MRI Diagnosis Of The Rotator Cuff Tear

Objective:To analyze MRI feature of the rotator cuff tear on different sequences and to compare the sensitivity in diagnosis of the rotator cuff tear for different sequences. Material and Methods:32 patients with complaint of shoulder pain underwent MR imaging of the shoulder on a 1.5T MR machine using T₁WI,T₂WI,STIR and PDFS sequences.The images were divided into three sets as T₁WI+T₂WI,T₁WI+T₂WI+STIR and T₁WI+T₂WI+PDFS.the morphologioal feature and signal characteristics of rotator cuff on each sequences were evaluated by two experienced radiologists independently. Sensitivity,specificity,accuracy,positive predictive value and negative predictive value of each set were calculated respectively using arthroscopy and open surgery as gold standard. The results of each set were compared using McNemar test.Results:19 patients with rotator cuff tear and 13 patients with normal rotator cuff were confirmed by arthroscopy and open surgery.Which included:12 cases of full thickness rotator cuff tear,7 cases of partial thickness rotator cuff tear,9 cases of abnormality of the glenoid labrum and shoulder instability,2 cases of shoulder impingement syndrome,1 case of shoulder periarthritis and 1 case of shoulder mass.In T₁WI+T₂WI set,12 of 19 rotator cuff tear were correctly identified.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 63.1%,84.6%,71.8%,85.7%and 61.1%,respectively.In T₁WI+T₂WI+STIR set,18 of 19 rotator cuff tear were correctly diagnosed.The sensitivity, specificity,accuracy,positive predictive value and negative predictive value were 94.7%, 69.2%,84.3%,81.8%and 90%,respectively.In T₁WI+T₂WI+PDFS set,18 of 19 rotator cuff tear were correctly diagnosed.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 94.7%,76.9%,87.5%,85.7%and 90.9%, respectively.The differences between T₁WI+T₂WI set and T₁WI+T₂WI+STIR set,between T₁WI+T₂WI set and T₁WI+T₂WI+PDFS set were statistically significant,while T₁WI+T₂WI +PDFS set and T₁WI+T₂WI+PDFS set didn't have statistically significant difference.Conclusion:MRI is a good imaging modality for diagnosis of the rotator cuff tear.Adding STIR and PDFS sequences to routine sequence protocol will improve the detection of the rotator cuff tear.