Estimating 3D supraspinatus intramuscular fatty infiltration in older adults: a pilot study

Abstract

Background

A recent report suggests that semi-quantitative two-dimensional Goutallier grade (2D-GG) correlates poorly with quantitative three-dimensional Dixon fat fraction (3D-Dixon-FF) on magnetic resonance imaging (MRI).

Purpose

To determine whether the finding of poor correlation of supraspinatus 3D-Dixon-FF with 2D-GG is reproducible, and to determine the strength of the correlation of 3D-Dixon-FF with quantitative 2D Dixon fat fraction (2D-Dixon-FF).

Material and Methods

Ten adults aged ≥60 years were recruited prospectively received shoulder MRI. 2D-Dixon-FF and 3D-Dixon-FF were measured on 6-point Dixon fat fraction maps. 2D-GG was rated on T1-weighted images.

Results

The mean age of participants was 70.7 ± 3.7 years. The mean 3D-Dixon-FF was 8.3% ± 5.7%; the mean 2D-Dixon-FF was 7.3% ± 4.4%; and the mean 2D-GG was 0.9 ± 0.7. There was a strong correlation for 3D-Dixon-FF with 2D-Dixon-FF (rho = 0.90; P < 0.001) and with 2D-GG (rho = 0.73; P = 0.017). Excellent inter-observer reliability was found for Dixon fat fraction (intraclass correlation coefficient = 0.946), which was good for Goutallier grade (weighted kappa = 0.634).

Conclusion

Supraspinatus 3D-Dixon-FF had a strong correlation with 2D-Dixon-FF and 2D-GG in our study population.

Keywords

Intramuscular fatty infiltration magnetic resonance imaging quantitative rotator cuff shoulder

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References

Yamamoto

Takagishi

Osawa

, et al. Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elbow Surg 2010;19:116–120.

Melis

Nemoz

Walch

. Muscle fatty infiltration in rotator cuff tears: descriptive analysis of 1688 cases. Orthop Traumatol Surg Res 2009;95:319–324.

McElvany

McGoldrick

Gee

, et al. Rotator cuff repair: published evidence on factors associated with repair integrity and clinical outcome. Am J Sports Med 2015;43:491–500.

Davis DL, Gilotra MN, Calderon R, et al. Reliability of supraspinatus intramuscular fatty infiltration estimates on T1-weighted MRI in potential candidates for rotator cuff repair surgery: full-thickness tear versus high-grade partial-thickness tear. Skeletal Radiol 2021;50:2233–2243.

Kweon

Gagnier

Robbins

, et al. Surgical versus nonsurgical management of rotator cuff tears: predictors of treatment allocation. Am J Sports Med 2015;43:2368–2372.

Gladstone

Bishop

, et al. Fatty infiltration and atrophy of the rotator cuff do not improve after rotator cuff repair and correlate with poor functional outcome. Am J Sports Med 2007;35:719–728.

Davis DL, Zhuo J, Almardawi R, et al. Association of patient self-reported shoulder scores to quantitative and semi-quantitative MRI measures of rotator cuff intramuscular fatty infiltration: a pilot study. AJR Am J Roentgenol 2019;213:1307–1304.

Ashry

Schweitzer

Cunningham

, et al.

Muscle atrophy as a consequence of rotator cuff tears: should we compare the muscles of the rotator cuff with those of the deltoid?

Skeletal Radiol 2007;36:841–845.

Deniz

Kose

Tugay

, et al.

Fatty degeneration and atrophy of the rotator cuff muscles after arthroscopic repair: does it improve, halt or deteriorate?

Arch Orthop Trauma Surg 2014;134:985–990.

10.

Goutallier

Postel

Bernageau

, et al. Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res 1994;304:78–83.

11.

Fuchs

Weishaupt

Zanetti

, et al. Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging. J Shoulder Elbow Surg 1999;8:599–605.

12.

Lee

Lucas

Lansdown

, et al. Magnetic resonance rotator cuff fat fraction and its relationship with tendon tear severity and subject characteristics. J Shoulder Elbow Surg 2015;24:1442–1451.

13.

Nardo

Karampinos

Lansdown

, et al. Quantitative assessment of fat infiltration in the rotator cuff muscles using water-fat MRI. J Magn Reson Imaging 2014;39:1178–1185.

14.

Agten

Rosskopf

Gerber

, et al. Quantification of early fatty infiltration of the rotator cuff muscles: comparison of multi-echo Dixon with single-voxel MR spectroscopy. Euro Radiol 2016;26:3719–3727.

15.

Vidt

Santago

2nd Tuohy

, et al. Assessments of fatty infiltration and muscle atrophy from a single magnetic resonance image slice are not predictive of 3–dimensional measurements. Arthroscopy 2016;32:128–139.

16.

Davis DL, Almardawi R, Henn RF, et al. Correlation of quantitative versus semiquantitative measures of supraspinatus intramuscular fatty infiltration to shoulder range of motion and strength: a pilot study. Curr Probl Diagn Radiol 2021;50:629–636.

17.

Davis DL, Gilotra MN, Hovis JP, et al. Association of rotator cuff tear patterns and intramuscular fatty infiltration on magnetic resonance imaging. J Clin Imaging Sci 2019;9:38.

18.

McClure

Michener

. Measures of adult shoulder function. Arthritis Rheum 2003;49:S50–S58.

19.

Vidt

Santago

2nd Hegedus

, et al. Can self-report instruments of shoulder function capture functional differences in older adults with and without a rotator cuff tear?

J Electromyogr Kinesiol 2016;29:90–99.

20.

Cicchetti

. Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychol Assess 1994;6:284–290.

21.

Davis DL, Kesler T, Gilotra MN, et al. Quantification of shoulder muscle intramuscular fatty infiltration on T1-weighted MRI: a viable alternative to the Goutallier classification system. Skeletal Radiol 2019;48:535–541.

22.

Grimm

Meyer

Nickel

, et al. Evaluation of 2-point, 3–point, and 6-point Dixon magnetic resonance imaging with flexible echo timing for muscle fat quantification. Eur J Radiol 2018;103:57–64.

23.

Lee

Yang

, et al.

Can a single sagittal magnetic resonance imaging slice represent whole fatty infiltration in chronic rotator cuff tears at the supraspinatus?

Clin Orthop Surg 2018;10:55–63.

24.

Yoo

Choi

Hong

, et al. Quantifying rotator cuff atrophy and fatty degeneration at the supraspinatus origin in the scapular fossa. Knee Surg Sports Traumotol 2015;23:399–407.