Comparisons of the Various Partial-Thickness Rotator Cuff Tears on MR Arthrography and Arthroscopic Correlation.
10.3348/kjr.2010.11.5.528
- Author:
Kyung Ah CHUN
1
;
Min Sung KIM
;
Young Joo KIM
Author Information
1. Department of Radiology, The Catholic University of Korea Uijeongbu St. Mary's Hospital, Gyeonggi-do 480-130, Korea. ka1000@catholic.ac.kr
- Publication Type:Original Article ; Comparative Study
- Keywords:
Shoulder;
MR arthrography;
Rotator cuff;
Partial-thickness tear
- MeSH:
*Arthroscopy;
Chi-Square Distribution;
Contrast Media/diagnostic use;
Female;
Gadolinium DTPA/diagnostic use;
Humans;
Image Interpretation, Computer-Assisted;
Magnetic Resonance Imaging/*methods;
Male;
Middle Aged;
Predictive Value of Tests;
Rotator Cuff/*injuries;
Sensitivity and Specificity
- From:Korean Journal of Radiology
2010;11(5):528-535
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To assess the diagnostic performance of MR arthrography in the diagnosis of the various types of partial-thickness rotator cuff tears by comparing the MR imaging findings with the arthroscopic findings. MATERIALS AND METHODS: The series of MR arthrography studies included 202 patients consisting of 100 patients with partial-thickness rotator cuff tears proved by arthroscopy and a control group of 102 patients with arthroscopically intact rotator cuffs, which were reviewed in random order. At arthroscopy, 54 articular-sided, 26 bursal-sided, 20 both articular- and bursal-sided partial-thickness tears were diagnosed. The MR arthrographies were analyzed by two radiologists for articular-sided tears, bursal-sided tears, and both articular- and bursal-sided tears of the rotator cuff. The sensitivity and specificity of each type of partial-thickness tears were determined. Kappa statistics was calculated to determine the inter- and intra-observer agreement of the diagnosis of partial-thickness rotator cuff tears. RESULTS: The sensitivity and specificity of the various types of rotator cuff tears were 85% and 90%, respectively for articular-sided tears, 62% and 95% for bursal-sided tears, as well as 45% and 99% for both articular- and bursal-sided tears. False-negative assessments were primarily observed in the diagnosis of bursal-sided tears. Conversely, both articular- and bursal-sided tears were overestimated as full-thickness tears. Inter-observer agreement was excellent for the diagnosis of articular-sided tears (k = 0.70), moderate (k = 0.59) for bursal-sided tears, and fair (k = 0.34) for both articular- and bursal-sided tears, respectively. Intra-observer agreement for the interpretation of articular- and bursal-sided tears was excellent and good, respectively, whereas intra-observer agreement for both articular- and bursal-sided tears was moderate. CONCLUSION: MR arthrography is a useful diagnostic tool for partial-thickness rotator cuff tears, but has limitations in that it has low sensitivity in bursal- and both articular- and bursal-sided tears. In addition, it shows only fair inter-observer agreement when it comes to predicting both articular- and bursal-sided tears.
