Diagnostic performance of indirect MR arthrography for the diagnosis of rotator cuff tears at 3.0 T

Purpose: To examine the value of fat-suppressed images in MR arthrography of the shoulder in patients with rotator cuff tears. Material and Methods: MR arthrography was performed in 25 patients (9 women, 16 men) ranging from 19 to 64 years. Standard T1-weighted spin-echo images (sSE) and fat-suppressed images (FS) were obtained after intraarticular injection of contrast material. The MR studies were analyzed according to contrast, image quality and conspicuity of pathology. A diagnosis was established without knowledge of the conventional arthrographic findings on the basis of sSE versus FS techniques. Results: The contrast between the intraarticular fluid and the adjacent structures in FS images was increased compared to sSE images in all patients. The conspicuity of anatomical structures was improved in 8 patients. Without fat suppression, 2 false-negative and one false-positive full-thickness tears were diagnosed. With the FS technique, 14 full-thickness tears and 4 partial-thickness tears of the cuff were correctly classified. Conclusion: The results suggest that, if MR arthrography is chosen for a diagnosis of rotator cuff disorders, a fat suppression sequence should be included.

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Diagnostic accuracy of MRA and MRI for the bursal-sided partial-thickness rotator cuff tears: a meta-analysis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1460-y ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 1

Author(s):

Tao Huang ◽

Jian Liu ◽

Yupeng Ma ◽

Dongsheng Zhou ◽

Liang Chen ◽

...

Keyword(s):

Rotator Cuff ◽

Meta Analysis ◽

Characteristic Curve ◽

Mr Arthrography ◽

Diagnostic Value ◽

Rotator Cuff Tears ◽

Cochrane Library ◽

Predictive Values ◽

Partial Thickness ◽

Sensitivity Specificity

Abstract Background Numerous quantitatively studies have focused on the diagnosis of bursal-sided partial-thickness rotator cuff tears (RCTs); however, the accuracy of magnetic resonance imaging (MRI) and MR arthrography (MRA) remains inconclusive. This study was performed systematically to compare the diagnostic value of MRA and MRI for the bursal-sided partial-thickness RCTs. Methods Three electronic databases, PubMed, Embase, and Cochrane Library, were utilized to retrieve articles comparing the diagnostic value of MRA and MRI for detecting bursal-sided partial-thickness RCTs. After screening and diluting out the articles that met the inclusion criteria to be used for statistical analysis, the pooled evaluation indexes include sensitivity, specificity, positive and negative predictive values, diagnostic odds ratio (DOR), and the area under the receiver operating characteristic curve (AUC). Results Twelve studies involving 1740 patients and 1741 shoulders were identified. The pooled sensitivity, specificity, DOR, and AUC of MRA to diagnose bursal-sided partial-thickness RCTs were 0.77 (95% CI, 0.67–0.85), 0.98 (95% CI, 0.95–0.99), 73.01 (95% CI, 35.01–152.26), and 0.88 (95% CI, 0.85–0.91), respectively. The pooled sensitivity, specificity, DOR, and AUC of MRI were 0.77 (95% CI, 0.66–0.86) and 0.96 (95% CI, 0.81–0.99), and 37.12 (95% CI, 8.08–170.64) and 0.82 (95% CI, 0.78–0.85), respectively. Conclusions This meta-analysis reveals that MRA and MRI have similar diagnostic value for the diagnosis of bursal-sided partial-thickness rotator cuff tears.

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Rotator cuff tears: assessment with MR arthrography in 275 patients with arthroscopic correlation

European Radiology ◽

10.1007/s00330-006-0370-7 ◽

2006 ◽

Vol 17 (2) ◽

pp. 491-498 ◽

Cited By ~ 102

Author(s):

S. Waldt ◽

M. Bruegel ◽

D. Mueller ◽

K. Holzapfel ◽

A. B. Imhoff ◽

...

Keyword(s):

Rotator Cuff ◽

Mr Arthrography ◽

Rotator Cuff Tears

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Accuracy of MRI, MR Arthrography, and Ultrasound in the Diagnosis of Rotator Cuff Tears: A Meta-Analysis

American Journal of Roentgenology ◽

10.2214/ajr.08.1241 ◽

2009 ◽

Vol 192 (6) ◽

pp. 1701-1707 ◽

Cited By ~ 346

Author(s):

Joseph O. de Jesus ◽

Laurence Parker ◽

Andrea J. Frangos ◽

Levon N. Nazarian

Keyword(s):

Rotator Cuff ◽

Meta Analysis ◽

Mr Arthrography ◽

Rotator Cuff Tears

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Diagnostic Value of MRA and MRI for The Articular-Sided Partial-Thickness Rotator Cuff Tears: A Meta-Analysis

10.21203/rs.3.rs-53384/v1 ◽

2020 ◽

Author(s):

Lianxin Li ◽

Jinlei Dong ◽

Qinghu Li ◽

Jinye Dong ◽

Dongsheng Zhou ◽

...

Keyword(s):

Rotator Cuff ◽

Meta Analysis ◽

Characteristic Curve ◽

Mr Arthrography ◽

Diagnostic Value ◽

Rotator Cuff Tears ◽

Cochrane Library ◽

Initial Examination ◽

Partial Thickness ◽

Sensitivity Specificity

Abstract Background: This study aims to compare the diagnostic accuracy of magnetic resonance imaging (MRI) and MR arthrography (MRA) for the articular-sided partial-thickness rotator cuff tear (PTRCT).Methods: Three electronic databases, PubMed/Medline, Embase and Cochrane Library, were utilized to retrieve articles comparing the diagnostic value of MRA and MRI for detecting articular-sided PTRCTs. The pooled statistical indexes included sensitivity, specificity, positive/negative predictive value, diagnostic odds ratio (DOR) and the area under receiver operating characteristic curve (AUC). Results: Eleven studies involving 1703 patients and 1704 shoulders were included. The pooled sensitivity, specificity, DOR and AUC and their 95% CIs of MRA to diagnose articular-sided PTRCTs were 0.81 (95% CI, 0.65-0.90), 0.96 (95% CI, 0.91-0.98), 68.14 (95% CI, 33.20-139.84) and 0.96 (95% CI, 0.94-0.97), respectively. The pooled sensitivity, specificity, DOR and AUC and their 95% CIs of MRI were 0.78 (95% CI, 0.65-0.87) and 0.97 (95% CI, 0.84-0.99), 47.82 (95% CI, 8.29-275.89) and 0.89 (95% CI, 0.86-0.92), respectively.Conclusions: This meta-analysis reveals that MRA has a better diagnostic value than that of MRI for the diagnosis of articular-sided partial-thickness rotator cuff tears, but only small improvement of sensitivity. Considering the price and invasion of MRA, MRI is recommended as an initial examination to detect patients suspected with articular-side partial-thickness rotator cuff tears.

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Diagnostic performance of ultrasound for rotator cuff tears: a systematic review and meta-analysis

Medical Ultrasonography ◽

10.11152/mu-2352 ◽

2020 ◽

Vol 22 (2) ◽

pp. 197 ◽

Cited By ~ 2

Author(s):

Weiyu Liang ◽

Huaiyu Wu ◽

Fajin Dong ◽

Hongtian Tian ◽

Jinfeng Xu

Keyword(s):

Rotator Cuff ◽

Likelihood Ratio ◽

Diagnostic Performance ◽

High Efficiency ◽

Meta Analysis ◽

High Sensitivity ◽

Diagnostic Odds Ratio ◽

Rotator Cuff Tears ◽

Cochrane Library ◽

Summary Receiver Operating Characteristic

Aim: Rotator cuff (RC) tears are considered to be the main reason for shoulder pain. Although ultrasound is a useful method to detect it, its effectiveness when diagnosing RC tears has been a heated discussion. Therefore, we aimed at evaluating RC tears’ ultrasound accuracy by conducting a systemically review and pooled comprehensive analysis.Materials and methods: Relevant articles up to May 2018 were searched from the Cochrane Library, Embase, and Pubmed databases. Either arthroscopy or magnetic resonance imaging (MRI) was considered as a reference standard. The results were estimated by pooled-sensitivity (P-SEN), pooled-specificity (P-SPE), pooled-diagnostic odds ratio (P-DOR), pooled-likelihood ratio+ (PLR+), pooled-likelihood ratio- (P-LR-), and the area under the summary receiver operating characteristic (SROC).Result: We selected seven prospective studies in accordance with the inclusion criteria that covered 554 rotator cuff tears in 868 patients. The P-SEN, P-SPE, P-LR+, P-LR-, P-DOR, area under the SROC curve of diagnostic performance of ultrasound for RC and post-test probability were 95% (95% CI: 88 – 98), 72% (95% CI: 61 – 81), 3.41 (95% CI: 2.40 – 4.84), 0.08 (95% CI: 0.03 – 0.16), 45.31 (95% CI: 21.04 – 97.59), 89% (95% CI: 0.86 – 0.91), and 46% and 2%, respectively.Conclusion: Our metaanalysis demonstrates that ultrasound has a high efficiency for RC tears’ diagnosis. It can be a promising method in patients with suspected RC tears because of its high sensitivity, specificity and diagnostic accuracy.

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Hybrid Technology Fusion MRI/US and Sonoelastography in Diagnosis of Fatty Degeneration and Atrophy of Supraspinatus Muscle of the Shoulder

Medical Visualization ◽

10.24835/1607-0763-2017-5-112-123 ◽

2017 ◽

pp. 112-123

Author(s):

V. E. Gazhonova ◽

M. V. Emelianenko ◽

M. P. Onishchenko

Keyword(s):

Rotator Cuff ◽

Muscle Atrophy ◽

Diagnostic Performance ◽

Interobserver Reliability ◽

Fatty Degeneration ◽

Rotator Cuff Tears ◽

Full Thickness ◽

Point Scale ◽

Supraspinatus Muscle ◽

Us Elastography

Evaluation of the rotator cuff muscles is of value for surgical indications and successful postoperative prognosis. Ultrasound is widely used for detection of rotator cuff tears, but it’s role in evaluation of the rotator cuff muscles is not yet defined. A new method Fusion MRI/US with elastography is able to show differences in tissue stiffness, and a simultaneous combination of two methods helps to overcome limitations from US – narrow field of view, and from MRI – impossibility for real time examination and low space resolution.Purpose.To investigate diagnostic performance and interobserver reliability of US elastography and to study possibilities of Fusion MRI/US technique in grading fatty degeneration and atrophy of the supraspinatus muscle.Materials and methods.72 patients from 128 with shoulder pain and disability with written diagnostic confirm were specially selected for the study with US elastography and MRI and 29 patients were enrolled for Fusion MRI/US study. Oblique sagittal scans through the supraspinatus muscle were performed during US elastography study in the standard manner for comparance with MRI. The amount of fatty degeneration was graded according to the modified Goutallier five-point scale, with use of a 3-point scale – with US elastography. US results for grade of atrophy and fatty degeneration were retrospectively reviewed by 2 blinded to each other results experts. Sensitivity and interobserver reliability was estimated.Results.The sensitivity of standard US in comparance to US elastography in assessment of muscle atrophy with the reference to MRI was 53% and 76%, respectively. The sensitivity of US and US elastography increased with increasing of the grade of muscle atrophy. The sensitivity of US and US elastography in detection of fatty degeneration was slightly better 65% and 85%, respectively. US elastography were more sensitive in evaluation of fatty degeneration in full thickness than in partial thickness rotator cuff tears. In all cases of full thickness tears US with elastography had a 100% sensitivity in assessment of atrophy and fatty degeneration in the reference to MRI. While in partial tears the sensitivity decreased to 66%. The agreement between MRI and US elastography for the grade of fatty degeneration of the supraspinatus was substantial (kappa = 0.78). The interobserver reliability for US was fair (kappa = 0.41), and for US elastography substantial (kappa=0,71).Conclusion. Sonoelastography helps to increase the diagnostic performance of US in identifying and grading fatty degeneration and atrophy of the supraspinatus. US with elastography can be used as a primary modality for fatty changes and atrophy of the supraspinatus.

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