Correlation between MRI and operative findings of the rotator cuff tear

Rotator cuff disease is one of the most common causes of shoulder pain. Various methods have been used to evaluate this problem. In this study, we determine the accuracy of magnetic resonance imaging (MRI) of the shoulder in diagnosing the rotator cuff tear based on operative findings. Ten patients with a painful shoulder requiring operation received an MRI of the shoulder before surgery. A GE 1.5 Tesla MR scanner with a five-inch planar surface coil was applied and the diagnosis was confirmed by an experienced radiologist in the field of musculoskeletal MRI. All patients underwent surgery within two weeks of MRI examination. Nine of the 10 patients were shown to have rotator cuff tear by MRI. Among the nine MRI positive patients, eight were proven to have such lesions on operation (two massive tears, four moderate complete tears, and two bursal side tears). One false-positive result was found to be an adhesive capsulitis and supraspinatus tendinitis at operation. The remaining case, diagnosed as tendinitis by MRI, turned out to be a small incomplete tear on operation. Therefore, the sensitivity of MRI for rotator cuff tear in this study was 0.89. The overall accuracy was 80%. We concluded that MRI has a high accuracy in detecting the rotator cuff tear. False-positive and false-negative diagnoses were attributed to a severe tendinitis and an incomplete tear, respectively.