磁共振成像上肩袖撕裂模式与肌内脂肪浸润的相关性
Association of Rotator Cuff Tear Patterns and Intramuscular Fatty Infiltration on Magnetic Resonance Imaging.
作者信息
Davis Derik L, Gilotra Mohit N, Hovis James Paul, Almardawi Ranyah, Hasan S Ashfaq
机构信息
Departments of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
Departments of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland.
出版信息
J Clin Imaging Sci. 2019 Aug 2;9:38. doi: 10.25259/JCIS_36_2019. eCollection 2019.
OBJECTIVE
The impact of rotator cuff (RC) tear pattern on intramuscular fatty infiltration (FI) is not well understood. The purpose of our study is to determine if differing RC tear patterns are associated with discordant presentations of intramuscular FI.
METHODS
Fifty-one adults with full-thickness tear of the posterosuperior RC on shoulder magnetic resonance imaging (MRI) were identified retrospectively. The study subjects were stratified by RC tear pattern: (1) L-shaped tear cohort, (2) crescent-/U-shaped tear cohort, and (3) complete tear cohort. Clinical information pertaining to age, sex, tear size, trauma history, and length of clinical symptoms was recorded from the institution's picture archiving and communication system. Goutallier grade was assessed on oblique sagittal T1-weighted MRI by two orthopedic surgeons and one orthopedic resident. A musculoskeletal radiologist recorded the shape and size of full-thickness RC tears. Descriptive, correlation, and reliability analyses were performed.
RESULTS
The L-shaped, crescent-/U-shaped, and compete tear cohorts demonstrated significant differences pertaining to tear size ( < 0.001) and infraspinatus Goutallier grade ( = 0.024), but not supraspinatus Goutallier grade ( = 0.370). Age had strong correlation to supraspinatus Goutallier grade (rs = 0.712, = 0.031) and infraspinatus Goutallier grade (rs = 0.712, = 0.029) in the crescent-/U-shaped tear cohort. Tear size had strong correlation to supraspinatus Goutallier grade (rs = 0.796, = 0.001) and infraspinatus Goutallier grade (rs = 0.793, = 0.001) in the complete tear cohort. Moderate interobserver agreement was present for supraspinatus (kappa, 0.484) and infraspinatus (kappa, 0.427) Goutallier grade.
CONCLUSION
RC tear pattern is associated with different presentations of intramuscular FI at the posterosuperior RC. Full-thickness tears involving the crescent region of the RC cuff are associated with age. Intramuscular FI is associated with RC tear size.
目的
肩袖（RC）撕裂模式对肌内脂肪浸润（FI）的影响尚未完全明确。本研究的目的是确定不同的RC撕裂模式是否与肌内FI的不同表现相关。
方法
回顾性纳入51例肩部磁共振成像（MRI）显示后上RC全层撕裂的成年人。研究对象按RC撕裂模式分层：（1）L形撕裂组，（2）新月形/U形撕裂组，（3）完全撕裂组。从该机构的图像存档和通信系统中记录有关年龄、性别、撕裂大小、创伤史和临床症状持续时间的临床信息。由两名骨科医生和一名骨科住院医师在斜矢状面T1加权MRI上评估Goutallier分级。一名肌肉骨骼放射科医生记录全层RC撕裂的形状和大小。进行描述性、相关性和可靠性分析。
结果
L形、新月形/U形和完全撕裂组在撕裂大小（<0.001）和冈下肌Goutallier分级（=0.024）方面存在显著差异，但在冈上肌Goutallier分级方面无显著差异（=0.370）。在新月形/U形撕裂组中，年龄与冈上肌Goutallier分级（rs = 0.712，= 0.031）和冈下肌Goutallier分级（rs = 0.712，= 0.029）有很强的相关性。在完全撕裂组中，撕裂大小与冈上肌Goutallier分级（rs = 0.796，= 0.001）和冈下肌Goutallier分级（rs = 0.793，= 0.001）有很强的相关性。冈上肌（kappa，0.484）和冈下肌（kappa，0.427）Goutallier分级的观察者间一致性为中等。
结论
RC撕裂模式与后上RC处肌内FI的不同表现相关。涉及RC袖带新月形区域的全层撕裂与年龄相关。肌内FI与RC撕裂大小相关。
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