St Mary's Hospital Paddington, London, UK.
J Shoulder Elbow Surg. 2012 Jun;21(6):749-53. doi: 10.1016/j.jse.2011.09.019. Epub 2011 Nov 9.
Tears of the supraspinatus are common and incompletely understood. The degree of fatty infiltration into the muscle is perceived to be a determining factor of successful surgical repair and postoperative function. It is the hypothesis of this study that the degree of central tendon retraction (CTR) as seen on magnetic resonance imaging corresponds to the amount of fatty infiltration classified according to the Goutallier grading system.
Magnetic resonance imaging scans of the supraspinatus were reviewed in 2 identifiable groups: 143 scans with no tear (NT) and 148 scans with a full-thickness tear (FTT) and CTR. The degree of CTR and the corresponding Goutallier grade were measured. The difference in Goutallier grade between the NT and FTT groups was measured with the Mann-Whitney test. The relationship between Goutallier grade and increasing amount of CTR was described by use of Spearman rank correlation. Studying the difference between the Goutallier grades and CTR was achieved by use of Mann-Whitney tests.
Of NT scans, 100% showed Goutallier grade 0 or 1. Among FTT scans, 2 showed grade 0, 21 showed grade 1, 35 showed grade 2, 14 showed grade 3, and 76 showed grade 4. The difference was statistically significant (P < .001) between the Goutallier grade 3 and 4 scans, and the degree of Goutallier grade increased with increasing CTR (P < .001).
Fatty infiltration can be directly linked to CTR and, as such, may help to determine surgical intervention between groups.
肩袖上的撕裂很常见，但尚未完全了解。肌肉内的脂肪浸润程度被认为是手术修复和术后功能成功的决定因素。本研究的假设是，磁共振成像上所见的中央肌腱回缩（CTR）程度与根据 Goutallier 分级系统分类的脂肪浸润量相对应。
对无撕裂（NT）和全层撕裂（FTT）伴 CTR 的 143 个和 148 个肩袖扫描进行了磁共振成像扫描。测量了 CTR 的程度和相应的 Goutallier 分级。用 Mann-Whitney 检验测量 NT 组和 FTT 组之间 Goutallier 分级的差异。用 Spearman 秩相关描述 Goutallier 分级与 CTR 增加量之间的关系。用 Mann-Whitney 检验研究 Goutallier 分级和 CTR 之间的差异。
NT 扫描中，100%的 Goutallier 分级为 0 或 1。在 FTT 扫描中，2 个为 0 级，21 个为 1 级，35 个为 2 级，14 个为 3 级，76 个为 4 级。Goutallier 分级 3 和 4 扫描之间的差异具有统计学意义（P <.001），Goutallier 分级随着 CTR 的增加而增加（P <.001）。
脂肪浸润可以直接与 CTR 相关，因此可以帮助确定手术干预的分组。
