Visual MRI Grading System to Evaluate Atrophy of the Supraspinatus Muscle.
	    		
		   		
		   			
		   		
	    	
    	 
    	10.3348/kjr.2014.15.4.501
   		
        
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Hyun Kyong LIM
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Sung Hwan HONG
			        		
			        		;
		        		
		        		
		        		
			        		Hye Jin YOO
			        		
			        		;
		        		
		        		
		        		
			        		Ja Young CHOI
			        		
			        		;
		        		
		        		
		        		
			        		Sae Hoon KIM
			        		
			        		;
		        		
		        		
		        		
			        		Jung Ah CHOI
			        		
			        		;
		        		
		        		
		        		
			        		Heung Sik KANG
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Department of Radiology, Seoul National University College of Medicine, Seoul 110-744, Korea. drhong@snu.ac.kr
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Original Article
 
        	
        	
        		- Keywords:
        			
	        			
	        				
	        				
			        		
				        		Rotator cuff tear;
			        		
			        		
			        		
				        		Supraspinatus muscle;
			        		
			        		
			        		
				        		Muscular atrophy;
			        		
			        		
			        		
				        		Magnetic resonance imaging;
			        		
			        		
			        		
				        		Occupation ratio
			        		
			        		
	        			
        			
        		
 
        	
            
            	- MeSH:
            	
	        			
	        				
	        				
				        		
					        		Adult;
				        		
			        		
				        		
					        		Aged;
				        		
			        		
				        		
					        		Feasibility Studies;
				        		
			        		
				        		
					        		Female;
				        		
			        		
				        		
					        		Humans;
				        		
			        		
				        		
					        		Joint Diseases;
				        		
			        		
				        		
					        		Magnetic Resonance Imaging;
				        		
			        		
				        		
					        		Male;
				        		
			        		
				        		
					        		Middle Aged;
				        		
			        		
				        		
					        		Muscular Atrophy/diagnosis/*pathology;
				        		
			        		
				        		
					        		Observer Variation;
				        		
			        		
				        		
					        		Reference Standards;
				        		
			        		
				        		
					        		Reproducibility of Results;
				        		
			        		
				        		
					        		Retrospective Studies;
				        		
			        		
				        		
					        		Rotator Cuff/*pathology;
				        		
			        		
				        		
					        		Young Adult
				        		
			        		
	        			
	        			
            	
            	
 
            
            
            	- From:Korean Journal of Radiology
	            		
	            		 2014;15(4):501-507
	            	
            	
 
            
            
            	- CountryRepublic of Korea
 
            
            
            	- Language:English
 
            
            
            	- 
		        	Abstract:
			       	
			       		
				        
				        	OBJECTIVE: To investigate the interobserver reproducibility and diagnostic feasibility of a visual grading system for assessing atrophy of the supraspinatus muscle on magnetic resonance imaging (MRI). MATERIALS AND METHODS: Three independent radiologists retrospectively evaluated the occupying ratio of the supraspinatus muscle in the supraspinatus fossa on 192 shoulder MRI examinations in 188 patients using a 3-point visual grading system (1, > or = 60%; 2, 30-59%; 3, < 30%) on oblique sagittal T1-weighted images. The inter-reader agreement and the agreement with the reference standard (3-point grades according to absolute occupying ratio values quantitatively measured by directly contouring the muscles on MRI) were analyzed using weighted kappa. The visual grading was applied by a single reader to a group of 100 consecutive patients who had undergone rotator cuff repair to retrospectively determine the association between the visual grades at preoperative state and postsurgical occurrences of retear. RESULTS: The inter-reader weighted kappa value for the visual grading was 0.74 when averaged across three reader pairs (0.70-0.77 for individual reader pairs). The weighted kappa value between the visual grading and the reference standard ranged from 0.75 to 0.83. There was a significant difference in retear rates of the rotator cuff between the 3 visual grades of supraspinatus muscle atrophy on MRI in univariable analysis (p < 0.001), but not in multivariable analysis (p = 0.026). CONCLUSION: The 3-point visual grading system may be a feasible method to assess the severity of supraspinatus muscle atrophy on MRI and assist in the clinical management of patients with rotator cuff tear.