Rotator cuff tears: assessment with MR arthrography in 275 patients with arthroscopic correlation.
We assessed the diagnostic performance of magnetic resonance (MR) arthrography in the diagnosis of articular-sided partial-thickness and full-thickness rotator cuff tears in a large symptomatic population. MR arthrograms obtained in 275 patients including a study group of 139 patients with rotator cuff tears proved by arthroscopy and a control group of 136 patients with arthroscopically intact rotator cuff tendons were reviewed in random order. MR imaging was performed on a 1.0 T system (Magnetom Expert, Siemens). MR arthrograms were analyzed by two radiologists in consensus for articular-sided partial-thickness and full-thickness tears of the supraspinatus, infraspinatus, and subscapularis tendons. At arthroscopy, 197 rotator cuff tears were diagnosed, including 105 partial-thickness (93 supraspinatus, nine infraspinatus, three subscapularis) and 92 full-thickness (43 supraspinatus, 20 infraspinatus, 29 subscapularis) tendon tears. For full-thickness tears, sensitivity, specificity, and accuracy were 96%, 99%, and 98%, respectively, and for partial tears 80%, 97%, and 95%, respectively. False negative and positive assessments in the diagnosis of articular-sided partial-thickness tears were predominantly [78% (35/45)] observed with small articular-sided (Ellman grade1) tendon tears. MR arthrography is highly accurate in the diagnosis of full-thickness rotator cuff tears and is accurate in the diagnosis of articular-sided partial-thickness tears. Limitations in the diagnosis of partial-thickness tears are mainly restricted to small articular-sided tears (Ellman grade 1) due to difficulties in differentiation between fiber tearing, tendinitis, synovitic changes, and superficial fraying at tendon margins.
Waldt
S
S
Department of Radiology, Technische Universität München, Klinikum rechts der Isar, Ismaninger Strasse 22, D-81675 Munich, Germany. waldt@roe.med.tum.de
Bruegel
M
M
Mueller
D
D
Holzapfel
K
K
Imhoff
A B
AB
Rummeny
E J
EJ
Woertler
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D001175:Arthrography; D001182:Arthroscopy; D016022:Case-Control Studies; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D005858:Germany; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012107:Research Design; D017006:Rotator Cuff / Q000473:pathology*; D000070636:Rotator Cuff Injuries; D012680:Sensitivity and Specificity; D012782:Shoulder / Q000473:pathology; D013708:Tendon Injuries / Q000473:pathology