Comparison of fat-saturation fast spin echo versus conventional spin-echo MRI in the detection of rotator cuff pathology.

The purpose of this study was to compare the diagnostic performance of fat-saturation fast-spin-echo (FSE) T2-weighted (T2W) sequences with conventional spin-echo (CSE) T2W sequences in the detection of rotator cuff pathology using surgery as the reference standard. Oblique coronal dual-echo CSE and FSE T2W images with fat saturation from 50 surgically confirmed MR shoulder examinations were acquired on a 1.5-T MR scanner. Blinded MR readers retrospectively analyzed each imaging sequence separately and ultimately correlated both sequences together with findings at surgery. FSE was 100% sensitive and 94% specific in detection of full-thickness tears (n = 19) and 73% sensitive and 97% specific in the detection of partial-thickness rotator cuff tears (n = 13). There was no statistically significant difference in the performance of FSE with fat saturation compared with CSE. The two discrepancies between imaging sequences related to the extent of partial-thickness tears. Our findings suggest that fat-saturation FSE imaging can effectively replace CSE imaging in the evaluation of rotator cuff pathology.

MR imaging of the rotator cuff: peritendinous and bone abnormalities in an asymptomatic population.

OBJECTIVE: MR imaging of the shoulder was performed in an asymptomatic population to determine the prevalence of MR-evident peritendinous and bone abnormalities. Findings were correlated with subject age and rotator cuff abnormalities. SUBJECTS AND METHODS: Dual-echo T2-weighted oblique coronal MR images of the shoulder were evaluated for 100 asymptomatic volunteers who were 19-88 years old. Twenty symptomatic patients with arthroscopic correlation were included as controls. Images were assessed independently by two reviewers with no knowledge of subject history or symptomatology. Bursal, peribursal, and bone findings were correlated with subject age and the appearance of the rotator cuff tendon. RESULTS: Changes characteristic of acromioclavicular joint osteoarthrosis were present in three fourths of the shoulders. One third had subacromial spurs. Changes in the peribursal fat plane and the presence of fluid in the subacromial-subdeltoid bursa paralleled the degree of MR-evident rotator cuff abnormalities. Joint fluid was observed in nearly all subjects. CONCLUSION: Our findings reveal a high prevalence of MR-evident bone and peritendinous shoulder abnormalities among asymptomatic individuals. The prevalence of subacromial spurs and humeral head cysts correlated closely with the severity of MR-evident rotator cuff abnormalities, as did changes in the bursa and peribursal fat. Acromioclavicular joint osteoarthrosis is seen in many shoulders independently of rotator cuff disease; therefore, its presence alone does not appear to be a reliable indicator of pain or tendon disease.