Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Another Assessment of Fat Degeneration of Retracted Supraspinatus Muscle

  • Jeong, Yeon-Seok (Department of Orthopaedic Surgery, Sanggye Paik Hospital, Inje University School of Medicine) ;
  • Yum, Jae-Kwang (Department of Orthopaedic Surgery, Sanggye Paik Hospital, Inje University School of Medicine) ;
  • Park, Sang-Yoon (Department of Orthopaedic Surgery, Sanggye Paik Hospital, Inje University School of Medicine)
  • Received : 2018.08.27
  • Accepted : 2018.10.09
  • Published : 2018.12.01
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Abstract

Background: The purpose of this study was to assess the relevance of preoperative magnetic resonance imaging (MRI) evaluation by occupation ratio (OR) at maximum diameter of supraspinatus muscle. Methods: Patients from the Inje University Sanggye Paik Hospital who received rotator cuff repair and underwent pre- and postoperative MRI were selected as subjects of this study. On T1-weighted MRIs, OR of fat and muscle at Y-shaped view, OR at a location on supraspinatus muscle where its diameter was maximum on coronal view, and pre- and postoperative Goutallier Classification and changes in the tangent sign were measured. Statistical significance of postoperative OR was assessed regarding time from symptom onset to surgery, size of rotator cuff tear, preoperative OR, and the difference between ORs measured at maximum diameter of supraspinatus muscle and Y-shaped view. Results: Preoperative OR at Y-shaped view was $52.28{\pm}8.57$ (32.5-65.3). Preoperative OR difference between maximum diameter and Y-shaped view was $13.76{\pm}10.51$ (2.38-42.04), and Pearson correlation coefficient was 0.604 (p=0.001). Postoperative OR at Y-shaped view was $63.77{\pm}9.35$ (37.3-76.1). Pearson correlation coefficient of pre- and postoperative Goutallier Classification was -0.579 (p=0.002) and Pearson correlation coefficient of the postoperative difference between ORs measured at maximum diameter of supraspinatus muscle and Y-shaped view was -0.386 (p=0.047). Conclusions: Fatty degeneration of supraspinatus muscle in rotator cuff tear patients should be evaluated not only in the conventional Y-shaped view, but also at location of maximum diameter of supraspinatus muscle to establish patients' therapeutic plan.

Keywords

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Fig. 2. Preoperative magnetic resonance imaging (MRI) of rotator cuff tear. (A) Preoperative MRI shows atrophy of supraspinatus muscle; grade I by the modified tangent (indicated by a dashed line) sign. (B) Preoperative MRI shows atrophy of supraspinatus muscle; grade II by the modified tangent (indicated by a dashed line) sign. (C) Preoperative MRI shows atrophy of supraspinatus muscle; grade III by the modified tangent (indicated by a dashed line) sign.

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Fig. 3. Measurements of pre- and postoperative magnetic resonance imagings (MRIs). (A) Coronal section of preoperative patient’s shoulder MRI. (B) Sagittal section of supraspinatus muscle, Y-shaped view cut from line b in panel A. Outer dash-lined area includes muscle and fat tissue. Inner dot-line is margin of muscle tissue. (C) Sagittal section of supraspinatus muscle, Y-shaped view cut from line c in panel A, at the location of maximum diameter of supraspinatus muscle. Outer dash-lined area includes muscle and fat tissue. Inner dot-line is margin of muscle tissue.

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Fig. 4. Magnetic resonance imaging (MRI) of a 61-year-old male patient with rotator cuff tear. (A) Sagittal view of preoperative T1-weighted MRI at location of maximum diameter of supraspinatus muscle measured from coronal section of shoulder MRI. (B) Sagittal view of preoperative T1-weighted MRI of supraspinatus muscle, Y-shaped view in coronal section of shoulder MRI. (C) Sagittal view of postoperative T1-weighted MRI of supraspinatus muscle, Y-shaped view in coronal section of shoulder MRI.

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Fig. 5. Magnetic resonance imaging (MRI) of a 51-year-old male patient with rotator cuff tear. (A) Sagittal view of preoperative T1-weighted MRI at location of maximum diameter of supraspinatus muscle measured from coronal section of shoulder MRI. (B) Sagittal view of preoperative T1-weighted MRI of supraspinatus muscle, Y-shaped view in coronal section of shoulder MRI. (C) Sagittal view of postoperative T1-weighted MRI of supraspinatus muscle, Y-shaped view in coronal section of shoulder MRI.

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Fig. 1. Magnetic resonance imaging (MRI) of rotator cuff tear patients. Preoperative MRI shows degrees of fat degeneration in supraspinatus muscle; grade I by Goutallier sign (A), grade II by Goutallier sign (B), grade III by Goutallier sign (C).

Table 1. Demographic

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Table 2. Result of Measurements

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Table 3. Pearson Correlation Coefficient (p-Value)

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