TITLE:
Comparison with Surgical Findings for the Accuracy of Routine MRI in Rotator Cuff Tears
AUTHORS:
Narendra Darai, Suvash Pokhrel, Rongbao Shu, Xiaojuan Zhang, Jiacheng Liu, Gaojun Teng
KEYWORDS:
Shoulder Joint, Partial-Thickness Rotator Cuff Tears (PTT), Full-Thickness Rotator Cuff Tears (FTT), Magnetic Resonance Imaging (MRI)
JOURNAL NAME:
Open Journal of Radiology,
Vol.6 No.2,
June
2,
2016
ABSTRACT: Objective: To evaluate the diagnostic efficacy of magnetic
resonance imaging (MRI) for the detection of partial-thickness rotator cuff
tears (PTT) and full-thickness rotator cuff tears(FTT) by comparing its
findings with surgical findings as the gold standard and to improve the
previous MRI accuracy in diagnosing rotator cuff tears (RCT) considering more
variables. Methods: In 45 months, 804
patients underwent MRI shoulder joint. Among them, only 95 cases had undergone
both MRI imaging and surgery accordingly. The patient records were evaluated
retrospectively if MRI and surgery were performed within 40 days of MRI. MRI
findings were categorized into PTT, FTT and no tears which were further divided
into different types according to four main nominal data as variables viz.
site, size, shape and muscle involvement in RCT and were correlated with
surgical findings for statistical calculation by using Kappa coefficient and McNemar
Bowker test. Results: 81 patients (86
RCTs) underwent surgery within 40 days. On the basis of site as variable, MRI
correctly depicted 100% of full thickness tears(FTT), 85% of bursal partial
thickness tears(PTT), 80.4% of articular partial thickness tears(PTT). The
consistency in diagnosis of RCT between MRI and surgery was moderate (Kappa
coefficient 0.645). Overall sensitivity, specificity and accuracy of MRI for
diagnosing PTT was 87.3%, 53.3% and 81.3%; and that for FTT was 100%, 98.7% and
98.8% respectively. Likewise on the basis of size, shape and muscles involved,
the consistency between MRI and surgery was poor for size and shape and
moderate for muscles involved; and the difference in diagnosing RCT by MRI and
surgery was significant for shape (P = 0.002) only, but not significant for
size (P = 0.16) and for muscles involved (P = 0.206) respectively. The
agreement between MRI and surgery in diagnosing calcific tendinitis and
shoulder joint hematoma with Kappa coefficient is (0.577) and (0.556)
respectively. Conclusion: MRI has
better accuracy for detecting FTT and has high sensitivity and positive
predictive value in diagnosing both PTT and FTT. Combining more others
variables in addition to RCT, MRI offers a great value in diagnosing RCT.