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Diagnosis of rotator cuff tears using 3-Tesla MRI versus 3-Tesla MRA: a systematic review and meta-analysis

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Abstract

Objective

To compare the diagnostic accuracy of magnetic resonance imaging (MRI), 2-dimensional magnetic resonance arthrogram (MRA) and 3-dimensional isotropic MRA in the diagnosis of rotator cuff tears when performed exclusively at 3-T.

Materials and methods

A systematic review was undertaken of the Cochrane, MEDLINE and PubMed databases in accordance with the PRISMA guidelines. Studies comparing 3-T MRI or 3-T MRA (index tests) to arthroscopic surgical findings (reference test) were included. Methodological appraisal was performed using QUADAS 2. Pooled sensitivity and specificity were calculated and summary receiver-operating curves generated. Kappa coefficients quantified inter-observer reliability.

Results

Fourteen studies comprising 1332 patients were identified for inclusion. Twelve studies were retrospective and there were concerns regarding index test bias and applicability in nine and six studies respectively. Reference test bias was a concern in all studies. Both 3-T MRI and 3-T MRA showed similar excellent diagnostic accuracy for full-thickness supraspinatus tears. Concerning partial-thickness supraspinatus tears, 3-T 2D MRA was significantly more sensitive (86.6 vs. 80.5 %, p = 0.014) but significantly less specific (95.2 vs. 100 %, p < 0.001). There was a trend towards greater accuracy in the diagnosis of subscapularis tears with 3-T MRA. Three-Tesla 3D isotropic MRA showed similar accuracy to 3-T conventional 2D MRA.

Conclusion

Three-Tesla MRI appeared equivalent to 3-T MRA in the diagnosis of full- and partial-thickness tears, although there was a trend towards greater accuracy in the diagnosis of subscapularis tears with 3-T MRA. Three-Tesla 3D isotropic MRA appears equivalent to 3-T 2D MRA for all types of tears.

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References

  1. Ostör AJ, Richards CA, Prevost AT, Speed CA, Hazleman BL. Diagnosis and relation to general health of shoulder disorders presenting to primary care. Rheumatology (Oxford). 2005;44(6):800–5.

    Article  Google Scholar 

  2. Mosher TJ. Musculoskeletal imaging at 3T: current techniques and future applications. Magn Reson Imaging Clin N Am. 2006;14(1):63–76.

    Article  PubMed  Google Scholar 

  3. De Jesus J, Parker L, Frangos AJ, Nazarian LN. Accuracy of MRI, MR arthrography, and ultrasound in the diagnosis of rotator cuff tears: a meta-analysis. AJR Am J Roentgenol. 2009;192(6):1701–7.

    Article  PubMed  Google Scholar 

  4. Smith TO, Daniell H, Geere J-A, Tomsc AP, Hing CB. The diagnostic accuracy of MRI for the detection of partial- and full-thickness rotator cuff tears in adults. Magn Reson Imaging. 2012;30:336–46.

    Article  PubMed  Google Scholar 

  5. Lenza M, Buchbinder R, Takwoingi Y, Johnston RV, Hanchard NCA, Faloppa F. Magnetic resonance imaging, magnetic resonance arthrography and ultrasonography for assessing rotator cuff tears in people with shoulder pain for whom surgery is being considered. Cochrane Database Syst Rev. 2013;9:CD009020.

    PubMed  Google Scholar 

  6. Lambert A, Loffroy R, Guiu B, Mejean N, Lerais JM, Cercueil JP, et al. Rotator cuff tears: value of 3.0T MRI. J Radiol. 2009;90:583–8.

    Article  PubMed  CAS  Google Scholar 

  7. Magee T. 3-T MRI of the shoulder: is MR arthrography necessary? AJR Am J Roentgenol. 2009;192:86–92.

    Article  PubMed  Google Scholar 

  8. Magee T. Can isotropic fast gradient echo imaging be substituted for conventional T1 weighted sequences in shoulder MR arthrography at 3Tesla? Magn Reson Imaging. 2007;26:118–22.

    Article  Google Scholar 

  9. Oh DK, Yoon YC, Kwon JW, Choi S-H, Jung JY, Bae S, et al. Comparison of indirect isotropic MR arthrography and conventional MR arthrography of labral lesions and rotator cuff tears: a prospective study. AJR Am J Roentgenol. 2009;192:473–9.

    Article  PubMed  Google Scholar 

  10. Choo HJ, Lee SJ, Kim O-H, Seo SS, Kim JH. Comparison of three-dimensional isotropic T1-weighted fast spin-echo MR arthrography with two-dimensional MR arthrography of the shoulder. Radiology. 2012;262(3):921–31.

    Article  PubMed  Google Scholar 

  11. Jung J-Y, Jee W-H, Park MY, Lee S-Y, Kim Y-S. Supraspinatus tendon tears at 3.0 T shoulder MR arthrography: diagnosis with 3D isotropic turbo spin-echo SPACE sequence versus 2D conventional sequences. Skelet Radiol. 2012;41:1401–10.

    Article  Google Scholar 

  12. Moher D, Liberati A, Tetzlaff J, Altman DG. The PRISMA group: preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2 group. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155(8):529–36.

    Article  PubMed  Google Scholar 

  14. Rosman AS, Korsten MA. Application of summary receiver operating characteristics (SROC) analysis to diagnostic clinical testing. Adv Med Sci. 2007;52:76–82.

    PubMed  CAS  Google Scholar 

  15. Furukawa R, Morihara T, Arai Y, Ito H, Kida Y, Sukenari T, et al. Diagnostic accuracy of magnetic resonance imaging for subscapularis tendon tears using radial-slice magnetic resonance images. J Shoulder Elbow Surg. 2014;23(11):e283–90.

    Article  PubMed  Google Scholar 

  16. Chauvin NA, Jaimes C, Ho-Fung V, Wells L, Ganley T, Jaramillo D. Diagnostic performance of magnetic resonance arthrography of the shoulder in children. Pediatr Radiol. 2013;43:1309–15.

    Article  PubMed  Google Scholar 

  17. Jung JY, Yoon YC, Cha DI, Yoo JC, Jung JY. The “bridging sign”: a MR finding for combined full-thickness tears of the subscapularis tendon and the supraspinatus tendon. Acta Radiol. 2013;54(1):83–8.

    Article  PubMed  Google Scholar 

  18. Magee T, Williams D. 3.0-T MRI of the supraspinatus tendon. AJR Am J Roentgenol. 2006;187:881–6.

    Article  PubMed  Google Scholar 

  19. Kang CH, Kim SS, Kim JH, Chung KB, Kim YH, Oh Y-W, et al. Supraspinatus tendon tears: comparison of 3D US and MR arthrography with surgical correlation. Skeletal Radiol. 2009;38:1063–9.

    Article  PubMed  Google Scholar 

  20. Jung JY, Yoon YC, Yi S-K, Yoo J, Choe B-K. Comparison study of indirect MR arthrography and direct MR arthrography of the shoulder. Skelet Radiol. 2009;38:659–67.

    Article  Google Scholar 

  21. Modi CS, Karthikeyan S, Marks A, et al. Accuracy of abduction-external rotation MRA versus standard MRA in the diagnosis of intra-articular shoulder pathology. Orthopaedics. 2013;36(3):e337–42.

    Article  Google Scholar 

  22. Gyftopoulos S, O’Donnell J, Shah NP, Goss J, Babb J, Recht MP. Correlation of MRI with arthroscopy for the evaluation of the subscapularis tendon: a musculoskeletal division’s experience. Skelet Radiol. 2013;42:1269–75.

    Article  Google Scholar 

  23. Magee T. MR versus MR arthrography in detection of supraspinatus tendon tears in patients without previous shoulder surgery. Skelet Radiol. 2014;43(1):43–8.

    Article  Google Scholar 

  24. ParK SY, Lee IS, Park SK, Cheon SJ, Ahn JH, Song JW. Comparison of three-dimensional isotropic and conventional MR arthrography with respect to the diagnosis of rotator cuff and labral lesions: focus on isotropic fat-suppressed proton density and VIBE sequences. Clin Radiol. 2014;69:e173–82.

    Article  PubMed  CAS  Google Scholar 

  25. Lee JH, Yoon YC, Jee S. Diagnostic performance of indirect MR arthrography for the diagnosis of rotator cuff tears at 3.0T. Acta Radiol. 2015;56(6):720–6.

    Article  PubMed  Google Scholar 

  26. Choo HJ, Lee SJ, Kim JH, Kim DW, Park YM, Kim OH, et al. Delaminated tears of the rotator cuff: prevalence, characteristics, and diagnostic accuracy using indirect MR arthrography. AJR Am J Roentgenol. 2015; 204(2):360–6.

    Article  PubMed  Google Scholar 

  27. Dinnes J, Loveman E, McIntyre L, Waugh N. The effectiveness of diagnostic tests for the assessment of shoulder pain due to soft tissue disorders: a systematic review. Health Technol Assess. 2003; 7:iii, 1–166.

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Authors and Affiliations

  1. Department of Trauma and Orthopaedics, Guy’s and St Thomas’ Hospital, King’s Health Partners, Great Maze Pond, London, SE1 9RT, UK

    Ciaran McGarvey, Ziad Harb, Christian Smith, Steven Corbett & Adil Ajuied

  2. Department of Radiology, Guy’s and St Thomas’ Hospital, King’s Health Partners, Great Maze Pond, London, SE1 9RT, UK

    Russell Houghton

  3. Fortius Clinic, 17 Fitzhardinge St, London, W1H 6EQ, UK

    Steven Corbett

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  1. Ciaran McGarvey
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Correspondence to Ciaran McGarvey.

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No grants or assistance was received. None of the authors have any disclosures or conflict of interest. IRB approval was not required.

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McGarvey, C., Harb, Z., Smith, C. et al. Diagnosis of rotator cuff tears using 3-Tesla MRI versus 3-Tesla MRA: a systematic review and meta-analysis. Skeletal Radiol 45, 251–261 (2016). https://doi.org/10.1007/s00256-015-2299-x

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  • DOI: https://doi.org/10.1007/s00256-015-2299-x

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