Correlation of Quantitative Versus Semiquantitative Measures of Supraspinatus Intramuscular Fatty Infiltration to Shoulder Range of Motion and Strength: A Pilot Study.

ABSTRACT

PURPOSE: The relationship of magnetic resonance imaging (MRI) measures of rotator cuff intramuscular fatty infiltration (FI) to shoulder range of motion (ROM) and strength are not well understood. Our purpose was to determine if supraspinatus quantitative Dixon fat fraction has superior correlation to shoulder ROM and strength as compared to semiquantitative Goutallier grade. METHODS: Thirty-seven study subjects received shoulder MRI; and measurement of ipsilateral shoulder forward flexion ROM, abduction ROM and abduction strength. Supraspinatus Dixon fat fraction was measured on 6-point Dixon MRI by 2 diagnostic radiology residents. Supraspinatus Goutallier grade was assessed on T1-weighted MRI by 2 musculoskeletal radiologists. Questionnaires recorded demographics. Based on characteristics, study subjects were divided into 3 groups Group 1, neither shoulder pain nor full-thickness supraspinatus tendon (SST) tear (n = 17; mean age, 63.0 ± 10.1 years); Group 2, positive complaint of shoulder pain but without full-thickness SST tear (n = 7; mean age, 57.4 ± 9.9 years); Group 3, positive complaint of shoulder pain and full-thickness SST tear (n = 13; mean age, 63.6 ± 8.1 years). One-way analysis of variance compared groups. Spearman (rho) rank order correlation was performed to determine correlation of supraspinatus Dixon fat fraction, or Goutallier grade, with measures of ROM and strength for the study population. Reliability analyses were performed for Dixon fat fraction and Goutallier grade. RESULTS: No significant differences were present among groups for age. Significant differences existed among groups for forward flexion ROM (P= 0.001), abduction ROM (P < 0.001), Dixon fat fraction (P = 0.004) and Goutallier grade (P = 0.012). Dixon fat fraction showed statistically significant inverse correlations with forward flexion ROM (rho = -0.47; P = 0.005), abduction ROM (rho = -0.35, P = 0.041), and abduction strength (rho = -0.42; P = 0.013). Goutallier grade demonstrated weak inverse correlation that lacked statistical significance (P > 0.05) for the same measures. Dixon fat fraction showed strong interobserver and intraobserver reliability with intraclass correlation coefficients of 0.956 and 0.999, respectively. Goutallier grade showed poor interobserver (kappa, 0.188) and moderate intraobserver (kappa, 0.608) reliability. CONCLUSION: Supraspinatus Dixon fat fraction has superior correlation to shoulder ROM and strength relative to Goutallier grade on MRI.