Predicting Retear after Repair of Full-Thickness Rotator Cuff Tear: Two-Point Dixon MR Imaging Quantification of Fatty Muscle Degeneration—Initial Experience with 1-year Follow-up

Nozaki, Taiki; Tasaki, Atsushi; Horiuchi, Saya; Ochi, Junko; Starkey, Jay; Hara, Takeshi; Saida, Yukihisa; Yoshioka, Hiroshi

doi:10.1148/radiol.2016151789

Cited by 49 publications

(56 citation statements)

References 35 publications

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“…One recent report also utilized quantitative fat imaging to evaluate progression of fatty infiltration after rotator cuff repair. 13 Nozaki et al 13 showed that patients with an eventual repair failure had higher baseline fat measurements in the supraspinatus. We observed a higher mean fat fraction at preoperative imaging for patients with an eventual repair failure compared with those with an intact repair.…”

Section: Discussionmentioning

confidence: 99%

“…16 Recently, there has been increased interest in the quantitative assessment of fatty infiltration with chemical shift–based MRI. 8,12,13 One method, the iterative decomposition of echoes of asymmetric length (IDEAL), has been shown to be both reproducible and to correlate with the Goutallier classification. 12 By using this sequence, precise fat fraction measurements that represent the percentage of intramuscular fat can be determined within any defined region of interest.…”

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confidence: 99%

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A Prospective, Quantitative Evaluation of Fatty Infiltration Before and After Rotator Cuff Repair

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Lee

Sam

et al. 2017

Orthopaedic Journal of Sports Medicine

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Background:Current evaluation of muscle fatty infiltration has been limited by subjective classifications. Quantitative fat evaluation through magnetic resonance imaging (MRI) may allow for an improved longitudinal evaluation of the effect of surgical repair on the progression of fatty infiltration.Hypotheses:We hypothesized that (1) patients with isolated full-thickness supraspinatus tendon tears would have less progression in fatty infiltration compared with patients with full-thickness tears of multiple tendons and (2) patients with eventual failed repair would have higher baseline levels of fatty infiltration.Study Design:Cohort study; Level of evidence, 2.Methods:Thirty-five patients with full-thickness rotator cuff tears were followed longitudinally. All patients received a shoulder MRI, including the iterative decomposition of echoes of asymmetric length (IDEAL) sequence for fat measurement, prior to surgical treatment and at 6 months after surgical repair. Fat fractions were recorded for all 4 rotator cuff muscles from measurements on 4 sagittal slices centered at the scapular-Y. Demographics and tear characteristics were recorded. Baseline and follow-up fat fractions were compared for patients with isolated supraspinatus tears versus multitendon tears and for patients with intact repairs versus failed repairs. Statistical significance was set at P < .05.Results:The mean fat fractions were significantly higher at follow-up than at baseline for the supraspinatus (9.8% ± 7.0% vs 8.3% ± 5.7%; P = .025) and infraspinatus (7.4% ± 6.1% vs 5.7% ± 4.4%; P = .027) muscles. Patients with multitendon tears showed no significant change for any rotator cuff muscle after repair. Patients with isolated supraspinatus tears showed a significant progression in the supraspinatus fat fraction from baseline to follow-up (from 6.8% ± 4.9% to 8.6% ± 6.8%; P = .0083). Baseline supraspinatus fat fractions were significantly higher in patients with eventual failed repairs compared with those with intact repairs (11.7% ± 6.8% vs 7.1% ± 4.8%; P = .037).Conclusion:Contrary to our initial hypothesis, patients with isolated supraspinatus tears showed a significant progression of fatty infiltration. Patients with eventual repair failure had higher baseline fat fractions in the supraspinatus.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

A Prospective, Quantitative Evaluation of Fatty Infiltration Before and After Rotator Cuff Repair

Lansdown

Lee

Sam

et al. 2017

Orthopaedic Journal of Sports Medicine

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“…17,28,33 2-point VIBE Dixon was selected because of its wide availability and well documented recent use in the muscle. 26,29,[33][34][35][36][37][38] Diffusion-weighted images (DWI) were acquired using a STEAM prototype sequence with an echoplanar imaging (EPI) readout 39 with spectral adiabatic inversion recovery fat suppression: TR/ TE: 6300 ms/42. 4…”

Section: Mr Measurementsmentioning

confidence: 99%

Normal values and test–retest variability of stimulated-echo diffusion tensor imaging and fat fraction measurements in the muscle

Farrow

Grainger

Tan

et al. 2019

The British Journal of Radiology

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Objectives: To assess the test–retest variability of both diffusion parameters and fat fraction (FF) estimates in normal muscle, and to assess differences in normal values between muscles in the thigh. Methods: 29 healthy volunteers (mean age 37 years, range 20–60 years, 17/29 males) completed the study. Magnetic resonance images of the mid-thigh were acquired using a stimulated echo acquisition mode-echoplanar imaging (STEAM-EPI) imaging sequence, to assess diffusion, and 2-point Dixon imaging, to assess FF. Imaging was repeated in 19 participants after a 30 min interval in order to assess test–retest variability of the measurements. Results: Intraclass correlation coefficients (ICCs) for test–retest variability were 0.99 [95% confidence interval, (CI): 0.98, 1] for FF, 0.94 (95% CI: 0.84, 0.97) for mean diffusivity and 0.89 (95% CI: 0.74, 0.96) for fractional anisotropy (FA). FF was higher in the hamstrings than the quadriceps by a mean difference of 1.81% (95% CI:1.63, 2.00)%, p < 0.001. Mean diffusivity was significantly lower in the hamstrings than the quadriceps (0.26 (0.13, 0.39) x10-3 mm2s−1, p < 0.001) whereas fractional anisotropy was significantly higher in the hamstrings relative to the quadriceps with a mean difference of 0.063 (0.05, 0.07), p < 0.001. Conclusions: This study has shown excellent test-retest, variability in MR-based FF and diffusion measurements and demonstrated significant differences in these measures between hamstrings and quadriceps in the healthy thigh. Advances in knowledge: Test–retest variability is excellent for STEAM-EPI diffusion and 2-point Dixon-based FF measurements in the healthy muscle. Inter- and intraobserver variability were excellent for region of interest placement for STEAM-EPI diffusion and 2-point Dixon-based FF measurements in the healthy muscle. There are significant differences in FF and diffusion measurements between the hamstrings and quadriceps in the normal muscle.

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“…Researchers have recently reported various ways of assessing rotator cuff tendon tears preoperatively. Nozaki et al [17] applied 2-point Dixon MRI to rotator cuff muscles and suggested that the fat fraction observed preoperatively may offer a way to predict the recurrence of a tear after repair surgery. Rosskopf et al [18] proposed that a preoperative evaluation of the supraspinatus muscle can help to establish a treatment plan, while measuring shear wave velocity by SWE can help to assess mechanical muscle properties and to determine the prognosis of a torn rotator cuff tendon.…”

Section: Discussionmentioning

confidence: 99%

Elasticity of torn supraspinatus tendons measured by shear wave elastography: a potential surrogate marker of chronicity?

et al. 2020

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Purpose: This study investigated whether shear wave elastography (SWE) could be used to estimate the chronicity of supraspinatus tendon (SST) tears. Methods: A retrospective study was performed. From November 2015 to July 2016, 113 patients (52 men, 61 women; age range, 21 to 79 years) with persistent shoulder pain underwent 119 rotator cuff tendon examinations by routine B-mode ultrasonography, while SST elasticity was measured using SWE. Following the exclusion of eight suboptimal examinations, four examinations with missing SST measurements, and 27 examinations of patients with other conditions, 80 examinations were analyzed. A torn SST was found in 54 examinations (27 with a partial-thickness tear and 27 with a full-thickness tear). Elasticity values were compared in multiple ways. The results were analyzed using the Mann-Whitney U test or Kruskal-Wallis test. Results: No statistically significant difference in elasticity values (in kPa) was found between normal (median, 94.65; interquartile range [IQR], 87.43 to 105.47) and torn SSTs (median, 96.79; IQR, 86.71 to 108.56) or between full-thickness tears (median, 93.80; IQR, 82.50 to 108.33) and partial-thickness tears (median, 96.83; IQR, 90.60 to 112.20). However, there was a statistically significant difference in elasticity according to whether the duration of symptoms was 1 year or less (median, 92.20; IQR, 84.01 to 104.38) or longer than 1 year (median, 105.10; IQR, 100.41 to 116.03; P=0.032). Conclusion: Elasticity values were significantly higher in torn SSTs in patients with chronic shoulder pain that had persisted for more than 1 year. Further studies with larger samples seem warranted to determine whether elasticity values measured by SWE can be used preoperatively as a surrogate marker of the chronicity of a rotator cuff tendon tear.

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Predicting Retear after Repair of Full-Thickness Rotator Cuff Tear: Two-Point Dixon MR Imaging Quantification of Fatty Muscle Degeneration—Initial Experience with 1-year Follow-up

Cited by 49 publications

References 35 publications

A Prospective, Quantitative Evaluation of Fatty Infiltration Before and After Rotator Cuff Repair

A Prospective, Quantitative Evaluation of Fatty Infiltration Before and After Rotator Cuff Repair

Normal values and test–retest variability of stimulated-echo diffusion tensor imaging and fat fraction measurements in the muscle

Elasticity of torn supraspinatus tendons measured by shear wave elastography: a potential surrogate marker of chronicity?

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