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Comparative Study
. 2010 Feb;20(2):450-7.
doi: 10.1007/s00330-009-1561-9. Epub 2009 Sep 2.

Detection of rotator cuff tears: the value of MRI following ultrasound

Matthieu J C M Rutten  1 , Gert-Jan Spaargaren, Ton van Loon, Maarten C de Waal Malefijt, Lambertus A L M Kiemeney, Gerrit J Jager
Affiliations
Comparative Study

Detection of rotator cuff tears: the value of MRI following ultrasound

Matthieu J C M Rutten et al. Eur Radiol. 2010 Feb.

Abstract

Objective: To evaluate the need for additional magnetic resonance imaging (MRI) following ultrasound (US) in patients with shoulder pain and/or disability and to compare the accuracy of both techniques for the detection of partial-thickness and full-thickness rotator cuff tears (RCT).

Methods: In 4 years, 5,216 patients underwent US by experienced musculoskeletal radiologists. Retrospectively, patient records were evaluated if MRI and surgery were performed within 5 months of US. US and MRI findings were classified into intact cuff, partial-thickness and full-thickness RCT, and were correlated with surgical findings.

Results: Additional MR imaging was performed in 275 (5.2%) patients. Sixty-eight patients underwent surgery within 5 months. US and MRI correctly depicted 21 (95%) and 22 (100%) of the 22 full-thickness tears, and 8 (89%) and 6 (67%) of the 9 partial-thickness tears, respectively. The differences in performance of US and MRI were not statistically significant (p = 0.15).

Conclusions: MRI following routine shoulder US was requested in only 5.2% of the patients. The additional value of MRI was in detecting intra-articular lesions. In patients who underwent surgery, US and MRI yielded comparably high sensitivity for detecting full-thickness RCT. US performed better in detecting partial-thickness tears, although the difference was not significant.

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Figures

Fig. 1
Fig. 1
Full-thickness rotator cuff tear. (a) Ultrasound appearance of a full-thickness tear (arrows) at the insertion of the supraspinatus tendon (SSP). GT = greater tuberosity. (b) The corresponding oblique coronal gradient T1-weighted MR arthrography image, showing the same configuration of the full-thickness tear (arrows) of the supraspinatus tendon (SSP). GT = greater tuberosity
Fig. 2
Fig. 2
Sonographically underestimated full-thickness rotator cuff tear. Long (a) and short (b) axis ultrasound section showing an intratendinous partial-thickness tear (arrows) at the insertion of the supraspinatus tendon (SSP). GT = greater tuberosity, H = humeral head. (c) The corresponding oblique coronal gradient T1-weighted MR arthrography image, showing the same intratendinous extending tear (arrows) of the supraspinatus tendon (SSP), but also leakage of intraarticularly injected contrast media to the subacromial–subdeltoid bursa (arrowheads), suggestive of a full-thickness SSP tear, which was surgically confirmed. GT = greater tuberosity
Fig. 3
Fig. 3
Partial-thickness rotator cuff tear in the supraspinatous tendon (SSP) underestimated with conventional MRI. (a) Ultrasound showed an intratendinous partial-thickness tear (arrow) in the insertion (i.e., at the footprint) of the SSP, which was confirmed surgically. (b) The corresponding oblique coronal T2-weighted fat saturated MR image shows high signal in the SSP, which was wrongly interpreted as tendinosis. GT = greater tuberosity
Fig. 4
Fig. 4
False-positive partial-thickness rotator cuff tear in the supraspinatous tendon (SSP). Both ultrasound (a) and the corresponding oblique coronal T2-weighted fat saturated MR image (b), show an undersurface partial-thickness tear (arrow) in the insertion (i.e., at the footprint) of the SSP. However, this finding was not confirmed during surgery. GT = greater tuberosity
See this image and copyright information in PMC

References

    1. Chang CY, Wang SF, Chiou HJ, Ma HL, Sun YC, Wu HD. Comparison of shoulder ultrasound and MR imaging in diagnosing full-thickness rotator cuff tears. Clin Imaging. 2002;26:50–54. doi: 10.1016/S0899-7071(01)00323-0. - DOI - PubMed
    1. Swen WA, Jacobs JW, Algra PR, et al. Sonography and magnetic resonance imaging equivalent for the assessment of full-thickness rotator cuff tears. Arthritis Rheum. 1999;42:2231–2238. doi: 10.1002/1529-0131(199910)42:10<2231::AID-ANR27>3.0.CO;2-Z. - DOI - PubMed
    1. Vlychou M, Dailiana Z, Fotiadou A, Papanagiotou M, Fezoulidis IV, Malizos K. Symptomatic partial rotator cuff tears: diagnostic performance of ultrasound and magnetic resonance imaging with surgical correlation. Acta Radiol. 2009;50:101–105. doi: 10.1080/02841850802600764. - DOI - PubMed
    1. Nelson MC, Leather GP, Nirschl RP, Pettrone FA, Freedman MT. Evaluation of the painful shoulder. A prospective comparison of magnetic resonance imaging, computerized tomographic arthrography, ultrasonography and operative findings. J Bone Joint Surg Am. 1991;73-A:707–716. - PubMed
    1. Bachmann GF, Melzer C, Heinrichs CM, Mohring B, Rominger MB. Diagnosis of rotator cuff lesions: comparison of US and MRI on 38 joint specimens. Eur Radiol. 1997;7:192–197. doi: 10.1007/s003300050133. - DOI - PubMed

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