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Reporting rotator cuff tears on magnetic resonance arthrography using the Snyder's arthroscopic classification

世界放射学杂志：英文版（电子版） 2017年第3期9卷 126-133页

作者： Alberto Aliprandi Carmelo Messina Paolo Arrigoni Michele Bandirali Giovanni Di Leo Stefano Longo Sandro Magnani Chiara Mattiuz Filippo Randelli silvana sdao Francesco Sardanelli Luca Maria Sconfienza Pietro Randelli Servizio di Radiologia IRCCS Policlinico San Donato Scuola di Specializzazione in Radiodiagnostica Università degli Studi di Milano Unità Operativa di Ortopedia e Traumatologia Ⅱ IRCCS Policlinico San Donato Dipartimento di Scienze Biomediche per la Salute Università degli Studi di Milano Unità Operativa di Ortopedia e Traumatologia V IRCCS Policlinico San Donato Unità Operativa di Radiologia/Diag-nostica per Immagini con Servizio di Radiologia Interventistica IRCCS Istituto Ortopedico Galeazzi Unità Operativa Complessa I Divisione Istituto Ortopedico Gaetano Pini

AIM To determine diagnostic performance of magnetic resonance arthrography(MRA) in evaluating rotator cuff tears(RCTs) using Snyder's classification for *** One hundred and twenty-six patients(64 males, 62 females; median age 55 years) underwent shoulder MRA and arthroscopy, which represented our reference standard. Surgical arthroscopic reports were reviewed and the reported Snyder's classification was recorded. MRA examinations were evaluated by two independent radiologists(14 and 5 years' experience) using Snyder's classification system, blinded to arthroscopy. Agreement between arthroscopy and MRA on partial-and fullthickness tears was calculated, first regardless of their extent. Then, analysis took into account also the extent of the tear. Interobserver agreement was also calculated the quadratically-weighted Cohen kappa *** On arthroscopy, 71/126 patients(56%) had a fullthickness RCT. The remaining 55/126 patients(44%) had a partial-thickness RCT. Regardless of tear extent, out of 71 patients with arthroscopically-confirmed fullthickness RCTs, 66(93%) were correctly scored by both readers. All 55 patients with arthroscopic diagnosis of partial-thickness RCT were correctly assigned as having a partial-thickness RCT at MRA by both readers. Interobserver reproducibility analysis showed total agreement between the two readers in distinguishing partial-thickness from full-thickness RCTs, regardless of tear extent(k = 1.000). With regard to tear extent, in patients in whom a complete tear was correctly diagnosed, correct tear extent was detected in 61/66 cases(92%); in the remaining 5/66 cases(8%), tear extent was underestimated. Agreement was k = 0.955. Interobserver agreement was total(k = 1.000).CONCLUSION MRA shows high diagnostic accuracy and reproducibility in evaluating RCTs using the Snyder's classification for reporting. Snyder's classification may be adopted for routine reporting of MRA.

关键词： Arthroscopy Magnetic resonance imaging Shoulder Arthrography Supraspinatus tendon Rotator cuff tear

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