance imaging (US-MRI) virtual navigation. METHODS: Sixty patients with an ache in the shoulder were diagnosed with supraspinatus tendon injuries using MRI. US-MRI virtual navigation was used to identify lesions in the supraspinatus tendon, and finally US elastography (UE) was performed. Volunteers whose supraspinatus tendons were diagnosed as normal by MRI were also selected for US elastography. The UE scores were then compared between patients and volunteers. RESULTS: A total of 60 patients were diagnosed with supraspinatus tendon injuries using MRI and forty-two patients classified as Grade I exhibited no obvious abnormality by US. The supraspinatus tendon injury scores were significantly higher in Grade I patients compared with volunteers (P < 0.05). CONCLUSION: US elastography is helpful for the diagnosis of the supraspinatus tendon injuries when used with US-MRI virtual navigation.

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MR imaging diagnosis of rotator cuff tears

Cited by 89 publications

References 12 publications

A clinical radiological and arthroscopic correlation in various shoulder pathologies: A prospective study

A clinical radiological and arthroscopic correlation in various shoulder pathologies: A prospective study

Gradient-echo versus fat-suppressed fast spin-echo MR imaging of rotator cuff tears.

Ultrasound elastography of the supraspinatus tendon guided by US-MRI virtual navigation

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