Joon-Yong Jung MD, Presenter: Nothing to Disclose

Won-Hee Jee MD, Abstract Co-Author: Nothing to Disclose

Michael Y. Park MD, Abstract Co-Author: Nothing to Disclose

So-Yeon Lee, Abstract Co-Author: Nothing to Disclose

Yang-Soo Kim MD, Abstract Co-Author: Nothing to Disclose

To prospectively determine the reliability and accuracy of shoulder MR arthrography with 3D isotropic fat-suppressed (FS) turbo spin-echo sequence (TSE-SPACE) for diagnosing rotator cuff tears compared with 2D conventional sequences at 3.0 T

Eighty-seven patients who underwent 3.0 T shoulder MR arthrography and arthroscopy were included. In addition to 2D conventional sequences, FS 3D TSE-SPACE was obtained to produce multiplanar intermediate-weighted images with 0.6-mm isotropic resolution. Each set of MR imaging from two different methods was independently scored for the presence of rotator cuff tear by two reviewers. Additionally, the depth (full or partial-thickness) and location (articular, bursal or interstitial) were categorized and correlated with arthroscopic findings. Diagnostic performances between readers were compared with ROC curves. Accuracy in predicting the depth and location was compared between two methods.

There were 33 full-thickness tears and 28 partial tears: articular (n=13), bursal (n= 14), and interstitial (n=1). Mean sensitivity, specificity and accuracy of both reviewers were 96%, 92% and 94% on conventional sequences and 91%, 84% and 89% on FS intermediate-weighted TSE-SPACE, respectively, which were not significantly different in both reviewers (McNemar). Interobserver agreements were almost perfect (κ=0.86) on conventional sequences and substantial (κ=0.70) on TSE-SPACE. The areas under the ROC curves for each reader were 0.98 and 0.98 for conventional sequences and 0.95 and 0.89 for TSE-SPACE, which were not significantly different. Mean accuracy in predicting the depth and location of the tears on conventional sequences was 90%, whereas on TSE-SPACE, mean accuracy was 68%. Retrospective re-review of the misinterpreted cases revealed that full-thickness tears were underestimated and bursal side partial tears were overlooked on TSE-SPACE.

Although MR arthrography using 3D FS TSE-SPACE sequence was a competitive method for diagnosing rotator cuff tears compared with conventional sequences, the accuracy in predicting the depth and location of rotator cuff tears was decreased on 3D FS TSE-SPACE.sequence.

Although MR arthrography using 3D TSE-SPACE is competitive in diagnosing rotator cuff tears, the accuracy in predicting the depth and location was decreased compared with conventional sequences.

Jung, J, Jee, W, Park, M, Lee, S, Kim, Y, Rotator Cuff Tears at 3.0 T Shoulder MR Arthrography: Diagnosis with 3D Isotropic Turbo Spin-Echo SPACE Sequence versus 2D Conventional Sequences.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9014479.html