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

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.

scholarly journals Rotátorköpeny-szakadás után kialakult zsíros degeneráció változása az ín rekonstrukcióját követően, 65 éves kor után

2019 ◽  
Vol 160 (14) ◽  
pp. 533-539
Author(s):  
Imre Sallai ◽  
Márton Weidl ◽  
Attila Szatmári ◽  
Imre Antal ◽  
Gábor Skaliczki
Keyword(s):  
Rotator Cuff ◽  
Muscle Atrophy ◽  
Rotator Cuff Repair ◽  
Constant Score ◽  
Fatty Degeneration ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Before And After ◽  
Cuff Repair

Abstract: Introduction: In the case of rotator cuff tears, the severity of the muscle atrophy and fatty degeneration has an effect on the success of the repair and on the functional outcome after surgery. Aim: The ability of regeneration reduces with ageing; therefore, the study examined the atrophy and the fatty degeneration after rotator cuff repair in patients over 65. Method: Eleven patients over 65 years of age were involved whose surgery was performed at the Department of Orthopaedics of Semmelweis University between 2012 and 2015. Their average age was 71.9 years and the average follow-up period was 39.9 months. Tear sizes were C1 in 3 cases, C2 in 3 cases, C3 in 4 cases, and C4 in 1 case. Each patient had magnetic resonance examination before and after the repair; the muscle atrophy and fatty degeneration were evaluated together with the type of the tear. Visual analogue scale and Constant score were used for the assessment of the pain and the shoulder function. Results: The average Constant score was 75 points. The occupancy ratio – referring to the severity of the atrophy – did not show significant improvement. The change in fatty degeneration and the atrophy were examined in different groups according to the size of the tears. In each group, the results showed progression. Conclusions: After rotator cuff repair in patients over 65, fatty degeneration and muscle atrophy also show progression. No significant relationship was found between the size of the tear and fatty degeneration or between the size of the tear and muscle atrophy. Orv Hetil. 2019; 160(14): 533–539.

Correlation Between Age and Tendon Strength in Supraspinatus Tendon With Full-Thickness Tears

2013 ◽  
Author(s):  
R. Matthew Miller ◽  
Daisuke Araki ◽  
Yoshimasa Fujimaki ◽  
Volker Musahl ◽  
Richard E. Debski
Keyword(s):  
Rotator Cuff ◽  
Treatment Outcomes ◽  
Clinical Problem ◽  
Supraspinatus Tendon ◽  
Fatty Degeneration ◽  
Rotator Cuff Tears ◽  
Full Thickness ◽  
Insufficient Information ◽  
Poor Treatment ◽  
The Relationship

Degenerative tears of the rotator cuff tendons are a significant clinical problem, with an incidence of more than 30% in asymptomatic persons over the age of 60 [1]. As the population continues to age, the incidence of partial and full-thickness rotator cuff tears continues to increase [2], with previous studies finding that greater age also correlates with worse surgical outcomes and increased fatty degeneration in the tissue [3]. Although the relationship between age, rotator cuff injury, and poor treatment outcomes has been previously established, insufficient information exists on the biological and mechanical changes in the tissue due to aging.

scholarly journals Is the Supraspinatus Muscle Atrophy Truly Irreversible after Surgical Repair of Rotator Cuff Tears?

2013 ◽  
Vol 5 (1) ◽  
pp. 55 ◽  
Author(s):  
Seok Won Chung ◽  
Sae Hoon Kim ◽  
Suk-Kee Tae ◽  
Jong Pil Yoon ◽  
Jung-Ah Choi ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Muscle Atrophy ◽  
Surgical Repair ◽  
Rotator Cuff Tears ◽  
Supraspinatus Muscle

Fatty infiltration in the intact supraspinatus tendon; a normal physiological response with increasing age and female gender

2021 ◽  
pp. 175857322110245
Author(s):  
Ailsa Wilson ◽  
Simon BM MacLean
Keyword(s):  
Rotator Cuff ◽  
Muscle Atrophy ◽  
Surgical Repair ◽  
Fatty Infiltration ◽  
Female Gender ◽  
Supraspinatus Tendon ◽  
Rotator Cuff Tears ◽  
Supraspinatus Muscle ◽  
Cuff Tear ◽  
3.0 T

Background Fatty infiltration and muscle atrophy of supraspinatus are used as markers of chronicity in rotator cuff tears and are known to both be independently related to poorer outcomes following surgical repair.1 We hypothesized that supraspinatus muscle atrophy and fatty infiltration increases with age irrespective of whether the rotator cuff is intact and therefore cannot be used as accurate markers for chronicity. Method Retrospective review of 280 patients who underwent 3.0 T shoulder MRI’s with either a normal scan or rotator cuff tear. Two independent observers reviewed the images. Data collected included intact rotator cuff tendons looking specifically at supraspinatus muscle height/length: suprascapular fossa ratio, tangent sign and Goutallier grade for fatty infiltration. Results There were 90 scans with intact rotator cuff tendons. Mean age was 51 years (range 17–86); 52 males, 38 females. On multiple regression analysis, there was a positive correlation of age with fatty infiltration and muscle atrophy on all parameters in the normal intact cuff. Females were significantly more likely than males to have a higher grade of fatty infiltration. Conclusion Age and female gender are risk factors for rotator cuff atrophy and fatty infiltration in patients with normal rotator cuffs. Therefore, these parameters should be used with caution by surgeons when deciding on tear chronicity and the potential to repair the torn rotator cuff.

scholarly journals Comparison of Clinical and Anatomical Outcomes between Delaminated Rotator Cuff Tear and Single Layer Rotator Cuff Tear

2018 ◽  
Vol 21 (4) ◽  
pp. 207-212 ◽  
Author(s):  
Jin Woo Park ◽  
Sung Hoon Moon ◽  
Jun Hee Lee
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Rotator Cuff Tear ◽  
Muscle Atrophy ◽  
Single Layer ◽  
Fatty Degeneration ◽  
Rotator Cuff Tears ◽  
Cuff Tear ◽  
Group 2 ◽  
Group 1

BACKGROUND: Delaminated rotator cuff tear is known to be a degenerative tear having a negative prognostic effect. This study undertook to compare the anatomical and clinical outcomes of delaminated tears and single layer tears.METHODS: Totally, 175 patients with medium to large rotator cuff tears enrolled for the study were divided into 2 groups, based on the tear pathology: single layer tear (group 1) and delaminated tear (group 2). Preoperatively, length of the remnant tendon, muscle atrophy of supraspinatus (SS), and fatty degeneration of SS and infraspinatus (IS) muscles were assessed on magnetic resonance imaging (MRI). For follow-up, the repair integrity of the rotator cuff was evaluated by ultrasonography. Clinical outcomes were assessed by evaluating the Constant score (CS) and Korean Shoulder Score (KSS).RESULTS: Retears were detected in 6 cases of group 1 (6.5%) and 11 cases of group 2 (13.3%). Although higher in group 2, the retear rate was significantly not different (p=0.133). Preoperative MRI revealed length of remnant tendon to be 15.46 ± 3.60 mm and 14.17 ± 3.16 mm (p=0.013), and muscle atrophy of SS (occupation ratio) was 60.54 ± 13.15 and 56.55 ± 12.88 (p=0.045), in group 1 and group 2, respectively. Fatty degeneration of SS and IS in both groups had no significant differences. Postoperatively, no significant differences were observed for CS and KSS values between the groups.CONCLUSIONS: Delaminated rotator cuff tears showed shorter remnant tendon length and higher muscle atrophy that correlate to a negative prognosis. These prognostic effects should be considered during delaminated rotator cuff tear treatment.

Full-Thickness Rotator Cuff Tears in the Throwing Athlete

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

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

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.

Long-term survivorship and outcomes after surgical repair of full-thickness rotator cuff tears

2011 ◽  
Vol 20 (4) ◽  
pp. 591-597 ◽  
Author(s):  
Peter J. Millett ◽  
Marilee P. Horan ◽  
Katie E. Maland ◽  
Richard J. Hawkins
Keyword(s):  
Rotator Cuff ◽  
Surgical Repair ◽  
Rotator Cuff Tears ◽  
Full Thickness
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