TITLE:
Surgeon-Operated In-Office Ultrasonography for the Diagnosis of Rotator Cuff Tears: A Comparison with Magnetic Resonance Imaging
AUTHORS:
Tsutomu Kobayashi, Atsushi Yamamoto, Hitoshi Shitara, Tsuyoshi Ichinose, Eiji Takasawa, Daisuke Shimoyama, Toshihisa Osawa, Kenji Takagishi
KEYWORDS:
Diagnostic Accuracy; Magnetic Resonance Imaging; Rotator Cuff Tear; Ultrasonography; Arthroscopic Surgery
JOURNAL NAME:
Surgical Science,
Vol.4 No.9A,
August
2,
2013
ABSTRACT: Objective: Few investigators have evaluated whether ultrasonography operated
by a surgeon during a patient’s clinic visit is capable of obtaining a similar
degree of accuracy as magnetic resonance imaging in regard to the diagnosis of
rotator cuff tears and lesions of the biceps tendon. The purpose of this study
was to clarify the accuracy of in-office ultrasonography for
the diagnosis of rotator cuff tears in comparison to magnetic resonance
imaging. Methods: One hundred
and three patients (105 shoulders) with a clinical diagnosis of impingement and
suspected rotator cuff tear, who subsequently underwent arthroscopic surgery
were retrospectively enrolled in this study, including 7 males with 89
shoulders, and 33 females with 33 shoulders, and their mean age was 60.9 years
(range, 30 to 83 years). The subjects were examined using ultrasonography and
magnetic resonance imaging within three months pre-operatively per normal
practice of the outpatient clinic. The two modalities were then compared to the
reference standard, arthroscopic findings. Results: Intra-operatively, 79 full-thickness and 15 partial-thickness rotator cuff
tears were found. The agreement between ultrasonography and magnetic resonance
imaging for diagnosis of rotator cuff tears was statistically good; observed
degree of agreement was 87% with Kappa coefficient of 0.73. Ultrasonography
showed a sensitivity of 94% and a specificity of 100% for full-thickness tears,
and a sensitivity of 80% and a specificity of 91% for partial-thickness tears.
The agreement of the two modalities for diagnosis of lesions of the biceps
tendon was also good; observed degree of agreement was 93% with Kappa
coefficient of 0.76. In addition, ultrasonography showed comparable accuracy
for classifying the size of rotator cuff tears to that of magnetic resonance
imaging. Conclusion: Surgeon-operated in-office ultrasonography is an appropriate technique for the
assessment of rotator cuff tears with a comparable sensitivity and specificity
to that of magnetic resonance imaging.