Shoulder measurements on MRI: Statistical analysis of patients without and with rotator cuff tears and predictive modeling

Abstract

This study aims to determine significant differences between various measurements of shoulder structures and relationships in patients with and without rotator cuff tears and identify a subset of these measurements that may merit further investigation. Shoulder MRIs of 120 patients with rotator cuff tears (RCT group) and 80 patients with normal examinations (No RCT group) were retrospectively identified. Numerous measurements of shoulder anatomy and relationships and pathology characterization were performed for each study. The mean and ranges of measurements for each group were identified, and P-values were calculated to assess differences between the two groups. Classification and Regression Tree (CART) identified prediction models for separating the two groups based on these shoulder MRI measurements. Statistically significant differences were observed for 9 of 18 of the shoulder measurements between the two groups (P < 0.05). Using long head of biceps tendon tear, tendinosis, and subacromial-subdeltoid bursal fluid, the prediction model from CART demonstrated 99.5% accuracy in separating the two groups. Subacromial distance, subacromial spur size, and acromioclavicular osteophyte could also separate the two groups with 97.5% accuracy. Other measures less commonly associated with impingement and rotator cuff tears could also be used to separate the two groups with up to 81.5% accuracy. This study introduces new measures and clarifies ranges for existing measurements on shoulder MRI. Abnormalities of some of these measurements may be associated with subacromial impingement, and combinations of these parameters may be useful for separating patients with or without rotator cuff tears. Clin. Anat. 33:173-186, 2020.

Morphologic and radiologic parameters correlating to shoulder function at diagnosis for patients with rotator cuff tear

“…Moreover, our study population had a mean subacromial distance that is quite substantial (6.9 AE 2.6 mm) compared with other studies' RCT patients. 28 This could explain why the subacromial distance did not affect function negatively. Of note, only 3 participants showed signs of erosion of the acromion.…”

Personalized, Predictive, Participatory, Precision, and Preventive (P5) Medicine in Rotator Cuff Tears

“…Matcuk, 2019 [51] To create predictive models to distinguish patients with RC tears from those without.…”

“…In patients with full-thickness RC tears, levels of pain, health education, and employment status are predictive factors of their emotional and psychological health [42]. Although predictive medicine is conventionally described as techniques and investigations based on genetics, emerging biomedical imaging techniques, machine learning methods, and subject-specific simulations may provide useful information for the definition of predictive models for diagnostic, therapeutic, and surgical scopes [41,43,[50][51][52]. MRI analyses have been used in studies aiming to individualize plausible risk factors as predictors for the allocation to surgery of patients with partial-thickness RC tears, or to predict preoperatively retear risks after surgery [45,49].…”