TITLE:
A Retrospective Analysis of the Effectiveness of MRI and Ultrasound in Identifying Rotator Cuff Tears
AUTHORS:
Craig Meiers, Lucas Teske, James Crabill, Christopher Robertson, Matthew Nelsen
KEYWORDS:
Ultrasound, MRI, Rotator Cuff, Arthroscopy
JOURNAL NAME:
Open Journal of Clinical Diagnostics,
Vol.7 No.1,
January
11,
2017
ABSTRACT: Magnetic Resonance Imaging (MRI) and Ultrasound (US)
imaging are both routinely used in the assessment of rotator cuff pathology.
Factors influencing the frequency of use of the respective technologies include
access to equipment, provider preference, and cost. The purpose of our study
was to compare the accuracy of in clinic ultrasound with that of MRI in
diagnosing pathology of the rotator cuff in a large sample size with limited
exclusionary criteria. 500 patient profiles assessed by each imaging type, MRI
and ultrasound, who then proceeded to arthroscopic surgery were gathered and
analyzed for interobserver agreement between the image interpretation and the
surgical observations. While ultrasound displayed slightly higher sensitivity
and specificity ratings in the diagnosis of full tears (0.90 and 0.92 vs. 0.86
and 0.91), MRI had a higher sensitivity (0.87 vs. 0.80) and Ultrasound had a
higher specificity (0.86 vs. 0.76) for general cuff damage. The Weighted Kappa Values
for both MRI (0.699) and Ultrasound (0.668) both indicate a substantial
strength of agreement between the image interpretation and surgical findings.
While there was a balanced distribution of errors observed in the MRI category, the most common error
made in the Ultrasound assessment was a false negative assessment of a partial
tear. The data indicate that in a clinical setting Ultrasound imaging is a cost-effective and accurate
alternative to MRI and can be a valuable addition to the diagnostic assessment
of rotator cuff injury and pathology.