Mr Arthrography in the Diagnosis of Rotator Cuff Tears

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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Full-Thickness Rotator Cuff Tears in the Throwing Athlete

Operative Techniques in Sports Medicine ◽

10.1016/j.otsm.2021.150800 ◽

2021 ◽

pp. 150800

Author(s):

Robert A Jack ◽

Michael C Ciccotti ◽

Steven B Cohen ◽

Michael G Ciccotti

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tears ◽

Full Thickness ◽

Throwing Athlete

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Can ultrasound suffice for triaging patients requiring surgical correction of rotator cuff tears—a comparative evaluation of ultrasound and magnetic resonance imaging

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00477-2 ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Aniket Agarwal ◽

Kavita Vani ◽

Anurag Batta ◽

Kavita Verma ◽

Shishir Chumber

Keyword(s):

Rotator Cuff ◽

Biceps Tendon ◽

Surgical Correction ◽

Statistical Testing ◽

Rotator Cuff Tears ◽

Full Thickness ◽

Partial Thickness ◽

Linear Probe ◽

Significant Difference ◽

Sensitivity Specificity

Abstract Background Objectives: To comparatively evaluate the role of ultrasound and MRI in rotator cuff and biceps tendon pathologies and to establish ultrasound as a consistently reproducible, quick and accurate primary investigation modality sufficient to triage patients requiring surgical correction of full thickness rotator cuff tears. Methods: Fifty patients, clinically suspected to have rotator cuff and/or biceps tendon pathologies, with no contraindications to MRI, were evaluated by US and MRI, in a prospective cross-sectional observational study. US was done with high-frequency linear probe, and MRI was done on a 1.5-T scanner using T1 oblique sagittal, proton density (PD)/T2 fat-suppressed (FS) oblique sagittal, T1 axial, PD/T2 FS axial, T1 oblique coronal, T2 oblique coronal and PD FS oblique coronal sequences. Statistical testing was conducted with the statistical package for the social science system version SPSS 17.0. The sensitivity, specificity, PPV, NPV and accuracy were also calculated to analyze the diagnostic accuracy of US findings correlating with MRI findings. A p value less than 0.05 was taken to indicate a significant difference. Results Mean age was 45 years; 74% patients were males; 77% females and 60% males had tears. Majority of patients with rotator cuff tears were in the sixth decade of life. The frequency of tears was higher among older patients. Fourteen percent of patients had full thickness tears while 64% had partial thickness tears. US was comparable to MRI for detection of full thickness tears with overall sensitivity, specificity, PPV and accuracy of 93.8%, 100%, 100% and 98.2%, respectively (p value < 0.001). For partial thickness tears, US had overall sensitivity, specificity, PPV and accuracy of 75.6%, 82.6%, 89.5% and 78%, respectively (p value < 0.001), as compared to MRI. Subacromial-subdeltoid bursal effusion and long head of biceps tendon sheath effusion were common associated, though, non-specific findings. Conclusion Ultrasound findings in our study were found to be in significant correlation with findings on MRI in detection of rotator cuff tears. US was equivalent to MRI in detection of full thickness tears and fairly accurate for partial thickness tears. Therefore, US should be considered as the first line of investigation for rotator cuff pathologies.

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