Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Visual MRI Grading System to Evaluate Atrophy of the Supraspinatus Muscle

  • Lim, Hyun Kyong (Department of Radiology, Seoul National University College of Medicine) ;
  • Hong, Sung Hwan (Department of Radiology, Seoul National University College of Medicine) ;
  • Yoo, Hye Jin (Department of Radiology, Seoul National University College of Medicine) ;
  • Choi, Ja-Young (Department of Radiology, Seoul National University College of Medicine) ;
  • Kim, Sae Hoon (Department of Orthopedic Surgery, Seoul National University College of Medicine) ;
  • Choi, Jung-Ah (Department of Radiology, Seoul National University College of Medicine) ;
  • Kang, Heung Sik (Department of Radiology, Seoul National University College of Medicine)
  • Received : 2013.07.18
  • Accepted : 2014.05.08
  • Published : 2014.07.01
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Abstract

Objective: To investigate the interobserver reproducibility and diagnostic feasibility of a visual grading system for assessing atrophy of the supraspinatus muscle on magnetic resonance imaging (MRI). Materials and Methods: Three independent radiologists retrospectively evaluated the occupying ratio of the supraspinatus muscle in the supraspinatus fossa on 192 shoulder MRI examinations in 188 patients using a 3-point visual grading system (1, ${\geq}60%$; 2, 30-59%; 3, < 30%) on oblique sagittal T1-weighted images. The inter-reader agreement and the agreement with the reference standard (3-point grades according to absolute occupying ratio values quantitatively measured by directly contouring the muscles on MRI) were analyzed using weighted kappa. The visual grading was applied by a single reader to a group of 100 consecutive patients who had undergone rotator cuff repair to retrospectively determine the association between the visual grades at preoperative state and postsurgical occurrences of retear. Results: The inter-reader weighted kappa value for the visual grading was 0.74 when averaged across three reader pairs (0.70-0.77 for individual reader pairs). The weighted kappa value between the visual grading and the reference standard ranged from 0.75 to 0.83. There was a significant difference in retear rates of the rotator cuff between the 3 visual grades of supraspinatus muscle atrophy on MRI in univariable analysis (p < 0.001), but not in multivariable analysis (p = 0.026). Conclusion: The 3-point visual grading system may be a feasible method to assess the severity of supraspinatus muscle atrophy on MRI and assist in the clinical management of patients with rotator cuff tear.

Keywords

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