Evaluation of subscapularis tendon tears of the anterosuperior aspect using radial-sequence magnetic resonance imaging

JSES International

Hiroshi Negi, MD, PhD¹  Nobuo Adachi, MD, PhD²  Norimasa Matsubara, MD³  Ryosuke Matsushita, MD, PhD³  Shin Yokoya, MD, PhD³  Yuji Akiyama³ 

[1]Corresponding author: Shin Yokoya, MD, PhD, 1-5-54 Ujinakanda, Minami-ku, Hiroshima, Japan.

[2]Department of Clinical Radiology, Hiroshima University Hospital, Hiroshima, Japan

[3]Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

关键词: Rotator cuff;    Arthroscopic rotator cuff repair;    Subscapularis tendon;    Radial magnetic resonance imaging;    Classification;    Conventional magnetic resonance imaging;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Magnetic resonance imaging (MRI) is widely used to diagnose subscapularis tendon tears; however, it is difficult to assess the anterosuperior aspect of these tears. Radial-sequence MRI can reveal the fiber components of the anterosuperior aspect, from perpendicular, by overcoming the partial volume effect. We aimed to classify the insertion of subscapularis tendon tears on radial-sequence MRI and determine the effectiveness of radial-sequence MRI for subscapularis tendon tear assessments. Methods: We retrospectively investigated 196 patients (mean age, 66.7 ± 9.0 years; 118 men, 78 women) who underwent 1.5 T MRI before arthroscopic rotator cuff repair. Radial-sequence MRI findings of the anterosuperior aspect insertion of the subscapularis tendon were classified into five grades, and intraoperative findings compared with preoperative conventional MRI and radial-sequence MRI. We calculated sensitivity, specificity, accuracy, and positive and negative predictive values. Interobserver and intraobserver reliability for radial-sequence MRI classification was calculated using kappa (κ). Results: Conventional MRI sensitivity of subscapularis tendon tears was 45.3%; specificity, 95.8%; accuracy, 82.1%; positive predictive value, 80.0%; and negative predictive value, 82.5%. Radial-sequence MRI sensitivity was 92.5%; specificity, 88.1%; accuracy, 89.3%; positive predictive value, 74.2%; and negative predictive value, 96.9%. Sensitivity (P < .001), accuracy (P = .04), specificity (P = .02), and negative predictive values (P < .001) in radial-sequence MRI were significantly higher than those in conventional MRI. Intraobserver and interobserver reliabilities for radial-sequence MRI classification were κ = 0.78 and 0.65, respectively, corresponding to high reproducibility, and defined as good. Conclusion: We provide evidence that radial-sequence MRI is an effective tool to evaluate subscapularis tendon tears, especially before surgery.

【 授权许可】

Unknown