Quantitative MRI indicators and features for partial subscapularis tendon tears on conventional shoulder MRI

Area of Science:

• Orthopedic imaging
• Musculoskeletal radiology
• Rotator cuff pathology

Background:

• Diagnosing partial subscapularis (SSC) tendon tears presents significant challenges.
• Inaccurate diagnosis can increase failure rates in massive posterosuperior rotator cuff repair.
• Improved preoperative diagnostic accuracy for partial SSC tears is crucial.

Purpose of the Study:

• To investigate quantitative indicators and features of partial SSC tears on conventional shoulder MRI.
• To enhance the preoperative diagnostic accuracy of partial subscapularis tears.

Main Methods:

• Retrospective review of 437 patients who underwent MRI and arthroscopy.
• Inclusion of 89 patients with partial SSC tears and 50 controls with normal SSC.
• Evaluation of six defined MRI features with quantitative indicators.

Main Results:

• The fissure sign demonstrated the highest diagnostic efficiency (81.3% accuracy, 92% specificity, 75.3% sensitivity).
• Thinning of SSC, fluid collection under the coraco-glenoid arch (CGA), and combined SSP complete tear showed high specificity but moderate sensitivity and accuracy.
• Lesser tuberosity cysts had moderate specificity, sensitivity, and accuracy; fat accumulation under the CGA showed no significant difference.

Conclusions:

• Specific MRI features with defined quantitative indicators can improve preoperative diagnosis of partial SSC tears.
• The fissure sign is a highly effective indicator for partial SSC tears.
• Utilizing these defined MRI features enhances diagnostic confidence and accuracy.