title: Delaminated tears of the rotator cuff: prevalence, characteristics, and diagnostic accuracy using indirect MR arthrography.
abstract: OBJECTIVE. The purpose of this study was to evaluate the prevalence, radiologic characteristics, and accuracy of diagnosing delaminated tears at the supraspinatus tendon-infraspinatus tendon (SST-IST) on indirect MR arthrography. MATERIALS AND METHODS. Of 531 consecutive shoulders that underwent indirect MR arthrography, 231 shoulders with tears at the SST-IST were included. On the MR images, delaminated tears at the SST-IST, defined as intratendinous horizontal splitting between the articular and bursal layers of the SST-IST with or without different degrees of retraction between the two layers, were identified and classified into six types. Other radiologic findings of the SST-IST, such as the presence of intramuscular cysts, were evaluated. We used video records of 127 arthroscopic surgeries to determine the diagnostic accuracy of indirect MRI for the detection of the delaminated tears at the SST-IST. RESULTS. On MRI, 56% (129/231) of shoulders with SST-IST tears had delaminated tears. Articular-delaminated full-thickness tears (n = 58) and articular-delaminated partial-thickness tears (n = 64) were the most common types. Approximately 82% (36/44) of articular-delaminated full-thickness tears occurring at the SST were combined with articular-delaminated partial-thickness tears at the IST. SST-IST footprint tears and intramuscular cysts were significantly more common in the shoulders with delaminated tears. The sensitivity and specificity of indirect MR arthrography for detection of delaminated tears were 92% and 94%, respectively. CONCLUSION. On indirect MR arthrography, approximately half of the shoulders with SST-IST tears had delaminated tears. The diagnostic accuracy of indirect MR arthrography for detection of delaminated tears was high.
authors.affiliation: 1 Department of Radiology, College of Medicine, Inje University Busan Paik Hospital, Gaegeum-dong Jin-gu, Busan, Korea 614-735.
authors.forename: Hye Jung
authors.initials: HJ
authors.lastname: Choo
authors.forename: Sun Joo
authors.initials: SJ
authors.lastname: Lee
authors.forename: Jung-Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Kim
authors.forename: Young-Mi
authors.initials: YM
authors.lastname: Park
authors.forename: Ok Hwa
authors.initials: OH
authors.lastname: Kim
authors.forename: Seon Jeong
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001175:Arthrography / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D000070636:Rotator Cuff Injuries; D013708:Tendon Injuries / Q000175:diagnosis* / Q000453:epidemiology*; D055815:Young Adult
keywords: MRI; arthrography; rotator cuff; shoulder