Jung Joon-Yong, Jee Won-Hee, Chun Ho Jong, Ahn Myeong Im, Kim Yang-Soo
Department of Radiology, School of Medicine, Catholic University of Korea, Seoul, Korea.
Acta Radiol. 2010 Mar;51(2):194-201. doi: 10.3109/02841850903300298.
Partial-thickness tear of the rotator cuff is a common cause of shoulder pain. Magnetic resonance (MR) arthrography has been described as a useful measure to diagnose rotator cuff abnormalities.
To determine the reliability and accuracy of MR arthrography with abduction and external rotation (ABER) view for the diagnosis of partial-thickness tears of the rotator cuff.
Among patients who underwent MR arthrographies, 22 patients (12 men, 10 women; mean age 45 years) who had either partial-thickness tear or normal tendon on arthroscopy were included. MR images were independently scored by two observers for partial-thickness tears of the rotator cuff. Interobserver and intraobserver agreements for detection of partial-thickness tears of the rotator cuff were calculated by using kappa coefficients. The differences in areas under the receiver operating characteristic (ROC) curves were assessed with a univariate Z-score test. Differences in sensitivity and specificity for interpretations based on different imaging series were tested for significance using the McNemar statistic.
Sensitivity, specificity, and accuracy of each reader on MR imaging without ABER view were 83%, 90%, and 86%, and 83%, 80%, and 82%, respectively, whereas on overall interpretation including ABER view, the sensitivity, specificity, and accuracy of each reader were 92%, 70%, and 82%, and 92%, 80%, and 86%, respectively. Including ABER view, interobserver agreement for partial-thickness tear increased from kappa=0.55 to kappa=0.68. Likewise, intraobserver agreements increased from kappa=0.79 and 0.53 to kappa=0.81 and 0.70 for each reader, respectively. The areas under the ROC curves for each reader were 0.96 and 0.90, which were not significantly different.
Including ABER view in routine sequences of MR arthrography increases the sensitivity, and inter- and intraobserver agreements for detecting partial-thickness tear of rotator cuff tendon.
肩袖部分厚度撕裂是肩部疼痛的常见原因。磁共振（MR）关节造影已被描述为诊断肩袖异常的一种有用方法。
确定外展和外旋（ABER）位MR关节造影诊断肩袖部分厚度撕裂的可靠性和准确性。
在接受MR关节造影的患者中，纳入22例患者（12例男性，10例女性；平均年龄45岁），这些患者在关节镜检查中存在部分厚度撕裂或肌腱正常。MR图像由两名观察者独立对肩袖部分厚度撕裂进行评分。使用kappa系数计算观察者间和观察者内对肩袖部分厚度撕裂检测的一致性。通过单变量Z评分检验评估受试者操作特征（ROC）曲线下面积的差异。使用McNemar统计量检验基于不同成像序列的解释在敏感性和特异性方面的差异是否具有统计学意义。
在没有ABER位的MR成像上，每位读者的敏感性、特异性和准确性分别为83%、90%和86%，以及83%、80%和82%，而在包括ABER位的整体解读中，每位读者的敏感性、特异性和准确性分别为92%、70%和82%，以及92%、80%和86%。包括ABER位时，观察者间对部分厚度撕裂的一致性从kappa = 0.55提高到kappa = 0.68。同样，每位读者的观察者内一致性分别从kappa = 0.79和0.53提高到kappa = 0.81和0.70。每位读者的ROC曲线下面积分别为0.96和0.90，差异无统计学意义。
在MR关节造影的常规序列中纳入ABER位可提高检测肩袖肌腱部分厚度撕裂的敏感性以及观察者间和观察者内的一致性。
