Rotator cuff tears: assessment with MR arthrography in 275 patients with arthroscopic correlation

Eur Radiol. 2007 Feb;17(2):491-8. doi: 10.1007/s00330-006-0370-7. Epub 2006 Sep 13.


We assessed the diagnostic performance of magnetic resonance (MR) arthrography in the diagnosis of articular-sided partial-thickness and full-thickness rotator cuff tears in a large symptomatic population. MR arthrograms obtained in 275 patients including a study group of 139 patients with rotator cuff tears proved by arthroscopy and a control group of 136 patients with arthroscopically intact rotator cuff tendons were reviewed in random order. MR imaging was performed on a 1.0 T system (Magnetom Expert, Siemens). MR arthrograms were analyzed by two radiologists in consensus for articular-sided partial-thickness and full-thickness tears of the supraspinatus, infraspinatus, and subscapularis tendons. At arthroscopy, 197 rotator cuff tears were diagnosed, including 105 partial-thickness (93 supraspinatus, nine infraspinatus, three subscapularis) and 92 full-thickness (43 supraspinatus, 20 infraspinatus, 29 subscapularis) tendon tears. For full-thickness tears, sensitivity, specificity, and accuracy were 96%, 99%, and 98%, respectively, and for partial tears 80%, 97%, and 95%, respectively. False negative and positive assessments in the diagnosis of articular-sided partial-thickness tears were predominantly [78% (35/45)] observed with small articular-sided (Ellman grade1) tendon tears. MR arthrography is highly accurate in the diagnosis of full-thickness rotator cuff tears and is accurate in the diagnosis of articular-sided partial-thickness tears. Limitations in the diagnosis of partial-thickness tears are mainly restricted to small articular-sided tears (Ellman grade 1) due to difficulties in differentiation between fiber tearing, tendinitis, synovitic changes, and superficial fraying at tendon margins.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Arthrography*
  • Arthroscopy*
  • Case-Control Studies
  • False Negative Reactions
  • False Positive Reactions
  • Female
  • Germany
  • Humans
  • Image Interpretation, Computer-Assisted
  • Image Processing, Computer-Assisted
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Research Design
  • Rotator Cuff / pathology*
  • Rotator Cuff Injuries*
  • Sensitivity and Specificity
  • Shoulder / pathology
  • Tendon Injuries / pathology