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Magnetic Resonance Materials in Physics, Biology and Medicine
Published in: Magnetic Resonance Materials in Physics, Biology and Medicine 6/2019

01-12-2019 | Magnetic Resonance Imaging | Short Communication

A quantitative alternative to the Goutallier classification system using Lava Flex and Ideal MRI techniques: volumetric intramuscular fatty infiltration of the supraspinatus muscle, a cadaveric study

Authors: Jose H. Trevino III, Krzysztof R. Gorny, Angel Gomez-Cintron, Chunfeng Zhao, Hugo Giambini

Published in: Magnetic Resonance Materials in Physics, Biology and Medicine | Issue 6/2019

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Abstract

Objective

The Goutallier classification system is the most commonly used method for grading intramuscular fatty infiltration in rotator cuff tears. This grading system presents low inter-observer reliability and an inability to provide quantitative and repeatable outcomes for intramuscular fat. We determined the correlation and reliability of two methods, the Lava Flex and Ideal IQ MRI techniques, in quantifying volumetric intramuscular fat, while also comparing to the Goutallier method.

Materials and methods

The supraspinatus muscles of seventeen cadaveric shoulders were scanned using the Lava Flex and Ideal IQ MRI imaging protocols. Histological analysis was performed on the same muscles. Agreement, reliability, and correlation analyses were performed to compare all outcomes.

Results

The Lava Flex protocol took an average of ~ 4 min, while the Ideal IQ required about ~ 11 min to complete. Bland–Altman analysis showed good agreement between the Lava Flex and Ideal IQ [LOA (− 0.10 and 0.05)], and ICC analyses showed excellent reliability (ICC (1,1) 0.948; ICC (2,1) 0.947). There was a 91% correlation between the Lava Flex and Ideal IQ MR protocols. Weighted Kappa analysis between histology and the Goutallier classification showed fair-to-moderate agreement.

Discussion

The Lava Flex technique, taking about 30% of the acquisition time, may prevent motion artifacts in outcomes associated with the longer Ideal IQ technique. However, potential magnetic field inhomogeneities should be considered. The Lava Flex technique may be a faster and valid alternative to the Goutallier classification system.
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Metadata
Title
A quantitative alternative to the Goutallier classification system using Lava Flex and Ideal MRI techniques: volumetric intramuscular fatty infiltration of the supraspinatus muscle, a cadaveric study
Authors
Jose H. Trevino III
Krzysztof R. Gorny
Angel Gomez-Cintron
Chunfeng Zhao
Hugo Giambini
Publication date
01-12-2019
Publisher
Springer International Publishing
Published in
Magnetic Resonance Materials in Physics, Biology and Medicine / Issue 6/2019
Print ISSN: 0968-5243
Electronic ISSN: 1352-8661
DOI
https://doi.org/10.1007/s10334-019-00774-y

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