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Related Experiment Video

Updated: Feb 3, 2026

Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
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Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft

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Optimizing methods to quantify intramuscular fat in rotator cuff tears with normalization.

Paul S Micevych1, Ankur Garg1,2, Lucas T Buchler1,3

  • 1Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL, 60611, USA.

Skeletal Radiology
|October 18, 2018
PubMed
Summary
This summary is machine-generated.

Normalizing MRI fat quantification in rotator cuff tears with the teres major muscle best accounts for age and BMI. This method helps accurately assess fat infiltration related to tendon tears.

Keywords:
Dixon fat–water separationFatty infiltrationIntramuscular degenerationSupraspinatus

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Area of Science:

  • Orthopedics and Sports Medicine
  • Radiology
  • Biomedical Engineering

Background:

  • Rotator cuff tears often lead to muscle fatty infiltration, which can be quantified using MRI.
  • Individual factors like age and BMI can confound the accurate measurement of this fat infiltration.
  • Standardized normalization techniques are crucial for reliable MRI-based assessments of rotator cuff pathology.

Purpose of the Study:

  • To compare the effectiveness of different muscle normalization methods (teres major, triceps brachii, teres minor) for quantifying rotator cuff fat infiltration on MRI.
  • To determine which normalization method best accounts for confounding factors such as age and BMI.
  • To evaluate the impact of normalization on the relationship between fat infiltration and rotator cuff tear characteristics.

Main Methods:

  • Thirty-seven patients with rotator cuff pathology underwent MRI using fat-water sequences to quantify intramuscular fat (%fat).
  • Normalized %fat was derived using three reference muscles: teres major, triceps brachii, and teres minor.
  • Relationships between %fat (pre- and post-normalization) and tear size, age, and BMI were analyzed using Fisher transformations.

Main Results:

  • Normalization with teres major effectively reduced confounding effects of age and BMI on rotator cuff %fat.
  • Normalization with triceps or teres minor failed to adequately control for age or BMI, and eliminated significant relationships with tear size.
  • Teres major normalization best preserved the relationship between tear size and fat infiltration in the infraspinatus/teres minor muscles.

Conclusions:

  • Normalization to the teres major muscle appears to be a robust method for MRI-based quantification of rotator cuff fat infiltration.
  • This approach can effectively control for confounding individual factors like age and BMI.
  • The teres major normalization method may be valuable for evaluating and monitoring fat infiltration specifically attributed to rotator cuff tendon tears.