DIAGNOSTIC PERFORMANCE OF MAGNETIC-RESONANCE-IMAGING FOR THE DIAGNOSIS OF ROTATOR CUFF TEARS USING SUPPLEMENTAL IMAGES IN THE OBLIQUE SAGITTAL PLANE

RATIONALE AND OBJECTIVES. The authors evaluated the diagnostic utility of supplemental imaging in the oblique sagittal (OS) plane for the magnetic resonance imaging (MRI) diagnosis of rotator cuff tears. METHODS. Two radiologists with varying levels of MRI experience blindly reviewed shoulder MR examinations of 50 patients for rotator cuff tears. Shoulder examinations were interpreted twice, initially using only double-echo spin-echo images obtained in the oblique coronal (OC) plane and later using double-echo spin-echo images obtained in the both the OC and OS planes. Tears were characterized according to size, location, and extent, and levels of diagnostic confidence were evaluated. RESULTS. Sensitivity and specificity of MR for the diagnosis of rotator cuff tear was 85% and 80%, respectively, with the OC series increasing to 95% and 93%, respectively with OCOS scans. However, these increases were not statistically significant. Receiver operating characteristic (ROC) curves suggest a trend toward increased diagnostic confidence when supplemental OS scans are available, especially for the less experienced reader. Characterization of rotator cuff tears was not improved with additional OS images. CONCLUSIONS. Supplemental OS scans did not demonstrate a definite improvement in diagnostic accuracy for rotator cuff tears compared to OC scans alone. Estimations based on sample size calculations indicate that a much larger population of patients would be needed to show a statistically significant difference.