title: Quantitative diffusion-weighted magnetic resonance imaging for the diagnosis of partial-thickness rotator cuff tears.
abstract: BACKGROUND
  This study investigated diffusion-weighted (DWI) magnetic resonance imaging (MRI) as an alternative to fat-suppressed T2-weighted imaging (FS-T2WI) for assessment of partial-thickness rotator cuff tears (RCTs).
  
  
  METHODS
  Patients with arthroscopy proven partial-thickness RCTs who also received MRI (FS-T2WI and DWI) before surgery were prospectively included. Receiver operating characteristic curves were used to compare DWI vs. FS-T2WI using lesion-to-muscle signal intensity ratios. A cutoff point for predicting partial-thickness tears was determined using the Youden index.
  
  
  RESULTS
  Included were 146 patients, with a mean age of 48.3 years (range, 19-86 years), of whom 43 had full-thickness RCTs, 67 had partial-thickness RCTs, and 36 had no tears. Areas under receiver operating characteristic curves for diagnosing partial-thickness tears were significantly higher for DWI (0.910) than for FS-T2WI (0.822, P = .016). Lesion-to-muscle signal intensity ratio cutoff values were 1.06 for DWI vs. 1.65 for FS-T2WI, respectively. The sensitivity and accuracy of DWI (89.1% [98 of 110] and 87.7% [128 of 146], respectively) for diagnosing partial-thickness and full-thickness tears were higher than for FS-T2WI (65.5% [72 of 110] and 72.6% [106 of 146], respectively). FS-T2WI, however, had higher specificity (94.4% [34 of 36]) than DWI (83.3% [30 of 36]).
  
  
  CONCLUSIONS
  DWI is more accurate and sensitive than FS-T2WI for diagnosing partial-thickness RCTs.
authors.affiliation: Department of Radiology, Tao-Yuan Armed Forces General Hospital, Tao-Yuan, Taiwan; Department of Diagnostic Radiology, National Defense Medical Center, Triservice General Hospital, Taipei, Taiwan. Electronic address: worenlo@ms46.hinet.net.
authors.forename: Huan-Chu
authors.initials: HC
authors.lastname: Lo
authors.affiliation: Othropaedic Department, Tao-Yuan Armed Forces General Hospital, Tao-Yuan, Taiwan.
authors.forename: Sheng-Tsai
authors.initials: ST
authors.lastname: Hung
authors.affiliation: Department of Radiology, Tao-Yuan Armed Forces General Hospital, Tao-Yuan, Taiwan.
authors.forename: Duen-Pang
authors.initials: DP
authors.lastname: Kuo
authors.affiliation: Department of Radiology, Tao-Yuan Armed Forces General Hospital, Tao-Yuan, Taiwan.
authors.forename: Yen-Lin
authors.initials: YL
authors.lastname: Chen
authors.affiliation: Othropaedic Department, Tao-Yuan Armed Forces General Hospital, Tao-Yuan, Taiwan.
authors.forename: Hung-Maan
authors.initials: HM
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000070636:Rotator Cuff Injuries / Q000175:diagnosis* / Q000601:surgery; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Diffusion-weighted; MR imaging; fat-suppressed T2-weighted MRI; full-thickness tears; partial-thickness; rotator cuff tears