Objective: A comparison of the difference between the two types of field MR scan in diagnosis of shoulder joint injury. Method: Randomly selected 153 patients with arthroscopic or open arthroplasty who had shoulder pain or dysfunction treated in our hospital from 2014 to 2017 were divided into 1.5 T group and 3.0 according to the field strength of MRI examination. Postoperative pathology was a gold standard. The sensitivity, specificity, consistency, and predictive value of two field-strength MRI examinations in the diagnosis of rotator cuff tears were calculated and compared. Results: The sensitivity, specificity, crude consistency, positive predictive value, and negative predictive value of the 1.5 T group were 68.75%, 82.35%, 73.47%, 88.00%, and 58.33%, respectively. The 3.0 T group was 72.22%, 89.47%, 78.18%, 92.86% and 62.96%, the differences between the above indicators were not statistically significant ( P > 0.05). Conclusion: There was no difference in the authenticity and benefit index of rotator cuff injury diagnosed by 1.5 T and 3.0 T MRI.
With the increasing aging in China, shoulder joint pain has become a common and frequent clinical condition. Rotator cuff injuries account for about 17% to 41% of shoulder pain and are increasingly recognized and emphasized by clinicians [
The 153 patients with shoulder pain or dysfunction who underwent arthroscopic or open repair from 2014 to 2017 were randomly selected and divided into 1.5 T and 3.0 T groups. 1.5 T group included 67 males and 31 females; 17 had a history of trauma; 36 had arthroscopic surgery and 62 had open tendon-tendon and tendon-bone repair. 3.0 T group included 36 males and 19 females; 10 patients had a history of trauma; 20 patients had arthroscopic surgery and 55 patients had open tendon-tendon and tendon-bone repair surgery. The differences in baseline data between the two groups were not statistically significant (P > 0.05) and were comparable.
Siemens Magneton Avanto 1.5 T MRI scanner, Siemens Magne Ton Verio 3.0 T MRI scanner. For conventional MR scanning, the patient was scanned in a supine position with the upper arm externally rotated (palm up), head first, and the shoulder joint as close to the midline of the bed as possible. The sequence included PDWI in transverse axis, FSTE T1WI (layer thickness 4 mm, spacing 0.4 mm), PDWI in oblique coronal position, FSTE T1WI (layer thickness 4 mm, spacing 0.4 mm), and PDWI in oblique sagittal position (layer thickness 4 mm, spacing 0.4 mm) for scanning. FOV): 180 × 180 mm.
The films were reviewed and diagnosed by two or more attending physicians independently, and finally compared with the intraoperative diagnosis of the shoulder joint. The MRI diagnosis of a complete rotator cuff tear was based on the following accepted diagnostic criteria [
The patients were operated by experienced orthopedic surgeons or above, and the MRI images were carefully compared with the 1.5 T or 3.0 T MRI images to determine whether the rotator cuff was damaged.
Data analysis was performed using SPSS19.0.
The rotator cuff is composed of supraspinatus, infraspinatus, subscapularis and teres minor tendons. It plays a major role in the movement of the shoulder joint
| Operation | MRI | Total | ||
|---|---|---|---|---|
| 1.5 T | Positive | 44 | 6 | 50 |
| Negative | 20 | 28 | 48 | |
| Total | 64 | 34 | 98 | |
| 3.0 T | Positive | 26 | 2 | 28 |
| Negative | 10 | 17 | 27 | |
| Total | 36 | 19 | 55 | |
| Sensibility | Specificity | Uniformity | Positive predictive value | Negative predictive value | |
|---|---|---|---|---|---|
| 1.5 T | 68.75 | 82.35 | 73.47 | 88.00 | 58.33 |
| 3.0 T | 72.22 | 89.47 | 78.18 | 92.86 | 62.96 |
| c2 | 0.13 | 0.09 | 0.42 | 0.08 | 0.15 |
and maintains the stability of the shoulder joint. Rotator cuff injury can lead to shoulder pain and limited function. Except for a few cases of trauma, most of them are caused by peak impact syndrome [
With high spatial and tissue resolution, MRI can diagnose rotator cuff injury, which is recognized by more and more clinicians and patients. However, the quality of MRI with different field strengths is different, and the inspection cost of medium and high-end MRI scanner is expensive. At this stage, China is in the objective national conditions of developing countries, and there are restrictions on the unbalanced allocation of regional medical treatment. Some economically relatively backward areas can not pursue the actual situation of high-end equipment, and patients in such areas sometimes cannot afford high examination costs.
In order to make the clinical diagnosis of rotator cuff injury more accurate and reliable, based on the results of surgical diagnosis, this study compared and analyzed the clinical data of the value of two field intensity MRI in the diagnosis of rotator cuff injury. The selected evaluation indexes include sensitivity, specificity, positive predictive value and negative predictive value.
In conclusion, using surgical diagnostic results as the gold standard, no difference was found in the veracity and yield indexes of 1.5 T and 3.0 T MRI for the diagnosis of rotator cuff injury in the absence of shoulder arthrography, suggesting that there is no need to pursue high-end MRI equipment in economically underdeveloped areas and that 3.0 T MRI is unnecessary for patients with poor financial income with suspected rotator cuff injury to reduce the patient’s burden of diagnosis and treatment. The burden of disease is reduced.
The authors declare no conflicts of interest regarding the publication of this paper.
Li, X., Shi, W.D., Xu, F., Li, Q.S. and Xiao, X. (2022) Investigation of the Value of Different Field Strength MRI Scans for the Diagnosis of Rotator Cuff in Juries. Open Journal of Radiology, 12, 32-36. https://doi.org/10.4236/ojrad.2022.121004