Min Sung Kim MD, Abstract Co-Author: Nothing to Disclose

Kyung Ah Chun MD, Presenter: Nothing to Disclose

Young-Joo Kim MD, PhD, Abstract Co-Author: Nothing to Disclose

To assess the diagnostic performance of MR arthrography in the diagnosis of different types ( articular side tear, bursal side tear, both articular and bursal side tear) of partial-thickness rotator cuff tears by comparing with arthroscopic findings.

MR arthrography obtained in 202 patients including 99 patients with partial-thickness rotator cuff tears proved by arthroscopy and a control group of 103 patients with arthroscopically intact rotator cuff were reviewed in random order. The protocol for MR arthrography consisted of axial, oblique coronal, oblique sagittal fat-suppressed T1-weighted sequences, oblique coronal T2-weighted sequence, abduction external rotation oblique axial fat-suppressed T1-weighted sequence if the patient is able to tolerate this position. MR arthrography were analyzed by two radiologists in consensus for articular side tear, bursal side tear, both articular and bursal side tears of rotator cuff. The sensitivity and specificity of each type of partial tear were determined. Kappa statistic was calculated to determine the interobserver agreement in the identification of partial-thickness rotator cuff tears.

At arthroscopy, 53 articular side, 27 bursal side, 19 both articular and bursal side partial-thickness tendon tears were diagnosed. For articular side tears, sensitivity, and specificity were 85% and 97%, for bursal side tears, 67% and 99%, and for both articular and bursal side tears, 58% and 100%. False negative assessments in the diagnosis of bursal side tear were predominantly observed. Both side tear was overestimated as full-thickness tear. Interobserver agreement was good in identification of articular side tear ( kappa = 0.75 ) and moderate ( kappa = 0.54 ) in identification of bursal side tear.

MR arthrography is useful tool in diagnosing partial-thickness rotator cuff tears, but has limitations with low sensitivity in bursal tear. Both articular and bursal side rotator cuff tear may mimic full-thickness tear in evaluation with MR arthrography.

MR arthrography can demonstrate different type of partial rotator cuff tear and is recommended in the evaluation of suspected rototor cuff injury.

Kim, M, Chun, K, Kim, Y, Partial-Tickness Rotator Cuff Tears: MR Arthrography with Arthroscopic Correlation.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5015688.html