From the Departments of Radiology (T.N., S.H., J.O., J.S., Y.S.) and Orthopaedic Surgery (A.T.), St Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan; Department of Radiological Sciences, University of California, Irvine, Calif (T.N., H.Y.); and Department of Intelligent Image Information, Division of Regeneration and Advanced Medical Sciences, Gifu University Graduate School of Medicine, Gifu, Japan (T.H.).
Radiology. 2016 Aug;280(2):500-9. doi: 10.1148/radiol.2016151789. Epub 2016 Mar 2.
Purpose To determine the degree of preoperative fatty degeneration within muscles, postoperative longitudinal changes in fatty degeneration, and differences in fatty degeneration between patients with full-thickness supraspinatus tears who do and those who do not experience a retear after surgery. Materials and Methods This prospective study had institutional review board approval and was conducted in accordance with the Committee for Human Research. Informed consent was obtained. Fifty patients with full-thickness supraspinatus tears (18 men, 32 women; mean age, 67.0 years ± 8.0; age range, 41-91 years) were recruited. The degrees of preoperative and postoperative fatty degeneration were quantified by using a two-point Dixon magnetic resonance (MR) imaging sequence; two radiologists measured the mean signal intensity on in-phase [S(In)] and fat [S(Fat)] images. Estimates of fatty degeneration were calculated with "fat fraction" values by using the formula S(Fat)/S(In) within the supraspinatus, infraspinatus, and subscapularis muscles at baseline preoperative and at postoperative 1-year follow-up MR imaging. Preoperative fat fractions in the failed-repair group and the intact-repair group were compared by using the Mann-Whitney U test. Results The preoperative fat fractions in the supraspinatus muscle were significantly higher in the failed-repair group than in the intact-repair group (37.0% vs 19.5%, P < .001). Fatty degeneration of the supraspinatus muscle tended to progress at 1 year postoperatively in only the failed-repair group. Conclusion MR imaging quantification of preoperative fat fractions by using a two-point Dixon sequence within the rotator cuff muscles may be a viable method for predicting postoperative retear. (©) RSNA, 2016.
目的 确定术前肌肉内脂肪变性程度、术后脂肪变性的纵向变化以及全层肩袖撕裂患者术后是否再撕裂与脂肪变性之间的差异。
材料与方法 本前瞻性研究经机构审查委员会批准,并符合人类研究委员会的规定。获得了知情同意。招募了 50 例全层冈上肌撕裂患者(18 名男性,32 名女性;平均年龄 67.0 岁±8.0;年龄范围 41-91 岁)。使用两点 Dixon 磁共振(MR)成像序列定量评估术前和术后脂肪变性程度;两名放射科医生测量同相位 [S(In)] 和脂肪 [S(Fat)] 图像上的平均信号强度。在基线术前和术后 1 年的 MR 成像时,使用“脂肪分数”值通过公式 S(Fat)/S(In) 计算冈上肌、冈下肌和肩胛下肌内的脂肪变性估计值。使用 Mann-Whitney U 检验比较失败修复组和完整修复组的术前脂肪分数。
结果 失败修复组的冈上肌术前脂肪分数明显高于完整修复组(37.0%比 19.5%,P <.001)。只有失败修复组的冈上肌脂肪变性在术后 1 年时趋于进展。
结论 使用两点 Dixon 序列在肩袖肌肉内定量评估术前脂肪分数可能是预测术后再撕裂的可行方法。(©)RSNA,2016 年。