Investigative Magnetic Resonance Imaging

Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회)
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The Difference in Diagnostic Performance for Detection of Supraspinatus Tendon Tears by Adding Angled Oblique Sagittal Plane Image to the Routine Shoulder MRI

고식적 견관절 자기공명영상에 추가적인 사각시상면 영상 이용 시 극상건 손상 검출 진단능 차이에 대한 고찰

  • Kim, Ji Hee (Department of Radiology, Soonchunhyang University Hospital) ;
  • Kim, Hyun Joo (Department of Radiology, Soonchunhyang University Hospital) ;
  • Cha, Jang Gyu (Department of Radiology, Soonchunhyang University Hospital) ;
  • Choi, Duk Lin (Department of Radiology, Soonchunhyang University Hospital) ;
  • Hong, Seong Sook (Department of Radiology, Soonchunhyang University Hospital) ;
  • Chang, Yun Woo (Department of Radiology, Soonchunhyang University Hospital) ;
  • Hwang, Jung Hwa (Department of Radiology, Soonchunhyang University Hospital)
  • 김지희 (순천향대학교 서울병원 영상의학과) ;
  • 김현주 (순천향대학교 서울병원 영상의학과) ;
  • 차장규 (순천향대학교 부천병원 영상의학과) ;
  • 최득린 (순천향대학교 서울병원 영상의학과) ;
  • 홍성숙 (순천향대학교 서울병원 영상의학과) ;
  • 장윤우 (순천향대학교 서울병원 영상의학과) ;
  • 황정화 (순천향대학교 서울병원 영상의학과)
  • Received : 2014.03.14
  • Accepted : 2014.05.20
  • Published : 2014.06.30
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Abstract

Purpose : The purpose of this study is to determine whether adding an angled oblique sagittal plane to the routine shoulder MRI improves the diagnostic performance in the evaluation of supraspinatus tendon tears with arthroscopic correlation. Materials and Methods: The study included 121 patients who had a shoulder MRI followed by arthroscopy. Two radiologists separately evaluated the supraspinatus tendon for tears on shoulder MRI either with or without the angled oblique sagittal images. Arthroscopy was used as the reference standard. The sensitivity and specificity for diagnosing supraspinatus tendon tears were calculated and compared by using McNemar test. Interobserver and intertechnique variability in the interpretation of supraspinatus tendon tears were calculated as a kappa value. Results: Adding the angled oblique sagittal images to the standard shoulder MRI showed improvement in the sensitivity for diagnosing full-thickness supraspinatus tendon tears and also in the sensitivity, specificity and accuracy for the detection of partial-thickness tears. However, there was no statistically significant difference in all of them between with and without the angled set. Interobserver agreement was substantial to almost perfect and intertechnique agreement was moderate. Conclusion: Adding an angled oblique sagittal plane image to the routine shoulder MRI showed no significantly different diagnostic performance in detecting the partial- and full-thickness supraspinatus tendon tears, compared to MRI without angled oblique sagittal plane.

목적 : 고식적 견관절 MRI 검사에 사각시상면 영상 추가 시 극상건 파열의 진단적 정확도가 증가하는지 관절경 수술 소견을 대비표준으로 삼아 알아보고자 하였다. 대상 및 방법 : 2011년 1월부터 2012년 12월까지 본원에서 견관절 MRI 검사를 하고 관절경 수술을 받은 121명의 환자를 대상으로 하였다. 두 명의 영상의학과 의사가 독립적으로 관상사면과 시상사면 영상을 이용하여 극상건 파열을 평가하고 4주후 사각시상면 영상을 추가하여 다시 판독하였다. 관절경 수술을 대비표준으로 이용하였다. 건 파열 진단의 민감도와 특이도는 McNemar test로 비교하였고 관찰자 간, 기술 간 일치도는 카파계수로 평가하였다. 결과 : 사각시상면 추가 시 고식적 견관절 MRI만 이용하였을 때 보다 극상건 전층 파열 진단의 민감도가 증가하였고, 부분 파열 진단의 민감도, 특이도, 정확도 모두 증가하였지만 통계학적으로 유의한 차이는 없었다. 관찰자간 일치도는 사각시상면을 추가하거나 하지 않았을 때 모두 높은 일치도를 보였다. 영상 소견과 관절경 수술 소견은 사각시상면 추가 시와 추가하지 않았을 때 모두 중등도의 일치도를 보였다. 결론 : 극상건의 전층 및 부분 파열 평가를 위해 고식적 MRI에 사각시상면 영상을 추가 시 기존의 영상면 만으로 평가하였을 때와 진단적 정확도에 의미 있는 차이는 없었다.

Keywords

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