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Quantitative assessment of fat infiltration in the rotator cuff muscles using water‐fat MRI
Author(s) -
Nardo Lorenzo,
Karampinos Dimitrios C.,
Lansdown Drew A.,
CarballidoGamio Julio,
Lee Sonia,
Maroldi Roberto,
Ma C. Benjamin,
Link Thomas M.,
Krug Roland
Publication year - 2014
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.24278
Subject(s) - rotator cuff , medicine , nuclear medicine , rank correlation , repeatability , magnetic resonance imaging , sagittal plane , coefficient of variation , radiology , chemistry , mathematics , chromatography , statistics
Purpose To evaluate a chemical shift‐based fat quantification technique in the rotator cuff muscles in comparison with the semiquantitative Goutallier fat infiltration classification (GC) and to assess their relationship with clinical parameters. Materials and Methods The shoulders of 57 patients were imaged using a 3T MR scanner. The rotator cuff muscles were assessed for fat infiltration using GC by two radiologists and an orthopedic surgeon. Sequences included oblique‐sagittal T 1 ‐, T 2 ‐, and proton density‐weighted fast spin echo, and six‐echo gradient echo. The iterative decomposition of water and fat with echo asymmetry and least‐squares estimation (IDEAL) was used to measure fat fraction. Pain and range of motion of the shoulder were recorded. Results Fat fraction values were significantly correlated with GC grades ( P < 0.0001, κ >0.9) showing consistent increase with GC grades (grade = 0, 0%–5.59%; grade = 1, 1.1%–9.70%; grade = 2, 6.44%–14.86%; grade = 3, 15.25%–17.77%; grade = 4, 19.85%–29.63%). A significant correlation between fat infiltration of the subscapularis muscle quantified with IDEAL versus 1) deficit in internal rotation (Spearman Rank Correlation Coefficient [SRC] = 0.39, 95% confidence interval [CI] 0.13–0.60, P < 0.01) and 2) pain (SRC coefficient = 0.313, 95% CI 0.049–0.536, P = 0.02) was found but was not seen between the clinical parameters and GC grades. Additionally, only quantitative fat infiltration measures of the supraspinatus muscle were significantly correlated with a deficit in abduction (SRC coefficient = 0.45, 95% CI 0.20–0.60, P < 0.01). Conclusion An accurate and highly reproducible fat quantification in the rotator cuff muscles using water‐fat magnetic resonance imaging (MRI) techniques is possible and significantly correlates with shoulder pain and range of motion. J. Magn. Reson. Imaging 2014;39:1178–1185 . © 2013 Wiley Periodicals, Inc .