Evaluation of subscapularis tendon tears of the anterosuperior aspect using radial-sequence magnetic resonance imaging

Background: Magnetic resonance imaging (MRI) is widely used to diagnose subscapularis tendon tears; however, it is difficult to assess the anterosuperior aspect of these tears. Radial-sequence MRI can reveal the fiber components of the anterosuperior aspect, from perpendicular, by overcoming the par...

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Main Authors: Ryosuke Matsushita, MD, PhD, Shin Yokoya, MD, PhD, Hiroshi Negi, MD, PhD, Norimasa Matsubara, MD, Yuji Akiyama, Nobuo Adachi, MD, PhD
Format: Article
Language:English
Published: Elsevier 2022-01-01
Series:JSES International
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666638321002097
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author Ryosuke Matsushita, MD, PhD
Shin Yokoya, MD, PhD
Hiroshi Negi, MD, PhD
Norimasa Matsubara, MD
Yuji Akiyama
Nobuo Adachi, MD, PhD
author_facet Ryosuke Matsushita, MD, PhD
Shin Yokoya, MD, PhD
Hiroshi Negi, MD, PhD
Norimasa Matsubara, MD
Yuji Akiyama
Nobuo Adachi, MD, PhD
author_sort Ryosuke Matsushita, MD, PhD
collection DOAJ
description Background: Magnetic resonance imaging (MRI) is widely used to diagnose subscapularis tendon tears; however, it is difficult to assess the anterosuperior aspect of these tears. Radial-sequence MRI can reveal the fiber components of the anterosuperior aspect, from perpendicular, by overcoming the partial volume effect. We aimed to classify the insertion of subscapularis tendon tears on radial-sequence MRI and determine the effectiveness of radial-sequence MRI for subscapularis tendon tear assessments. Methods: We retrospectively investigated 196 patients (mean age, 66.7 ± 9.0 years; 118 men, 78 women) who underwent 1.5 T MRI before arthroscopic rotator cuff repair. Radial-sequence MRI findings of the anterosuperior aspect insertion of the subscapularis tendon were classified into five grades, and intraoperative findings compared with preoperative conventional MRI and radial-sequence MRI. We calculated sensitivity, specificity, accuracy, and positive and negative predictive values. Interobserver and intraobserver reliability for radial-sequence MRI classification was calculated using kappa (κ). Results: Conventional MRI sensitivity of subscapularis tendon tears was 45.3%; specificity, 95.8%; accuracy, 82.1%; positive predictive value, 80.0%; and negative predictive value, 82.5%. Radial-sequence MRI sensitivity was 92.5%; specificity, 88.1%; accuracy, 89.3%; positive predictive value, 74.2%; and negative predictive value, 96.9%. Sensitivity (P < .001), accuracy (P = .04), specificity (P = .02), and negative predictive values (P < .001) in radial-sequence MRI were significantly higher than those in conventional MRI. Intraobserver and interobserver reliabilities for radial-sequence MRI classification were κ = 0.78 and 0.65, respectively, corresponding to high reproducibility, and defined as good. Conclusion: We provide evidence that radial-sequence MRI is an effective tool to evaluate subscapularis tendon tears, especially before surgery.
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spelling doaj.art-b12115b89b6843db91fad9d31c48ec2d2022-12-21T19:36:20ZengElsevierJSES International2666-63832022-01-016197103Evaluation of subscapularis tendon tears of the anterosuperior aspect using radial-sequence magnetic resonance imagingRyosuke Matsushita, MD, PhD0Shin Yokoya, MD, PhD1Hiroshi Negi, MD, PhD2Norimasa Matsubara, MD3Yuji Akiyama4Nobuo Adachi, MD, PhD5Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanDepartment of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Corresponding author: Shin Yokoya, MD, PhD, 1-5-54 Ujinakanda, Minami-ku, Hiroshima, Japan.Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanDepartment of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanDepartment of Clinical Radiology, Hiroshima University Hospital, Hiroshima, JapanDepartment of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanBackground: Magnetic resonance imaging (MRI) is widely used to diagnose subscapularis tendon tears; however, it is difficult to assess the anterosuperior aspect of these tears. Radial-sequence MRI can reveal the fiber components of the anterosuperior aspect, from perpendicular, by overcoming the partial volume effect. We aimed to classify the insertion of subscapularis tendon tears on radial-sequence MRI and determine the effectiveness of radial-sequence MRI for subscapularis tendon tear assessments. Methods: We retrospectively investigated 196 patients (mean age, 66.7 ± 9.0 years; 118 men, 78 women) who underwent 1.5 T MRI before arthroscopic rotator cuff repair. Radial-sequence MRI findings of the anterosuperior aspect insertion of the subscapularis tendon were classified into five grades, and intraoperative findings compared with preoperative conventional MRI and radial-sequence MRI. We calculated sensitivity, specificity, accuracy, and positive and negative predictive values. Interobserver and intraobserver reliability for radial-sequence MRI classification was calculated using kappa (κ). Results: Conventional MRI sensitivity of subscapularis tendon tears was 45.3%; specificity, 95.8%; accuracy, 82.1%; positive predictive value, 80.0%; and negative predictive value, 82.5%. Radial-sequence MRI sensitivity was 92.5%; specificity, 88.1%; accuracy, 89.3%; positive predictive value, 74.2%; and negative predictive value, 96.9%. Sensitivity (P < .001), accuracy (P = .04), specificity (P = .02), and negative predictive values (P < .001) in radial-sequence MRI were significantly higher than those in conventional MRI. Intraobserver and interobserver reliabilities for radial-sequence MRI classification were κ = 0.78 and 0.65, respectively, corresponding to high reproducibility, and defined as good. Conclusion: We provide evidence that radial-sequence MRI is an effective tool to evaluate subscapularis tendon tears, especially before surgery.http://www.sciencedirect.com/science/article/pii/S2666638321002097Rotator cuffArthroscopic rotator cuff repairSubscapularis tendonRadial magnetic resonance imagingClassificationConventional magnetic resonance imaging
spellingShingle Ryosuke Matsushita, MD, PhD
Shin Yokoya, MD, PhD
Hiroshi Negi, MD, PhD
Norimasa Matsubara, MD
Yuji Akiyama
Nobuo Adachi, MD, PhD
Evaluation of subscapularis tendon tears of the anterosuperior aspect using radial-sequence magnetic resonance imaging
JSES International
Rotator cuff
Arthroscopic rotator cuff repair
Subscapularis tendon
Radial magnetic resonance imaging
Classification
Conventional magnetic resonance imaging
title Evaluation of subscapularis tendon tears of the anterosuperior aspect using radial-sequence magnetic resonance imaging
title_full Evaluation of subscapularis tendon tears of the anterosuperior aspect using radial-sequence magnetic resonance imaging
title_fullStr Evaluation of subscapularis tendon tears of the anterosuperior aspect using radial-sequence magnetic resonance imaging
title_full_unstemmed Evaluation of subscapularis tendon tears of the anterosuperior aspect using radial-sequence magnetic resonance imaging
title_short Evaluation of subscapularis tendon tears of the anterosuperior aspect using radial-sequence magnetic resonance imaging
title_sort evaluation of subscapularis tendon tears of the anterosuperior aspect using radial sequence magnetic resonance imaging
topic Rotator cuff
Arthroscopic rotator cuff repair
Subscapularis tendon
Radial magnetic resonance imaging
Classification
Conventional magnetic resonance imaging
url http://www.sciencedirect.com/science/article/pii/S2666638321002097
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