Association of Patient Self-Reported Shoulder Scores to Quantitative and Semiquantitative MRI Measures of Rotator Cuff Intramuscular Fatty Infiltration: A Pilot Study

Davis, Derik L.; Zhuo, Jiachen; Almardawi, Ranyah; Mulligan, Michael E.; Resnik, Charles S.; Abdullah, Selwan B.; Khalifah, Hussain Al; Henn, R. Frank; Gilotra, Mohit N.; Hasan, S. Ashfaq; Gullapalli, Rao P.

doi:10.2214/ajr.19.21218

Cited by 15 publications

(22 citation statements)

References 48 publications

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“…Rotator cuff injury is not only a tendon problem, it is often accompanied by progressive and irreversible fat infiltration and involves adjacent muscles. 5 The pathological description of this intramuscular fat infiltration was first reported by Goutallier et al . 6 The muscle microstructures correspondingly change, such as myofibril lysis and degeneration, and are finally replaced by adipose tissue; the increased fat will accumulate outside and inside the muscle bundle.…”

Section: Introductionmentioning

confidence: 78%

“…At the same time, studies have also pointed out that fat infiltration is closely related to muscle atrophy and loss of contractility. 5 , 45 However, when the tendon is severed, muscles show significant fat infiltration, rather than further atrophy. The experimental group were all chronic degenerative rotator cuff injuries, characterized by obvious shoulder pain, weakness and limited mobility, MRI showed significant fatty infiltration of the supraspinatus muscle.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, understanding the molecular mechanism of rotator cuff injury is a scientific problem that needs to Rotator cuff injury is not only a tendon problem, it is often accompanied by progressive and irreversible fat infiltration and involves adjacent muscles. 5 The pathological description of this intramuscular fat infiltration was first reported by Goutallier et al 6 The muscle microstructures correspondingly change, such as myofibril lysis and degeneration, and are finally replaced by adipose tissue; the increased fat will accumulate outside and inside the muscle bundle. 7 Therefore, muscle atrophy and fat infiltration become two major complications of rotator cuff tendinopathy, especially chronic rotator cuff injury or huge rotator cuff tear, and seriously affect the postoperative recovery, resulting in rotator cuff re-tear.…”

Section: Introductionmentioning

confidence: 91%

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Proteomic analysis reveals rotator cuff injury caused by oxidative stress

Yuan

Qian

et al. 2021

Therapeutic Advances in Chronic Disease

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Background and aims: Rotator cuff tendinopathy is common and is related to pain and dysfunction. However, the pathological mechanism of rotator cuff injury and shoulder pain is unclear. Objective: to investigate the pathological mechanism of rotator cuff injury and shoulder pain, and screen out the marker proteins related to rotator cuff injury by proteomics. Methods: Subacromial synovium specimens were collected from patients undergoing shoulder arthroscopic surgery. The experimental group were patients with rotator cuff repair surgery, and the control group were patients with habitual dislocation of the shoulder joint. Pathological examination was performed, and then followed by non-labeled quantitative proteomic detection. Finally, from analysis of the biological information of the samples, specific proteins related to rotator cuff injury and shoulder pain were deduced by functional analysis of differential proteins. Results: All the patients in experimental groups were representative. A large number of adipocytes and inflammatory cells were found in the pathological sections of the experimental group; the proteomics analysis screen identified 80 proteins with significant differences, and the analysis of protein function revealed that S100A11 ( p = 0.011), PLIN4 ( p = 0.017), HYOU1 ( p = 0.002) and CLIC1 ( p = 0.007) were closely related to oxidative stress and chronic inflammation. Conclusion: Rotator cuff injury is closely related to oxidative stress and chronic inflammatory response, and the results suggest that the expression of S100A11, PLIN4, HYOU1 and CLIC1 in the synovium of rotator cuff injury provides a new marker for the study of its pathological mechanism.

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Section: Introductionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

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Proteomic analysis reveals rotator cuff injury caused by oxidative stress

Yuan

Qian

et al. 2021

Therapeutic Advances in Chronic Disease

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“…The authors manually measured quantitative 3D-FF by averaging the FF in all voxels of the RC muscles. The fatty infiltration scores (Goutallier 17 and Fuchs 14 grades) are not quantitative and are prone to subjectivity and unreliability, 11 Of note, the substantial difference observed in 2D-FF and 3D-FF might be associated with the inhomogeneous fat distribution in the torn muscle after RCT. 53 In fact, the rationale for using a single image to evaluate fatty infiltration of the whole muscle has been challenged in some basic science studies.…”

Section: Discussionmentioning

confidence: 99%

“…The authors manually measured quantitative 3D-FF by averaging the FF in all voxels of the RC muscles. The fatty infiltration scores (Goutallier 17 and Fuchs 14 grades) are not quantitative and are prone to subjectivity and unreliability, 11 limiting the capacity of the Vidt et al study to elucidate the exact FF differences between the 2D and 3D measurements. Notwithstanding, our findings and those of Vidt et al validated that FF in the 2D model cannot represent the entire fatty infiltration in the RC muscles.…”

Section: Discussionmentioning

confidence: 99%

Advantages of 3–dimensional Measurements for Supraspinatus Intramuscular Fatty Evaluation in Patients With Medium to Massive Rotator Cuff Tears: Comparison With a Single Sagittal Slice

Liu

Jin

et al. 2022

Am J Sports Med

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Background: Fatty infiltration of the rotator cuff muscles is highly related to poor outcomes after rotator cuff tears. Fat fraction (FF) based on traditional 2–dimensional measurements (2D-FF) from a single sagittal Y-view slice cannot determine intramuscular FF in the rotator cuff muscles; the newly developed 3–dimensional method (3D-FF) is supposed to precede 2D measurements for intramuscular FF evaluation in accuracy and reliability. Purpose: (1) To measure 3D-FF and (2) to compare 3D-FF and 2D-FF in terms of quantitative values and intra- and interobserver agreement. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Six-point Dixon magnetic resonance imaging was performed in patients with full–thickness supraspinatus tears. 2D-FF was calculated on a single sagittal Y-view. Semiautomatic segmentation software (ITK-SNAP) was used to reconstruct 3D volumes of the supraspinatus muscle and fat. 3D-FF was obtained by dividing the fat volume by the total volume of the supraspinatus muscle. A paired t test was used to compare the individual differences between 2D-FF and 3D-FF results. Linear regression and Bland-Altman analyses were performed to determine the agreement between 2D-FF and 3D-FF. Intraclass correlation coefficients (ICCs) were calculated to determine intra- and interobserver agreement. Results: The 3D muscular and fatty models presented an inhomogeneous distribution of intramuscular fat in the supraspinatus, indicating the superiority of 3D-FF over 2D-FF in capturing all muscle morphologic information. 2D-FF was significantly higher than 3D-FF in the supraspinatus with large (19.5% ± 5.9% vs 16.2% ± 3.7%; P = .002) and massive (34.8% ± 13.3% vs 26.2% ± 9.4%; P < .001) rotator cuff tears. 2D-FF overestimated the FF compared with 3D-FF by >50% in 14.7% of all patients and by >15% in 67.6% of patients with large or massive RCTs. The discrepancy between 2D-FF and 3D-FF increased with increasing mean FF. The intra- and interobserver agreement of 3D-FF (ICCs, 0.89-0.99 and 0.89-0.95) was superior to that of 2D-FF (ICCs, 0.71-0.95 and 0.64-0.79). Conclusion: 3D-FF indicated an inhomogeneous distribution of intramuscular fat by capturing all muscle and fat morphologic information. In patients with large and massive rotator cuff tears, 2D-FF of the supraspinatus was significantly higher than 3D-FF. 3D-FF was more reliable than 2D-FF for estimating fatty infiltration in the supraspinatus, with better intra- and interobserver agreement.

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