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Comparison of Preoperative Magnetic Resonance Image (MRI) and Arthroscopic Rotator Cuff Tear Size according to Timing of MRI

수술 전 검사 시기에 따른 자기공명영상과 관절경상의 회전근 개 파열의 크기 비교

  • Park, Chang-Min (Department of Orthopaedic Surgery, College of Medicine, Catholic University of Daegu) ;
  • Chae, Seung-Bum (Department of Orthopaedic Surgery, College of Medicine, Catholic University of Daegu) ;
  • Choi, Chang-Hyuk (Department of Orthopaedic Surgery, College of Medicine, Catholic University of Daegu)
  • 박창민 (대구가톨릭대학병원 정형외과학교실) ;
  • 채승범 (대구가톨릭대학병원 정형외과학교실) ;
  • 최창혁 (대구가톨릭대학병원 정형외과학교실)
  • Received : 2012.12.04
  • Accepted : 2013.06.07
  • Published : 2013.06.30

Abstract

Purpose: To know if magnetic resonance image (MRI) re-examination is needed before surgery, we compared the pre-operative MRI recorded at different time points and the corresponding arthroscopic findings. Materials and Methods: Depending on the timing of evaluation, the MRI was classified into three groups: group A, MRI was taken 1 month before the surgery (44 cases, average 16 days); group B, 1-6 months before the surgery (41 cases, average 91 days); and group C, 6-12 months before the surgery (25 cases, average 230 days). The anterior to posterior tear size (length) and medial retraction size (width) of rotator cuff tear were measured for each group and they were compared with the actual arthroscopic findings. Results: Results of this study showed that arthroscopic rotator cuff tear length and width were larger than those of MRI. The difference of the rotator cuff tear size was 3.6(${\pm}1.2$) mm of length and 0.6(${\pm}0.4$) mm of width in group A, 4.2(${\pm}1.7$) mm and 2.4(${\pm}1.1$) mm in group B, and 4.5(${\pm}2.1$) mm and 3.0(${\pm}1.5$) mm in group C. There was a tendency of the larger size difference for longer pre-operative period, but it was not statistically significant. Conclusion: The rotator cuff tear size did not show remarkable differences between pre-operative MRI taken within 1 year before surgery and the actual arthroscopy. It is concluded that additional MRI evaluation is not required within 1 year.

목적: 회전근 개 파열 환자에서 수술 전 시행한 자기 공명 영상 검사를 수술까지 경과되는 시간을 기준으로 분류하고 수술 시 관절경상의 회전근 개 파열의 크기와 비교하여 자기 공명 영상 재검사의 필요 여부를 알아 보고자 하였다. 대상 및 방법: 110예에서 수술 전 시행한 자기 공명 영상 검사를 시기에 따라 수술 전 1개월(A군, 평균 16일, 44예), 1개월~6개월(B군, 평균 91일, 41예), 6개월~1년(C군, 평균 230일, 25예)으로 분류하여 관절경하 회전근 개 파열의 전후방 크기(길이) 및 내측 퇴축의 크기(너비)를 비교하였다. 결과: A, B, C군에서 관절경상 파열의 크기가 더 크게 나타났으며 A군에서 시행한 자기 공명 영상과 관절경의 회전근개 파열의 크기 차이는 길이와 너비 각각 3.6(${\pm}1.2$) mm, 0.6(${\pm}0.4$) mm, B군에서는 4.2(${\pm}1.7$) mm, 2.4(${\pm}1.1$) mm, C군에서 4.5(${\pm}2.1$) mm, 3.0(${\pm}1.5$) mm의 차이를 보였다. 각 군간 파열의 길이 및 너비는 자기 공명 영상 검사와 수술까지의 시간이 길어질수록 증가하는 양상을 보였으나 통계학적 유의성은 없었다. 결론: 수술 1년 이내에 시행한 자기 공명 영상 검사상 회전근 개 파열의 크기는 관절경 소견과 유사하였으며 수술 시 추가적인 자기 공명 영상 검사는 필요 없을 것으로 생각된다.

Keywords

References

  1. Balich SM, Sheley RC, Brown TR, Sauser DD, Quinn SF. MR imaging of the rotator cuff tendon: interobserver agreement and analysis of interpretive errors. Radiology. 1997;204:191-4. https://doi.org/10.1148/radiology.204.1.9205245
  2. Magee T, Williams D. 3.0-T MRI of the supraspinatus tendon. AJR Am J Roentgenol. 2006;187:881-6. https://doi.org/10.2214/AJR.05.1047
  3. Singson RD, Hoang T, Dan S, FriedmanM. MR evaluation of rotator cuff pathology using T2-weighted fast spin-echo technique with and without fat suppression. AJR Am J Roentgenol. 1996;166:1061-5. https://doi.org/10.2214/ajr.166.5.8615243
  4. Boenisch U, Lembcke O, Naumann T. Classification, clinical findings and operative treatment of degenerative and posttraumatic shoulder disease: what do we really need to know from an imaging report to establish a treatment strategy? Eur J Radiol. 2000;35:103-18. https://doi.org/10.1016/S0720-048X(00)00226-6
  5. Mantone JK, Burkhead WZ Jr, Noonan J Jr. Nonoperative treatment of rotator cuff tears. Orthop Clin North Am. 2000;31:295-311. https://doi.org/10.1016/S0030-5898(05)70149-8
  6. Safran O, Schroeder J, Bloom R, Weil Y, Milgrom C. Natural history of nonoperatively treated symptomatic rotator cuff tears in patients 60 years old or younger. Am J Sports Med. 2011;39:710-4. https://doi.org/10.1177/0363546510393944
  7. Bjorkenheim JM. Structure and function of the rabbit's supraspinatus muscle after resection of its tendon. Acta Orthop Scand. 1989;60:461-3. https://doi.org/10.3109/17453678909149320
  8. Nakagaki K, Tomita Y, Sakurai G, Oshiro O, Tamai S, Ozaki J. Anatomical study on the atrophy of supraspinatus muscle belly with cuff tear. Nihon Seikeigeka Gakkai Zasshi. 1994;68:516-21.
  9. Thomazeau H, Boukobza E, Morcet N, Chaperon J, Langlais F. Prediction of rotator cuff repair results by magnetic resonance imaging. Clin Orthop Relat Res. 1997;344:275-83.
  10. Thomazeau H, Rolland Y, Lucas C, Duval JM, Langlais F. Atrophy of the supraspinatus belly: Assessment by MRI in 55 patients with rotator cuff pathology. Acta Orthop Scand. 1996;67:264-8. https://doi.org/10.3109/17453679608994685
  11. Goutallier D, Postel. JM, Bernaqeau J, Lavau L, Voisin MC. Fatty muscle degeneration in cuff ruptures. Pre-and postoperative evaluation by CT scan. Clin Orthop Relat Res. 1994;304:78-83.
  12. Fuchs B, Weishaupt D, Zanetti M, Hodler J, Gerber C. 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. https://doi.org/10.1016/S1058-2746(99)90097-6
  13. Jobe FW, Moynes DR. Delineation of diagnostic criteria and a rehabilitation program for rotator cuff injuries. Am J Sports Med. 1982;10:336-9. https://doi.org/10.1177/036354658201000602
  14. Gerber C, Fuchs B, Hodler J. The result of massive tears of the rotator cuff. J Bone Joint Surg Am. 2000; 82:505-15.
  15. Gupta R, Leggin BG, Iannotti JP. Results of surgical repair of full thickness tears of the rotator cuff. Orthop Clin North Am. 1997;28:241-8. https://doi.org/10.1016/S0030-5898(05)70283-2
  16. Iannotti JP. Full-thickness rotator cuff tears: factors affecting surgical outcome. J Am Acad Ortho Surg. 1994;2:87-95. https://doi.org/10.5435/00124635-199403000-00002
  17. Bryant L, Shnier R, Bryant C, Murrell GA. A comparison of clinical estimation, ultrasonography, magnetic resonance imaging, and arthroscopy in determining the size of rotator cuff tears. J Shoulder Elbow Surg. 2002;11:219-24. https://doi.org/10.1067/mse.2002.121923
  18. 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 Elbow Surg. 2001;10:199-203. https://doi.org/10.1067/mse.2001.113086
  19. Maman E, Harris C, White L, Tomlinson G, Shashank M, Boynton E. Outcome of nonoperative treatment of symptomatic rotator cuff tears monitored by magnetic resonance imaging. J Bone Joint Surg Am. 2009;91:1898-906. https://doi.org/10.2106/JBJS.G.01335

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  1. Comparison of Clinical and Radiological Results in the Arthroscopic Repair of Full-Thickness Rotator Cuff Tears With and Without the Anterior Attachment of the Rotator Cable vol.45, pp.11, 2017, https://doi.org/10.1177/0363546517709772