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Quantitative MRI characterization of arthroscopically verified supraspinatus pathology: comparison of tendon tears, tendinosis and asymptomatic supraspinatus tendons with T2 mapping

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Quantitative MRI T2 mapping is a non-invasive imaging technique sensitive to biochemical changes, but no studies have evaluated T2 mapping in pathologic rotator cuff tendons. It was sought to evaluate the efficacy of T2 mapping in detecting differences in the supraspinatus tendon (SST) among patients with tendinosis, partial tears and minimally retracted full-thickness tears, relative to asymptomatic volunteers.

Methods

The pathologic cohort consisted of two arthroscopically verified groups: tendinosis and a tear group of partial tears or minimally retracted full-thickness tears, and was compared to an asymptomatic cohort with no prior history of shoulder pathology. The SST was manually segmented from the footprint to the medial humeral head in the coronal and sagittal planes and divided into six clinically relevant subregions. Mean T2 values and inter- and intra-rater reliability were assessed.

Results

In the anterolateral subregion, the tear group exhibited significantly higher mean T2 values (43.9 ± 12.7 ms) than the tendinosis (34.9 ± 3.9 ms; p = 0.006) and asymptomatic (33.6 ± 5.3 ms; p = 0.015) groups. In the posterolateral subregion, the tear group had higher mean T2 values (45.2 ± 13.7) than the asymptomatic group (34.7 ± 6.7; p = 0.012). Inter- and intra-rater reliability was mostly excellent (ICC > 0.75).

Conclusion

T2 mapping is an accurate non-invasive method to identify quantitatively early rotator cuff pathology. The lateral region in the coronal plane in particular may differentiate partial and small minimally retracted full-thickness tears from tendinosis and asymptomatic tendons. Understanding and being able to measure quantitatively the process of tendon degeneration and subsequent tearing may help clinicians to better predict at-risk groups and to stratify treatment options.

Level of evidence

III.

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Acknowledgments

Funding for this study came from the internal institution Steadman Philippon Research Institute, where the research was performed. None of the authors have a conflict of interest related to the subject of this article.

Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study. This study was approved by the Institutional Review Board at Steadman Philippon Research Institute, and the approved protocol number is 2012–2007.

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Authors and Affiliations

  1. The Steadman Clinic, 181 W Meadow Dr, Suite 400, Vail, CO, 81657, USA

    Edmund Ganal & Peter J. Millett

  2. Steadman Philippon Research Institute, 181 W Meadow Dr, Vail, CO, 81657, USA

    Charles P. Ho, Katharine J. Wilson, Rachel K. Surowiec, W. Sean Smith & Grant J. Dornan

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  1. Edmund Ganal
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  2. Charles P. Ho
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  7. Peter J. Millett
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Correspondence to Peter J. Millett.

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Ganal, E., Ho, C.P., Wilson, K.J. et al. Quantitative MRI characterization of arthroscopically verified supraspinatus pathology: comparison of tendon tears, tendinosis and asymptomatic supraspinatus tendons with T2 mapping. Knee Surg Sports Traumatol Arthrosc 24, 2216–2224 (2016). https://doi.org/10.1007/s00167-015-3547-2

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  • DOI: https://doi.org/10.1007/s00167-015-3547-2

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