Supraspinatus tendon tears at 3.0 T shoulder MR arthrography: diagnosis with 3D isotropic turbo spin-echo SPACE sequence versus 2D conventional sequences

ObjectiveTo assess the diagnostic performance of shoulder MR arthrography with 3D isotropic fat-suppressed (FS) turbo spin-echo sequence (TSE-SPACE) for supraspinatus tendon tears in comparison with 2D conventional sequences at 3.0 T.Materials and methodsThe study was HIPAA-compliant and approved by the institutional review board with a waiver of informed consent. Eighty-seven arthroscopically confirmed patients who underwent 3.0 T shoulder MR arthrography with 2D sequences and 3D TSE-SPACE were included in a consecutive fashion from March 2009 to February 2010. Two reviewers independently analyzed 2D sequences and 3D TSE-SPACE. Sensitivity, specificity, accuracy, and interobserver agreement (κ) were compared between 2D sequences and 3D TSE-SPACE for full-thickness and partial-thickness supraspinatus tendon tears together and for partial-thickness supraspinatus tendon tears alone.ResultsThere were 33 full-thickness tears and 28 partial-thickness tears of supraspinatus tendons. For full-thickness and partial-thickness supraspinatus tendon tears together, the mean sensitivity, specificity, and accuracy of both readers were 96, 92, and 94% on 2D sequences and 91, 84, and 89% on 3D TSE-SPACE. For partial-thickness supraspinatus tendon tears alone, the mean sensitivity, specificity, and accuracy were 95, 92, and 94% on 2D sequences and 84, 85, and 84% on 3D TSE-SPACE. There was no statistical difference between 2D sequences and 3D TSE-SPACE. Interobserver agreements were almost perfect on 2D conventional sequences and substantial on 3D TSE-SPACE.ConclusionCompared with 2D conventional sequences, MR arthrography using 3D TSE-SPACE was comparable for diagnosing supraspinatus tendon tears despite limitations in detecting small partial-thickness tears and in discriminating between full-thickness and deep partial-thickness tears.

[1]  Andrea J. Frangos,et al.  Accuracy of MRI, MR arthrography, and ultrasound in the diagnosis of rotator cuff tears: a meta-analysis. , 2009, AJR. American journal of roentgenology.

[2]  Richard Kijowski,et al.  Knee joint: comprehensive assessment with 3D isotropic resolution fast spin-echo MR imaging--diagnostic performance compared with that of conventional MR imaging at 3.0 T. , 2009, Radiology.

[3]  W. Jee,et al.  Magnetic resonance arthrography including aber view in diagnosing partial-thickness tears of the rotator cuff: Accuracy, and inter- and intra-observer agreements , 2010, Acta radiologica.

[4]  W. Stetson,et al.  The use of magnetic resonance arthrography to detect partial-thickness rotator cuff tears. , 2005, The Journal of bone and joint surgery. American volume.

[5]  J C Gore,et al.  Factors influencing contrast in fast spin-echo MR imaging. , 1992, Magnetic resonance imaging.

[6]  L. Higgins,et al.  Rim-rent tear of the rotator cuff: a common and easily overlooked partial tear. , 2007, AJR. American journal of roentgenology.

[7]  A. Tomonaga,et al.  Partial-thickness tears of the rotator cuff. A clinicopathological review based on 66 surgically verified cases. , 1996, International orthopaedics.

[8]  M. Matava,et al.  Partial-Thickness Rotator Cuff Tears , 2005, The American journal of sports medicine.

[9]  B. Flannigan,et al.  MR arthrography of the shoulder: comparison with conventional MR imaging. , 1990, AJR. American journal of roentgenology.

[10]  J. Yoo,et al.  Comparison of indirect isotropic MR arthrography and conventional MR arthrography of labral lesions and rotator cuff tears: a prospective study. , 2009, AJR. American journal of roentgenology.

[11]  J. H. Brown,et al.  Rotator cuff: evaluation with fat-suppressed MR arthrography. , 1993, Radiology.

[12]  H. Genant,et al.  MR arthrographic depiction of tears of the rotator cuff: benefit of abduction and external rotation of the arm. , 1994, Radiology.

[13]  Philip J Beatty,et al.  Isotropic MRI of the knee with 3D fast spin-echo extended echo-train acquisition (XETA): initial experience. , 2007, AJR. American journal of roentgenology.

[14]  T. Magee.  Can isotropic fast gradient echo imaging be substituted for conventional T1 weighted sequences in shoulder MR arthrography at 3 Tesla? , 2007, Journal of magnetic resonance imaging : JMRI.

[15]  K. Meister,et al.  MR arthrography of partial thickness tears of the undersurface of the rotator cuff: an arthroscopic correlation , 2004, Skeletal Radiology.

[16]  B. Shaffer,et al.  New approaches to diagnosis and arthroscopic management of partial-thickness cuff tears. , 2008, Clinics in sports medicine.

[17]  J. Beltrán,et al.  Shoulder MR arthrography: how, why, when. , 2005, Radiologic clinics of North America.

[18]  W. Bautz,et al.  Direct MR arthrography of the shoulder: 2D vs. 3D gradient-echo imaging. , 2001, Magnetic resonance imaging.

[19]  M. Schickendantz,et al.  Shoulder MRI: what do we miss? , 2010, AJR. American journal of roentgenology.

[20]  T. Magee,et al.  3.0-T MRI of the supraspinatus tendon. , 2006, AJR. American journal of roentgenology.

[21]  Joong K. Lee,et al.  Horizontal component of partial-thickness tears of rotator cuff: imaging characteristics and comparison of ABER view with oblique coronal view at MR arthrography initial results. , 2002, Radiology.

[22]  T. Magee.  3-T MRI of the shoulder: is MR arthrography necessary? , 2009, AJR. American journal of roentgenology.

[23]  J. Hanley,et al.  The meaning and use of the area under a receiver operating characteristic (ROC) curve. , 1982, Radiology.

[24]  Richard Kijowski,et al.  Effects of refocusing flip angle modulation and view ordering in 3D fast spin echo , 2008, Magnetic resonance in medicine.

[25]  J. Yoo,et al.  Three-dimensional isotropic shoulder MR arthrography: comparison with two-dimensional MR arthrography for the diagnosis of labral lesions at 3.0 T. , 2009, Radiology.

[26]  D Resnick,et al.  Rotator cuff disease: assessment with MR arthrography versus standard MR imaging in 36 patients with arthroscopic confirmation. , 1992, Radiology.

[27]  Christopher F. Beaulieu,et al.  Ankle: isotropic MR imaging with 3D-FSE-cube--initial experience in healthy volunteers. , 2008, Radiology.

[28]  H Ellman,et al.  Diagnosis and treatment of incomplete rotator cuff tears. , 1990, Clinical orthopaedics and related research.

[29]  R. Ramnath.  3T MR imaging of the musculoskeletal system (Part II): clinical applications. , 2006, Magnetic resonance imaging clinics of North America.