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Predicting the surgical reparability of large-to-massive rotator cuff tears by B-mode ultrasonography: a cross-sectional study

Ultrasonography 2022년 41권 1호 p.177 ~ 188
Chen Po-Cheng, Wu Kuan-Ting, Chen Yi-Cun, Huang Yu-Chi, Chang Ching-Di, Lin Wei-Chen, Chou Wen-Yi,
소속 상세정보
 ( Chen Po-Cheng ) - Chang Gung University College of Medicine Kaohsiung Chang Gung Memorial Hospital Department of Physical Medicine and Rehabilitation
 ( Wu Kuan-Ting ) - Chang Gung University College of Medicine Kaohsiung Chang Gung Memorial Hospital Department of Orthopedic Surgery
 ( Chen Yi-Cun ) - Chang Gung University College of Medicine Kaohsiung Chang Gung Memorial Hospital Department of Physical Medicine and Rehabilitation
 ( Huang Yu-Chi ) - Chang Gung University College of Medicine Kaohsiung Chang Gung Memorial Hospital Department of Physical Medicine and Rehabilitation
 ( Chang Ching-Di ) - Chang Gung University College of Medicine Kaohsiung Chang Gung Memorial Hospital Department of Diagnostic Radiology
 ( Lin Wei-Chen ) - Chang Gung University College of Medicine Kaohsiung Chang Gung Memorial Hospital Department of Diagnostic Radiology
 ( Chou Wen-Yi ) - Chang Gung University College of Medicine Kaohsiung Chang Gung Memorial Hospital Department of Orthopedic Surgery

Abstract


Purpose: This study aimed to compare the ability of B-mode ultrasonography and magnetic resonance imaging (MRI) to predict the repairability of large-to-massive rotator cuff tears (RCTs).

Methods: This cross-sectional study included participants with large-to-massive RCTs who underwent arthroscopic repair. B-mode ultrasonography and MRI were conducted prior to arthroscopic repair. B-mode ultrasonography was used to evaluate the echogenicity of the rotator cuff muscle using the Heckmatt scale. Intra-rater and inter-rater reliabilities were examined for two independent physicians. MRI was used to evaluate the degrees of tendon retraction, fatty infiltration of rotator cuff muscles, and muscle atrophy. Finally, two experienced orthopedic surgeons performed surgery and decided whether the torn stump could be completely repaired intraoperatively.

Results: Fifty participants were included, and 32 complete repairs and 18 partial repairs were performed. B-mode ultrasonography showed good intra-rater reliability and inter-rater reliability for assessment of the muscle echogenicity of the supraspinatus and infraspinatus muscles. The correlation coefficients between B-mode ultrasound findings and MRI findings showed medium to large effect sizes (r=0.4-0.8). The Goutallier classification of the infraspinatus muscles was the MRI predictor with the best discriminative power for surgical reparability (area under the curve [AUC], 0.89; 95% confidence interval [CI], 0.81 to 0.98), while the Heckmatt scale for infraspinatus muscles was the most accurate ultrasound predictor (AUC, 0.85; 95% CI, 0.74 to 0.96). No significant differences in AUCs among the MRI and ultrasound predictors were found.

Conclusion: B-mode ultrasonography was a reliable examination tool and had a similar ability to predict surgical reparability to that of MRI among patients with large-to-massive RCTs.

키워드

Large-to-massive rotator cuff tears; Reparability; B-mode ultrasound

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