Reliability of MR Quantification of Rotator Cuff Muscle Fatty Degeneration Using a 2-point Dixon Technique in Comparison with the Goutallier Classification

Horiuchi, Saya; Nozaki, Taiki; Tasaki, Atsushi; Yamakawa, Akira; Kaneko, Yasuhito; Hara, Takeshi; Yoshioka, Hiroshi

doi:10.1016/j.acra.2017.03.026

Cited by 31 publications

(34 citation statements)

References 20 publications

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“…The rotator cuff integrity was determined by using magnetic resonance images (MRI; 1.5-Tesla [Excelart; Toshiba Medical Systems, Tokyo, Japan]) obtained preoperatively, at 6, 12, and 24 months after surgery. Any tendon defect filled with fluid was considered a tear [ 8 , 13 , 16 ]. Postoperative rotator cuff integrity was classified into five categories using the Sugaya classification [ 20 ]: type 1 indicated a completely healed tendon, types 2 and 3 indicated incompletely healed tendon, and types 4 and 5 indicated a re-torn tendon after surgery.…”

Section: Methodsmentioning

confidence: 99%

Clinical and structural outcomes after arthroscopic rotator cuff repair: a comparison between suture bridge techniques with or without medial knot tying

et al. 2018

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PurposeTo compare arthroscopic suture bridge (SB) techniques with medial tying to those without tying, considering clinical and structural outcomes.MethodsWe included 124 patients with rotator cuff tears after arthroscopic rotator cuff repair (ARCR). Fifty-three patients with clinical and structural evaluations 3, 12, and 24 months postoperatively were included and divided into 29 patients with medial tying (WMT group) and 24 without tying (WOMT group). Clinical outcomes comprised the University of California Los Angeles (UCLA) and Japanese Orthopaedic Association (JOA) scores. Structural outcomes were evaluated with magnetic resonance images (MRI) using Sugaya classifications.ResultsJOA and UCLA scores in the WMT and WOMT groups improved significantly from before surgery to 24 months after surgery (P < 0.01, respectively). No significant difference was noted between groups. No significant postoperative retears (Sugaya types 4 and 5) between WMT and WOMT groups were noted at 3 months (5 vs 3 cases), 12 months (6 vs 5 cases), and 24 months (7 vs 6 cases) postoperatively. Complete healing (Sugaya type 1) was noted at 3 months (8 vs 11 cases), 12 months (10 vs 10 cases), and 24 months (8 vs 13 cases, P = 0.024) postoperatively. Incomplete healing (Sugaya types 2 and 3) were noted at 3 months (16 vs 10 cases), 12 months (13 vs 9 cases), and 24 months (14 vs 5 cases, P = 0.024) postoperatively.ConclusionClinical outcomes for both techniques were comparable, but the number of incompletely healed tendons in SB with medial tying was significantly larger at 24 months after surgery.Level of evidenceThis study is a level III, case-control study.Clinical relevanceThis study revealed the influence of medial tying in rotator cuff repair.

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Section: Methodsmentioning

confidence: 99%

Clinical and structural outcomes after arthroscopic rotator cuff repair: a comparison between suture bridge techniques with or without medial knot tying

et al. 2018

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“…Recent technological developments in MRI permit 3D analysis of the entire RC muscle, 8,18,22 including quantitative analysis of its fat fraction. 8,15,[18][19][20]22 It was the purpose of this investigation to quantitatively and longitudinally analyze supraspinatus muscle atrophy and fatty infiltration before and after arthroscopic supraspinatus repair and compare the results of repairs that healed with those that ultimately failed to heal using full muscle volume MRI segmentation and magnetic resonance (MR) Dixon sequences for quantitative analysis of intramuscular fat content.…”

Section: -In-5mentioning

confidence: 99%

mentioning

confidence: 99%

“…1,31 Fatty infiltration is mostly graded by MRI adaptations of the classification of Goutallier, 6,11 which is influenced by the retraction of the myotendinous unit 23 and has not demonstrated better-than-moderate interreader reliability. 6,15 If nonoperative management fails, arthroscopic RC repair is the gold standard for the treatment of symptomatic full-thickness RC tears. A healed tendon-to-bone repair is associated with not only a better overall clinical state and higher postoperative strength but also a better outcome than if the repair has failed to heal.…”

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Changes of Supraspinatus Muscle Volume and Fat Fraction After Successful or Failed Arthroscopic Rotator Cuff Repair

et al. 2019

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Background: Muscle atrophy and fatty infiltration are limiting factors for successful rotator cuff (RC) repair. Quantitative data regarding these hallmarks of degenerative muscle changes after RC repair in humans are scarce. By utilizing a new application of the 6-point Dixon magnetic resonance imaging technology, 3-dimensional volume and fat fraction analysis of the whole RC muscle have become possible. Purpose: Quantitative analysis of atrophy and fatty infiltration of the supraspinatus muscle after healed and failed RC tendon-to-bone repair. Study Design: Cohort study; Level of evidence, 3. Methods: Muscle volume and fat fraction were measured preoperatively and at 3 and 12 months postoperatively in 19 failed and 21 healed arthroscopic supraspinatus tendon repairs, with full muscle volume segmentation and magnetic resonance Dixon sequences. Results: In both groups, the muscle volume initially decreased 3 months after RC repair by –3% in intact ( P = .140) and –10% in failed repair ( P = .004) but recovered between 3 and 12 months to 103% ( P = .274) in intact and 92% ( P = .040) in failed repairs when compared with the preoperative volume (difference of change between groups, preoperative to 12 month: P = .013). The supraspinatus muscle’s fat fraction did not significantly change after successful repair (6.5% preoperative, 6.6% after 3 months, and 6.7% after 12 months; all nonsignificant). There was, however, a significant increase from 7.8% to 10.8% at 3 months ( P = .014) and 11.4% at 12 months ( P = .020) after failed repair (difference between groups at 3- and 12-month follow-up: P = .018 and P = .001, respectively). Conclusion: After successful arthroscopic repair, RC tendon tear–induced fatty infiltration can be almost stopped, and muscle atrophy can even be slightly reversed. In case of a failed repair, however, these changes are further pronounced during the first 3 postoperative months but seem to stabilize thereafter.

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“…[2324] Given high reproducibility in muscle area and FF measurements, fat quantification MRI of the psoas may prove to be a valuable prognostic tool in malignancy, rotator cuff disease, and systemic disease–related cachexia studies. [2829]…”

Section: Discussionmentioning

confidence: 99%

Pelvic muscle size and myosteatosis: Relationship with age, gender, and obesity

Pacicco

Ratner

et al. 2019

Indian Journal of Radiology and Imaging

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Purpose: To evaluate interreader performance in the measurement of the cross-sectional area and myosteatosis of pelvic skeletal muscles using fat quantification magnetic resonance imaging (MRI) and correlate with patient anthropomorphic characteristics. Materials and Methods: A Health Insurance Portability and Accountability Act–compliant retrospective cross-sectional study was performed. Between January and April 2016, 61 patients (26 males and 35 females) underwent a lumbosacral plexus 3T MRI with a modified three-dimensional spoiled gradient echo sequence dedicated to fat quantification (mDixon Quant; Philips Healthcare). Two independent reviewers outlined muscle cross-sectional area on axial images using a freehand region of interest tool and documented proton-density fat fraction (FF) and muscle area (cm 2 ) of the psoas, gluteus medius, gluteus maximus, and rectus femoris muscles on each side. Interreader agreement was assessed by intraclass correlation coefficient (ICC), and correlation between the measurements and subject's age, gender, and body mass index (BMI) was assessed using multiple linear regression analysis. Results: Excellent interreader agreement was obtained (ICC ≥0.74) for all muscle groups except for the left gluteus medius area and right psoas FF which showed good agreement (0.65 and 0.61, respectively). Statistically significant ( P ≤ 0.05) positive correlation was seen between the gluteal muscle FF and area with BMI, and rectus muscle FF with age and BMI. Statistically significant negative correlation between the rectus femoris area and age was also observed. Conclusion: Fat quantification MRI is a highly reproducible imaging technique for the assessment of myosteatosis and muscle size. Intramuscular FF and cross-sectional area were correlated with age and BMI across multiple muscle groups.

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Reliability of MR Quantification of Rotator Cuff Muscle Fatty Degeneration Using a 2-point Dixon Technique in Comparison with the Goutallier Classification

Cited by 31 publications

References 20 publications

Clinical and structural outcomes after arthroscopic rotator cuff repair: a comparison between suture bridge techniques with or without medial knot tying

Clinical and structural outcomes after arthroscopic rotator cuff repair: a comparison between suture bridge techniques with or without medial knot tying

Changes of Supraspinatus Muscle Volume and Fat Fraction After Successful or Failed Arthroscopic Rotator Cuff Repair

Pelvic muscle size and myosteatosis: Relationship with age, gender, and obesity

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