Accuracy of MRI in diagnosing intra-articular pathology of the long head of the biceps tendon: results with a large cohort of patients
| Autor: | Jung Youn Kim, Yong Girl Rhee, Sung Min Rhee |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Pathology Shoulder Diagnostic criteria lcsh:Diseases of the musculoskeletal system Long head of biceps tendon Sensitivity and Specificity Rotator Cuff Injuries 03 medical and health sciences Arthroscopy Rotator Cuff 0302 clinical medicine Magnetic resonance imaging Rheumatology Predictive Value of Tests Internal medicine Bicipital groove medicine Humans Orthopedics and Sports Medicine Rotator cuff Retrospective Studies 030203 arthritis & rheumatology Observer Variation 030222 orthopedics Diagnostic efficacy medicine.diagnostic_test Receiver operating characteristic business.industry Shoulder Joint Tendon medicine.anatomical_structure Orthopedic surgery Preoperative Period Tears lcsh:RC925-935 business Research Article |
| Zdroj: | BMC Musculoskeletal Disorders, Vol 20, Iss 1, Pp 1-9 (2019) BMC Musculoskeletal Disorders |
| ISSN: | 1471-2474 |
| Popis: | Background It is difficult to diagnose the pathology of the long head of the biceps tendon (LHBT) clinically. This study aimed to determine the diagnostic value of standard non-enhancing magnetic resonance imaging (MRI) for detecting LHBT pathology and identify the most useful diagnostic signs on MRI. Methods A total of 554 patients with preoperative 3-Tesla (3 T) MRI who underwent arthroscopic surgery for rotator cuff tears were retrospectively enrolled. Abnormal signs of LHBT on MRI included diameter change, contour irregularity, and alteration of signal intensity. Arthroscopic findings were classified according to tear progress and used as a reference standard: Type I, normal tendon; Type II, hourglass-shaped hypertrophic tendon with fraying extending into the bicipital groove; Type III, partial tear involving less than 50% of tendon width at the intraarticular region without fraying in the bicipital groove; Type IV, partial tear involving more than 50% of tendon width and extending into the bicipital groove; and Type V, complete tear (cutoff) of the tendon. Using receiver operating characteristic, prediction accuracies of MRI findings were assessed compared to those of arthroscopic findings. Results Arthroscopic findings showed LHBT pathology in 124 (22.4%) cases. High diagnostic efficacy was achieved when ‘at least 2 abnormal signs’ was set as diagnostic criteria (sensitivity: 77.9%; specificity: 93.7%; positive predictive value: 76.3%). Types II and III lesions showed the highest sensitivities (36.8 and 66.7%, respectively) in abnormal alteration of signal intensity in the parasagittal view while Type IV showed the highest sensitivity (82.3%) in diameter change in axial view. Interobserver agreements were substantial to almost perfect, with kappa value of 0.69–0.81. Conclusions The standard non-enhancing 3 T MRI had a high diagnostic value in preoperative detection of LHBT pathology. Its accuracy was increased when diagnostic criterion was set as ‘2 or more abnormal signs (diameter change, contour irregularity, and alteration of signal intensity)’. The single diagnostic sign with the highest sensitivity was alteration of signal intensity in the parasagittal view. |
| Databáze: | OpenAIRE |
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