Clin Orthop Surg.  2018 Mar;10(1):55-63. 10.4055/cios.2018.10.1.55.

Can a Single Sagittal Magnetic Resonance Imaging Slice Represent Whole Fatty Infiltration in Chronic Rotator Cuff Tears at the Supraspinatus?

• Lee YB
• Yang CJ
• Li CZ
• Zhuan Z
• Kwon SC
• Noh KC

• KMID: 2405483
• DOI: http://doi.org/10.4055/cios.2018.10.1.55

Abstract

BACKGROUND
This study aimed to investigate whether fatty infiltration (FI) measured on a single sagittal magnetic resonance imaging (MRI) slice can represent FI of the whole supraspinatus muscle.
METHODS
This study retrospectively reviewed the MRIs of 106 patients (age 50-79 years) divided into three rotator cuff tear-size groups: medium, large, and massive. Fat mass and muscle mass on all T1-weighted sagittal MRI scans (FA and MA) were measured. Of the total MRI scans, the Y-view was defined as the most lateral image of the junction of the scapular spine with the scapular body on the oblique sagittal T1-weighted image. Fat mass and muscle mass seen on this Y-view single slice were recorded as F1 and M1, respectively. Fat mass and muscle mass were also assessed on MRI scans lateral and medial to the Y-view. The means of fat mass and muscle mass on these three slices were recorded as F3 and M3, respectively. Average FI ratios (fat mass/muscle mass) of the three assessment methods (F1/M1, FA/MA, and F3/M3) were compared. Intraclass correlation coefficients (ICCs) were calculated for inter- and intraobserver reliability.
RESULTS
ICCs showed higher reliability (> 0.8) for all measurements. F1/M1 values were not statistically different from FA/MA and F3/M3 values (p > 0.05), except in males with medium and large tears. F3/M3 and FA/MA were not statistically different. The difference between F1/M1 and FA/MA did not exceed 2%.
CONCLUSIONS
A single sagittal MRI slice can represent the whole FI in chronic rotator cuff tears, except in some patient groups. We recommend measurement of FI using a single sagittal MRI slice, given the effort required for repeated measurements.

Keyword

Fatty infiltration; Magnetic resonance imaging; Chronic rotator cuff tear; Supraspinatus; Single sagittal slice

MeSH Terms

Humans
Magnetic Resonance Imaging*
Male
Retrospective Studies
Rotator Cuff*
Spine
Tears*

Figure

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  Fig. 1 Scapular Y-view. In the magnetic resonance imaging oblique sagittal view of the shoulder, the surface where the scapula and spine form a Y-shape is referred to as the scapular Y-view.

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  Fig. 2 Study participant recruitment flow chart. Recruitment criteria and illustration of the selection process. MRI: magnetic resonance imaging.

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  Fig. 3 Measurement of the fatty infiltration ratio in a sagittal magnetic resonance imaging image using the picture archiving and communication system computer program. (A) The area of the muscle portion in the supraspinatus muscle was established using a free line range of interest function. (B) The pseudo-color mapping function was used to establish the parts that showed a signal intensity of fat. (C) The color mapping of the fatty infiltration area was provided. (D) By calculating the color-mapped portion in the muscle, the area of muscle and fat, and their ratio could be derived.

• 

  Fig. 4 Three-slice levels in a shoulder magnetic resonance imaging oblique sagittal view. (A) The medial third slice to the scapular Y-view. (B) The scapular Y-view. (C) The lateral half slice to the scapular Y-view (in this case, the fifth slice).

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