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KMID : 0880420140150040501
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Korean Journal of Radiology
2014 Volume.15 No. 4 p.501 ~ p.507
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Visual MRI Grading System to Evaluate Atrophy of the Supraspinatus Muscle
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Lim Hyun-Kyong
Hong Sung-Hwan
Yoo Hye-Jin
Choi Ja-Young
Kim Sae-Hoon
Choi Jung-Ah
Kang Heung-Sik
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Abstract
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Objective: To investigate the interobserver reproducibility and diagnostic feasibility of a visual grading system for assessing atrophy of the supraspinatus muscle on magnetic resonance imaging (MRI).
Materials and Methods: Three independent radiologists retrospectively evaluated the occupying ratio of the supraspinatus muscle in the supraspinatus fossa on 192 shoulder MRI examinations in 188 patients using a 3-point visual grading system (1, ≥ 60%; 2, 30-59%; 3, < 30%) on oblique sagittal T1-weighted images. The inter-reader agreement and the agreement with the reference standard (3-point grades according to absolute occupying ratio values quantitatively measured by directly contouring the muscles on MRI) were analyzed using weighted kappa. The visual grading was applied by a single reader to a group of 100 consecutive patients who had undergone rotator cuff repair to retrospectively determine the association between the visual grades at preoperative state and postsurgical occurrences of retear.
Results: The inter-reader weighted kappa value for the visual grading was 0.74 when averaged across three reader pairs (0.70-0.77 for individual reader pairs). The weighted kappa value between the visual grading and the reference standard ranged from 0.75 to 0.83. There was a significant difference in retear rates of the rotator cuff between the 3 visual grades of supraspinatus muscle atrophy on MRI in univariable analysis (p < 0.001), but not in multivariable analysis (p = 0.026).
Conclusion: The 3-point visual grading system may be a feasible method to assess the severity of supraspinatus muscle atrophy on MRI and assist in the clinical management of patients with rotator cuff tear.
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KEYWORD
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Rotator cuff tear, Supraspinatus muscle, Muscular atrophy, Magnetic resonance imaging, Occupation ratio
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