Jung-Ah Choi MD, Presenter: Nothing to Disclose

Eugene Joe, Abstract Co-Author: Nothing to Disclose

Eugene Lee, Abstract Co-Author: Nothing to Disclose

Hee Seok Jeong MD, Abstract Co-Author: Nothing to Disclose

DaeHyun Hwang MD, PhD, Abstract Co-Author: Nothing to Disclose

To evaluate and compare the diagnostic efficacy in diagnosis of subscapularis (SSC) tendon tears on ultrasound (US) and MR arthrography (MRA) and compare between examiners with differing levels of experience.

198 cases of arthroscopically confirmed rotator cuff tendon tears were prospectively evaluated on MRA and US (by two examiners with differing levels of experience) before arthroscopic surgery. The status of SSC tendons were graded as follows: 0 – normal/tendinopathy, 1- articular low grade partial tear, 2- bursal low grade partial tear, 3 – high grade partial/full thickness tear. Arthroscopy was used as the gold standard. Sensitivity, specificity, and agreement were calculated according to each modality, compared between the two modalities, and compared between the two examiners. Agreement between each modality and arthroscopic finding was determined by weighted kappa. Diagnostic values were compared between US and MRA using McNemar’s test.  

On arthroscopy, 64 cases had low grade partial tears, 52 had high grade/full thickness tears, 82 showed no tear. The overall weighted kappa for US was 79.63%, whereas it was 81.06% for MRA. For the staff radiologist, the weighted kappa was 81.99% for US, whereas for the fellow, it was 78.38%. The sensitivity and specificity of US for diagnosis of SSC tears were 76.4% and 97.6%, respectively; those of MRA were 82.9% and 98.1%, respectively, with no significant difference for diagnosis of SSC tears. For the staff radiologist, the sensitivity and specificity of US were 86.3% and 97.6%, respectively, whereas for the fellow, the values were 72.8% and 99.5%, respectively.

MRA showed slightly better agreement and higher sensitivity for diagnosis of SSC tears although not statistically different. US performed by the staff radiologist had higher sensitivity for diagnosis of SSC tears.  

US has comparable diagnostic sensitivity and specificity to MRA in diagnosis of SSC tears; however, sensitivity is higher if performed by a more experienced examiner.

Choi, J, Joe, E, Lee, E, Jeong, H, Hwang, D, Evaluation of the Subscapularis Tendon on MR Arthrography and Ultrasound: How Accurate Are We in Diagnosis of Tears?.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14018743.html