MR imaging of the rotator cuff tendon: interobserver agreement and analysis of interpretive errors

Radiology. 1997 Jul;204(1):191-4. doi: 10.1148/radiology.204.1.9205245.


Purpose: To evaluate accuracy in interpretation of shoulder magnetic resonance (MR) images and interobserver agreement and to characterize the types of errors.

Materials and methods: Five radiologists with varying experience independently and retrospectively twice interpreted the MR images of 222 symptomatic patients who underwent both MR imaging and shoulder arthroscopy. The first interpretation was a blind review; the second was with knowledge of the arthroscopic findings.

Results: For full-thickness tears, the sensitivity, specificity, and accuracy were 84%-96%, 94%-98%, and 92%-97%, respectively, and for partial tears, 35%-44%, 85%-97%, and 77%-87%, respectively. There was no statistically significant difference between readers in the detection of partial or full-thickness tears. There was a statistically significant difference between readers in the no-tear category. Cohen kappa values generally indicated improved interobserver agreement proportional to the readers' experience (full-thickness tears, 0.731-0.881; partial tears, 0.168-0.443).

Conclusion: Diagnosis of a full-thickness tear can be learned to a high degree of accuracy. Despite the radiologist's level of experience and knowledge of the arthroscopic findings, the sensitivity for diagnosis of partial tears is poor.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Arthroscopy
  • Clinical Competence
  • Female
  • Humans
  • Magnetic Resonance Imaging / standards*
  • Male
  • Middle Aged
  • Observer Variation
  • Reproducibility of Results
  • Retrospective Studies
  • Rotator Cuff / pathology*
  • Rotator Cuff Injuries*
  • Sensitivity and Specificity
  • Single-Blind Method
  • Time Factors
  • Wounds and Injuries / classification
  • Wounds and Injuries / diagnosis