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Journal of Orthopaedic Surgery and Research
Published in: Journal of Orthopaedic Surgery and Research 1/2019

Open Access 01-12-2019 | Magnetic Resonance Imaging | Research article

Diagnostic accuracy of MRA and MRI for the bursal-sided partial-thickness rotator cuff tears: a meta-analysis

Authors: Tao Huang, Jian Liu, Yupeng Ma, Dongsheng Zhou, Liang Chen, Fanxiao Liu

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2019

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Abstract

Background

Numerous quantitatively studies have focused on the diagnosis of bursal-sided partial-thickness rotator cuff tears (RCTs); however, the accuracy of magnetic resonance imaging (MRI) and MR arthrography (MRA) remains inconclusive. This study was performed systematically to compare the diagnostic value of MRA and MRI for the bursal-sided partial-thickness RCTs.

Methods

Three electronic databases, PubMed, Embase, and Cochrane Library, were utilized to retrieve articles comparing the diagnostic value of MRA and MRI for detecting bursal-sided partial-thickness RCTs. After screening and diluting out the articles that met the inclusion criteria to be used for statistical analysis, the pooled evaluation indexes include sensitivity, specificity, positive and negative predictive values, diagnostic odds ratio (DOR), and the area under the receiver operating characteristic curve (AUC).

Results

Twelve studies involving 1740 patients and 1741 shoulders were identified. The pooled sensitivity, specificity, DOR, and AUC of MRA to diagnose bursal-sided partial-thickness RCTs were 0.77 (95% CI, 0.67–0.85), 0.98 (95% CI, 0.95–0.99), 73.01 (95% CI, 35.01–152.26), and 0.88 (95% CI, 0.85–0.91), respectively. The pooled sensitivity, specificity, DOR, and AUC of MRI were 0.77 (95% CI, 0.66–0.86) and 0.96 (95% CI, 0.81–0.99), and 37.12 (95% CI, 8.08–170.64) and 0.82 (95% CI, 0.78–0.85), respectively.

Conclusions

This meta-analysis reveals that MRA and MRI have similar diagnostic value for the diagnosis of bursal-sided partial-thickness rotator cuff tears.
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Literature
1.
Gumina S, Carbone S, Campagna V, Candela V, Sacchetti FM, Giannicola G. The impact of aging on rotator cuff tear size. Musculoskelet Surg. 2013;97(Suppl 1):69–72.PubMed
2.
Klaips CL, Jayaraj GG, Hartl FU. Pathways of cellular proteostasis in aging and disease. J Cell Biol. 2018;217(1):51–63.PubMedPubMedCentral
3.
Flatow EL, Soslowsky LJ, Ticker JB, et al. Excursion of the rotator cuff under the acromion. Patterns of subacromial contact. Am J Sports Med. 1994;22(6):779–88.PubMed
4.
Ko JY, Huang CC, Chen WJ, Chen CE, Chen SH, Wang CJ. Pathogenesis of partial tear of the rotator cuff: a clinical and pathologic study. J Shoulder Elb Surg. 2006;15(3):271–8.
5.
Ogawa K, Yoshida A, Inokuchi W, Naniwa T. Acromial spur: relationship to aging and morphologic changes in the rotator cuff. J Shoulder Elb Surg. 2005;14(6):591–8.
6.
Kim YS, Kim JM, Bigliani LU, Kim HJ, Jung HW. In vivo strain analysis of the intact supraspinatus tendon by ultrasound speckles tracking imaging. J Orthop Res. 2011;29(12):1931–7.PubMed
7.
Fukuda H. Partial-thickness rotator cuff tears: a modern view on Codman’s classic. J Shoulder Elb Surg. 2000;9(2):163–8.
8.
Kanatli U, Ayanoglu T, Aktas E, Ataoglu MB, Ozer M, Cetinkaya M. Grade of coracoacromial ligament degeneration as a predictive factor for impingement syndrome and type of partial rotator cuff tear. J Shoulder Elb Surg. 2016;25(11):1824–8.
9.
Boytim VB, Tyler CV Jr. History and physical examination for identifying rotator cuff tears. Am Fam Physician. 2017;96(9):Online.PubMed
10.
Jain NB, Yamaguchi K. History and physical examination provide little guidance on diagnosis of rotator cuff tears. Evidence-based med. 2014;19(3):108.
11.
Sipola P, Niemitukia L, Kroger H, Hofling I, Vaatainen U. Detection and quantification of rotator cuff tears with ultrasonography and magnetic resonance imaging - a prospective study in 77 consecutive patients with a surgical reference. Ultrasound Med Biol. 2010;36(12):1981–9.PubMed
12.
Teefey SA, Rubin DA, Middleton WD, Hildebolt CF, Leibold RA, Yamaguchi K. Detection and quantification of rotator cuff tears. Comparison of ultrasonographic, magnetic resonance imaging, and arthroscopic findings in seventy-one consecutive cases. J Bone Joint Surg Am. 2004;86(4):708–16.PubMed
13.
de Jesus JO, Parker L, Frangos AJ, Nazarian LN. Accuracy of MRI, MR arthrography, and ultrasound in the diagnosis of rotator cuff tears: a meta-analysis. AJR Am J Roentgenol. 2009;192(6):1701–7.PubMed
14.
Teng A, Liu F, Zhou D, He T, Chevalier Y, Klar RM. Effectiveness of 3-dimensional shoulder ultrasound in the diagnosis of rotator cuff tears: a meta-analysis. Med. 2018;97(37):e12405.
15.
Yamaguchi K, Tetro AM, Blam O, Evanoff BA, Teefey SA, Middleton WD. Natural history of asymptomatic rotator cuff tears: a longitudinal analysis of asymptomatic tears detected sonographically. J Shoulder Elb Surg. 2001;10(3):199–203.
16.
Liu F, Meng Q, Yin H, Yan Z. Stem Cells in Rotator Cuff Injuries and Reconstructions: A systematic review and meta-analysis. Curr Stem Cell Res Ther. 2019;14(8):683-97.
17.
McConville OR, Iannotti JP. Partial-thickness tears of the rotator cuff: evaluation and management. J Am Acad Orthop Surg. 1999;7(1):32–43.PubMed
18.
Breazeale NM, Craig EV. Partial-thickness rotator cuff tears. Pathogenesis and treatment. Orthop Clin North Am. 1997;28(2):145–55.PubMed
19.
Lehman RC, Perry CR. Arthroscopic surgery for partial rotator cuff tears. Arthroscopy. 2003;19(7):E81–4.PubMed
20.
Park JY, Yoo MJ, Kim MH. Comparison of surgical outcome between bursal and articular partial thickness rotator cuff tears. Orthopedics. 2003;26(4):387–90 discussion 390.PubMed
21.
Weber SC. Arthroscopic debridement and acromioplasty versus mini-open repair in the management of significant partial-thickness tears of the rotator cuff. Orthop Clin North Am. 1997;28(1):79–82.PubMed
22.
Weber SC. Arthroscopic debridement and acromioplasty versus mini-open repair in the treatment of significant partial-thickness rotator cuff tears. Arthroscopy. 1999;15(2):126–31.PubMed
23.
Wright SA, Cofield RH. Management of partial-thickness rotator cuff tears. J Shoulder Elb Surg. 1996;5(6):458–66.
24.
Salem H, Carter A, Tjoumakaris F, Freedman KB. Double-row repair technique for bursal-sided partial-thickness rotator cuff tears. Arthroscopy techniques. 2018;7(3):e199–203.PubMedPubMedCentral
25.
Yang S, Park HS, Flores S, et al. Biomechanical analysis of bursal-sided partial thickness rotator cuff tears. J Shoulder Elb Surg. 2009;18(3):379–85.
26.
Kim KC, Shin HD, Cha SM, Park JY. Repair integrity and functional outcome after arthroscopic conversion to a full-thickness rotator cuff tear: articular- versus bursal-side partial tears. Am J Sports Med. 2014;42(2):451–6.PubMed
27.
Xiao J, Cui G. Clinical and structural results of arthroscopic repair of bursal-side partial-thickness rotator cuff tears. J Shoulder Elb Surg. 2015;24(2):e41–6.
28.
Kim HJ, Kim JY, Kee YM, Rhee YG. Bursal-sided rotator cuff tears: simple versus everted type. Am J Sports Med. 2018;46(2):441–8.PubMed
29.
Chun KA, Kim MS, Kim YJ. Comparisons of the various partial-thickness rotator cuff tears on MR arthrography and arthroscopic correlation. Korean J Radiol. 2010;11(5):528–35.PubMedPubMedCentral
30.
McInnes MDF, Moher D, Thombs BD, et al. Preferred reporting items for a systematic review and meta-analysis of diagnostic test accuracy studies: the PRISMA-DTA statement. Jama. 2018;319(4):388–96.PubMed
31.
Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155(8):529–36.
32.
Fritz LB, Ouellette HA, O’Hanley TA, Kassarjian A, Palmer WE. Cystic changes at supraspinatus and infraspinatus tendon insertion sites: association with age and rotator cuff disorders in 238 patients. Radiology. 2007;244(1):239–48.PubMed
33.
Magee T. 3-T MRI of the shoulder: is MR arthrography necessary? AJR Am J Roentgenol. 2009;192(1):86–92.PubMed
34.
Oh DK, Yoon YC, Kwon JW, et al. Comparison of indirect isotropic MR arthrography and conventional MR arthrography of labral lesions and rotator cuff tears: a prospective study. AJR Am J Roentgenol. 2009;192(2):473–9.PubMed
35.
Choo HJ, Lee SJ, Kim OH, Seo SS, Kim JH. Comparison of three-dimensional isotropic T1-weighted fast spin-echo MR arthrography with two-dimensional MR arthrography of the shoulder. Radiology. 2012;262(3):921–31.PubMed
36.
Modi CS, Karthikeyan S, Marks A, et al. Accuracy of abduction-external rotation MRA versus standard MRA in the diagnosis of intra-articular shoulder pathology. Orthopedics. 2013;36(3):e337–42.PubMed
37.
Lee JH, Yoon YC, Jee S, Kwon JW, Cha JG, Yoo JC. Comparison of three-dimensional isotropic and two-dimensional conventional indirect MR arthrography for the diagnosis of rotator cuff tears. Korean J Radiol. 2014;15(6):771–80.PubMedPubMedCentral
38.
Choo HJ, Lee SJ, Kim JH, et al. Delaminated tears of the rotator cuff: prevalence, characteristics, and diagnostic accuracy using indirect MR arthrography. AJR Am J Roentgenol. 2015;204(2):360–6.PubMed
39.
Farshad-Amacker NA, Buck FM, Farshad M, Pfirrmann CW, Gerber C. Partial supraspinatus tears are associated with tendon lengthening. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 2015;23(2):408–14.
40.
Lee JH, Yoon YC, Jung JY, Yoo JC. Rotator cuff tears noncontrast MRI compared to MR arthrography. Skelet Radiol. 2015;44(12):1745–54.
41.
Lo HC, Hung ST, Kuo DP, Chen YL, Lee HM. Quantitative diffusion-weighted magnetic resonance imaging for the diagnosis of partial-thickness rotator cuff tears. J Shoulder Elb Surg. 2016;25(9):1433–41.
42.
Perez JR, Massel D, Barrera CM, et al. Rotator cuff tears in the pediatric population: comparing findings on arthroscopic evaluation to pre-operative magnetic resonance imaging. J clinical orthopaedics and trauma. 2018;9(Suppl 1):S123–8.
43.
Shin SJ. A comparison of 2 repair techniques for partial-thickness articular-sided rotator cuff tears. Arthroscopy. 2012;28(1):25–33.PubMed
44.
Waldt S, Bruegel M, Mueller D, et al. Rotator cuff tears: assessment with MR arthrography in 275 patients with arthroscopic correlation. Eur Radiol. 2007;17(2):491–8.PubMed
45.
Kim SJ, Kim SH, Lim SH, Chun YM. Use of magnetic resonance arthrography to compare clinical features and structural integrity after arthroscopic repair of bursal versus articular side partial-thickness rotator cuff tears. Am J Sports Med. 2013;41(9):2041–7.PubMed
46.
Oh JH, Kim JY, Lee HK, Choi JA. Classification and clinical significance of acromial spur in rotator cuff tear: heel-type spur and rotator cuff tear. Clin Orthop Relat Res. 2010;468(6):1542–50.PubMed
47.
Nagler RM, Laufer D. Protection against irradiation-induced damage to salivary glands by adrenergic agonist administration. Int J Radiat Oncol Biol Phys. 1998;40(2):477–81.PubMed
48.
Jung JY, Yoon YC, Choi SH, Kwon JW, Yoo J, Choe BK. Three-dimensional isotropic shoulder MR arthrography: comparison with two-dimensional MR arthrography for the diagnosis of labral lesions at 3.0 T. Radiology. 2009;250(2):498–505.PubMed
49.
Park YH, Lee JY, Moon SH, et al. MR arthrography of the labral capsular ligamentous complex in the shoulder: imaging variations and pitfalls. AJR Am J Roentgenol. 2000;175(3):667–72.PubMed
50.
Jung JY, Jee WH, Chun CW, Kim YS. Diagnostic performance of MR arthrography with anterior trans-subscapularis versus posterior injection approach for subscapularis tendon tears at 3.0 T. Eur Radiol. 2017;27(3):1303–11.PubMed
51.
Chung CB, Dwek JR, Feng S, Resnick D. MR arthrography of the glenohumeral joint: a tailored approach. AJR Am J Roentgenol. 2001;177(1):217–9.PubMed
52.
Fotiadou AN, Vlychou M, Papadopoulos P, Karataglis DS, Palladas P, Fezoulidis IV. Ultrasonography of symptomatic rotator cuff tears compared with MR imaging and surgery. Eur J Radiol. 2008;68(1):174–9.PubMed
53.
Co S, Bhalla S, Rowan K, Aippersbach S, Bicknell S. Comparison of 2- and 3-dimensional shoulder ultrasound to magnetic resonance imaging in a community hospital for the detection of supraspinatus rotator cuff tears with improved worktime room efficiency. Can Assoc Radiol J. 2012;63(3):170–6.PubMed
54.
Grainger AJ, Elliott JM, Campbell RS, Tirman PF, Steinbach LS, Genant HK. Direct MR arthrography: a review of current use. Clin Radiol. 2000;55(3):163–76.PubMed
55.
Nelson MC, Leather GP, Nirschl RP, Pettrone FA, Freedman MT. Evaluation of the painful shoulder. A prospective comparison of magnetic resonance imaging, computerized tomographic arthrography, ultrasonography, and operative findings. J Bone Joint Surg Am. 1991;73(5):707–16.PubMed
Metadata
Title
Diagnostic accuracy of MRA and MRI for the bursal-sided partial-thickness rotator cuff tears: a meta-analysis
Authors
Tao Huang
Jian Liu
Yupeng Ma
Dongsheng Zhou
Liang Chen
Fanxiao Liu
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2019
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-019-1460-y

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