[논문]Another Assessment of Fat Degeneration of Retracted Supraspinatus Muscle

Jeong, Yeon-Seok; Yum, Jae-Kwang; Park, Sang-Yoon

doi:10.5397/cise.2018.21.4.200

Another Assessment of Fat Degeneration of Retracted Supraspinatus Muscle 원문보기

Clinics in shoulder and elbow, v.21 no.4, 2018년, pp.200 - 206

Jeong, Yeon-Seok (Department of Orthopaedic Surgery, Sanggye Paik Hospital, Inje University School of Medicine) , Yum, Jae-Kwang (Department of Orthopaedic Surgery, Sanggye Paik Hospital, Inje University School of Medicine) , Park, Sang-Yoon (Department of Orthopaedic Surgery, Sanggye Paik Hospital, Inje University School of Medicine)

Abstract ▼ AI-Helper

Background: The purpose of this study was to assess the relevance of preoperative magnetic resonance imaging (MRI) evaluation by occupation ratio (OR) at maximum diameter of supraspinatus muscle. Methods: Patients from the Inje University Sanggye Paik Hospital who received rotator cuff repair and underwent pre- and postoperative MRI were selected as subjects of this study. On T1-weighted MRIs, OR of fat and muscle at Y-shaped view, OR at a location on supraspinatus muscle where its diameter was maximum on coronal view, and pre- and postoperative Goutallier Classification and changes in the tangent sign were measured. Statistical significance of postoperative OR was assessed regarding time from symptom onset to surgery, size of rotator cuff tear, preoperative OR, and the difference between ORs measured at maximum diameter of supraspinatus muscle and Y-shaped view. Results: Preoperative OR at Y-shaped view was $52.28{\pm}8.57$ (32.5-65.3). Preoperative OR difference between maximum diameter and Y-shaped view was $13.76{\pm}10.51$ (2.38-42.04), and Pearson correlation coefficient was 0.604 (p=0.001). Postoperative OR at Y-shaped view was $63.77{\pm}9.35$ (37.3-76.1). Pearson correlation coefficient of pre- and postoperative Goutallier Classification was -0.579 (p=0.002) and Pearson correlation coefficient of the postoperative difference between ORs measured at maximum diameter of supraspinatus muscle and Y-shaped view was -0.386 (p=0.047). Conclusions: Fatty degeneration of supraspinatus muscle in rotator cuff tear patients should be evaluated not only in the conventional Y-shaped view, but also at location of maximum diameter of supraspinatus muscle to establish patients' therapeutic plan.

주제어

표/그림 (8)

그림 Fig. 1. Magnetic resonance imaging (MRI) of rotator cuff tear patients. Preoperative MRI shows degrees of fat degeneration in supraspinatus muscle; grade I by Goutallier sign (A), grade II by Goutallier sign (B), grade III by Goutallier sign (C).
표 Table 1. Demographic
그림 Fig. 2. Preoperative magnetic resonance imaging (MRI) of rotator cuff tear. (A) Preoperative MRI shows atrophy of supraspinatus muscle; grade I by the modified tangent (indicated by a dashed line) sign. (B) Preoperative MRI shows atrophy of supraspinatus muscle; grade II by the modified tangent (indicated by a dashed line) sign. (C) Preoperative MRI shows atrophy of supraspinatus muscle; grade III by the modified tangent (indicated by a dashed line) sign.
그림 Fig. 3. Measurements of pre- and postoperative magnetic resonance imagings (MRIs). (A) Coronal section of preoperative patient’s shoulder MRI. (B) Sagittal section of supraspinatus muscle, Y-shaped view cut from line b in panel A. Outer dash-lined area includes muscle and fat tissue. Inner dot-line is margin of muscle tissue. (C) Sagittal section of supraspinatus muscle, Y-shaped view cut from line c in panel A, at the location of maximum diameter of supraspinatus muscle. Outer dash-lined area includes muscle and fat tissue. Inner dot-line is margin of muscle tissue.
표 Table 2. Result of Measurements
그림 Fig. 4. Magnetic resonance imaging (MRI) of a 61-year-old male patient with rotator cuff tear. (A) Sagittal view of preoperative T1-weighted MRI at location of maximum diameter of supraspinatus muscle measured from coronal section of shoulder MRI. (B) Sagittal view of preoperative T1-weighted MRI of supraspinatus muscle, Y-shaped view in coronal section of shoulder MRI. (C) Sagittal view of postoperative T1-weighted MRI of supraspinatus muscle, Y-shaped view in coronal section of shoulder MRI.
표 Table 3. Pearson Correlation Coefficient (p-Value)
그림 Fig. 5. Magnetic resonance imaging (MRI) of a 51-year-old male patient with rotator cuff tear. (A) Sagittal view of preoperative T1-weighted MRI at location of maximum diameter of supraspinatus muscle measured from coronal section of shoulder MRI. (B) Sagittal view of preoperative T1-weighted MRI of supraspinatus muscle, Y-shaped view in coronal section of shoulder MRI. (C) Sagittal view of postoperative T1-weighted MRI of supraspinatus muscle, Y-shaped view in coronal section of shoulder MRI.

AI 본문요약
AI-Helper

* AI 자동 식별 결과로 적합하지 않은 문장이 있을 수 있으니, 이용에 유의하시기 바랍니다.

제안 방법

In addition, different interpretations from the results of this study can be made if the severity of fatty degeneration is not similar degeneration at the maximum diameter location of the supraspinatus muscle and in the Y-shaped view. However, the significance of this study can be found in the fact that this study is one of the recent studies on accurate assessment of fatty degeneration in patients with rotator cuff tear and has presented an analysis by one of accurate evaluation methods.
As a result, they recommended assessing OR on the second inner plane in the Y-shaped view. In this study, the shape of the supraspinatus muscle was examined in the coronal plane rather than examining a specific inner plane image, and OR was measured by setting the maximum diameter location of the retracted supraspinatus muscle as the measurement position. Then, we analyzed the statistical significance for the relationship between the difference between ORs measured at the maximum diameter and in the Y-shaped view (ODMY) and the postoperative OR.
Radiographic evaluation was performed with 3-mm-thick T1- weighted MRIs of the axial, oblique coronal, and oblique sagittal planes (repetition time, 450–750 msec; echo time, 10–12 msec; the field of views, 150×150; 448×403 pixel matrix) using 3.0T MRI (MAGNETOM® Skyra; Siemens Medical, Berlin, Germany).
In this study, the shape of the supraspinatus muscle was examined in the coronal plane rather than examining a specific inner plane image, and OR was measured by setting the maximum diameter location of the retracted supraspinatus muscle as the measurement position. Then, we analyzed the statistical significance for the relationship between the difference between ORs measured at the maximum diameter and in the Y-shaped view (ODMY) and the postoperative OR. The reason why OR was measured at the maximum diameter location of the retracted supraspinatus muscle is that this method allows accurate assessment since the position is the location where the cross section of the muscle is largest and there is also the advantage that assessment is less affected by MRI performed than when the measurement position was set as in Fukuta et al.
It is thought that when preoperative MRI shows that the supraspinatus muscle is pulled toward the proximal portion due to the rupture or chronic rupture, the conventional assessment of fatty degeneration in the Y-shaped view is not sufficient to evaluate the state of the supraspinatus muscle. Therefore, in this study, we aimed to evaluate the need for the evaluation of fatty degeneration not only in the Y-shaped view, where the evaluation region becomes different depending on the degree of muscle pull of the supraspinatus muscle, but also at the maximum diameter location of the supraspinatus muscle to evaluate the overall fatty degeneration of the pulled supraspinatus muscle.
¹⁶⁾ pointed out that it is difficult to assess the degree of fatty degeneration of the supraspinatus muscle using the OR of the supraspinatus muscle on a sagittal view. Thus, they assessed the OR in the first, second and third inner planes of the supraspinatus muscle in the Y-shaped view of the MRIs divided into 5-mm segments, and analyzed the statistical significance. As a result, they recommended assessing OR on the second inner plane in the Y-shaped view.

대상 데이터

Among 82 patients who were diagnosed with rotator cuff tear and underwent rotator cuff repair in our institution from January 2012 to December 2016, 37 patients who did not undergo immediate postoperative MRI and 18 patients in whom fatty degeneration was not detected on MRI were excluded, and a total of 27 patients were included in this study. The state of the muscle was evaluated in comparison with the preoperative state.
22 mm (15–44 mm). The cases of supraspinatus tears included 5 patients with a partial tear and 22 patients with a full-thickness tear. Regarding the tears of the infraspinatus muscle, 5 patients had no tear, 3 patients had a partial tear, and 19 patients had a full-thickness tear.
1 years (median: 58 years; range: 40–67 years). The subjects consisted of 13 women and 14 men, and the right shoulder was involved in 20 cases and the left shoulder in 7 cases. The mean time from symptom onset to surgery was 21.

데이터처리

The Kolmogorov-Smirnov test was used for the test for normality of the measured variables, and paired t-test was performed for preand postoperative assessment results according to the Goutallier classification and modified tangent sign. The Pearson correlation coefficient was used to analyze the relationship between the ODMY and variables, such as the time from symptom onset to surgery, the size of rotator cuff tear, the preoperative OR, the Goutallier classification before and after surgery, and the modified tangent sign before and after surgery. The level of statistical significance was set at p<0.
Values are presented as Pearson correlation coefficient of pre- and postoperative Goutallier classification (p-value).

이론/모형

4 or less, a poor level, respectively). The Kolmogorov-Smirnov test was used for the test for normality of the measured variables, and paired t-test was performed for preand postoperative assessment results according to the Goutallier classification and modified tangent sign. The Pearson correlation coefficient was used to analyze the relationship between the ODMY and variables, such as the time from symptom onset to surgery, the size of rotator cuff tear, the preoperative OR, the Goutallier classification before and after surgery, and the modified tangent sign before and after surgery.

참고문헌 (19)

1 Iannotti JP Full-thickness rotator cuff tears: factors affecting surgical outcome J Am Acad Orthop Surg 1994 2 2 87 95 10708996

상세보기
2 Hamano N Yamamoto A Shitara H Does successful rotator cuff repair improve muscle atrophy and fatty infiltration of the rotator cuff? A retrospective magnetic resonance imaging study performed shortly after surgery as a reference J Shoulder Elbow Surg 2017 26 6 967 74 28214172
3 Goutallier D Postel JM Bernageau J Lavau L Voisin MC Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan Clin Orthop Relat Res 1994 304 78 83 8020238
4 Gladstone JN Bishop JY Lo IK Flatow EL Fatty infiltration and atrophy of the rotator cuff do not improve after rotator cuff repair and correlate with poor functional outcome Am J Sports Med 2007 35 5 719 28 17337727

상세보기
5 Thomazeau H Rolland Y Lucas C Duval JM Langlais F Atrophy of the supraspinatus belly. Assessment by MRI in 55 patients with rotator cuff pathology Acta Orthop Scand 1996 67 3 264 8 8686465

상세보기
6 Liem D Lichtenberg S Magosch P Habermeyer P Magnetic resonance imaging of arthroscopic supraspinatus tendon repair J Bone Joint Surg Am 2007 89 8 1770 6 17671017
7 Shen PH Lien SB Shen HC Lee CH Wu SS Lin LC Long-term functional outcomes after repair of rotator cuff tears correlated with atrophy of the supraspinatus muscles on magnetic resonance images J Shoulder Elbow Surg 2008 17 1 Suppl 1S 7S 17931908
8 Jo CH Shin JS Changes in appearance of fatty infiltration and muscle atrophy of rotator cuff muscles on magnetic resonance imaging after rotator cuff repair: establishing new time-zero traits Arthroscopy 2013 29 3 449 58 23312876

상세보기
9 Vidt ME Santago AC 2nd Tuohy CJ Assessments of fatty infiltration and muscle atrophy from a single magnetic resonance image slice are not predictive of 3-dimensional measurements Arthroscopy 2016 32 1 128 39 26391648

상세보기
10 Gerber C Schneeberger AG Hoppeler H Meyer DC Correlation of atrophy and fatty infiltration on strength and integrity of rotator cuff repairs: a study in thirteen patients J Shoulder Elbow Surg 2007 16 6 691 6 17931904
11 Yamaguchi H Suenaga N Oizumi N Hosokawa Y Kanaya F Will preoperative atrophy and fatty degeneration of the shoulder muscles improve after rotator cuff repair in patients with massive rotator cuff tears? Adv Orthop 2012 2012 195876 22288018

상세보기
12 Chung SW Kim SH Tae SK Yoon JP Choi JA Oh JH Is the supraspinatus muscle atrophy truly irreversible after surgical repair of rotator cuff tears? Clin Orthop Surg 2013 5 1 55 65 23467404
13 Deniz G Kose O Tugay A Guler F Turan A Fatty degeneration and atrophy of the rotator cuff muscles after arthroscopic repair: does it improve, halt or deteriorate? Arch Orthop Trauma Surg 2014 134 7 985 90 24845686

상세보기
14 Gerber C Meyer DC Schneeberger AG Hoppeler H von Rechenberg B Effect of tendon release and delayed repair on the structure of the muscles of the rotator cuff: an experimental study in sheep J Bone Joint Surg Am 2004 86 9 1973 82 15342760
15 Fuchs B Weishaupt D Zanetti M Hodler J Gerber C Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging J Shoulder Elbow Surg 1999 8 6 599 605 10633896
16 Fukuta S Tsutsui T Amari R Wada K Sairyo K Tendon retraction with rotator cuff tear causes a decrease in cross-sectional area of the supraspinatus muscle on magnetic resonance imaging J Shoulder Elbow Surg 2016 25 7 1069 75 26908171
17 Zanetti M Gerber C Hodler J Quantitative assessment of the muscles of the rotator cuff with magnetic resonance imaging Invest Radiol 1998 33 3 163 70 9525755

상세보기
18 Kuzel BR Grindel S Papandrea R Ziegler D Fatty infiltration and rotator cuff atrophy J Am Acad Orthop Surg 2013 21 10 613 23 24084435

상세보기
19 Warner JJ Higgins L Parsons IM 4th Dowdy P Diagnosis and treatment of anterosuperior rotator cuff tears J Shoulder Elbow Surg 2001 10 1 37 46 11182734

표제어: PCR

동의어: Packet Collision Rate

용어 설명 출처 목록 (6)

용어 설명: PCR은 세균 특이성이 있는 primer를 이용하여 적은 수의 세균이 있을지라도 쉽게 검출할 수 있는 유용한 방법이며, 이를 이용하여 구강 내 치면세균막이나 타액에서 직접 세균을 검출할 수 있게 되었다[8].

내보내기 구분	파일저장 인쇄 메일전송
구성항목	기본정보 상세정보 관리번호, 논문명, 저널/프로시딩명, 저자 , 발행년, 권, 호, 시작페이지, 끝페이지, 발행기관 관리번호, 논문명, 대등논문명, 저자 , 저널/프로시딩명, 발행기관, 발행년, 발행언어, 권, 호, 시작페이지, 끝페이지, ISBN, ISSN, 주제분야, 키워드, 초록(한글), 초록(영문), 저자(소속기관)
저장형식	Text(ASCII format) Excel format RefWorks Direct Export RIS format (for Reference Manager, ProCite, EndNote), Scholar's Aids, Mendeley
메일정보	받는사람 (필수) @ 보내는사람 (선택) @ 제목 내용 KISTI 검색결과 이메일 서비스
안내	총 건의 자료가 검색되었습니다. 다운받으실 자료의 인덱스를 입력하세요. (1-10,000) 검색결과의 순서대로 최대 10,000건 까지 다운로드가 가능합니다. 데이타가 많을 경우 속도가 느려질 수 있습니다.(최대 2~3분 소요) 다운로드 파일은 UTF-8 형태로 저장됩니다. 파일의 내용이 제대로 보이지 않을실 때는 웹브라우저 상단의 보기 -> 인코딩 -> 자동선택 여부를 확인하십시오. ~ Text(ASCII format) Excel format

연합인증