Three-dimensional quantitative measurements of atrophy and fat infiltration in sub-regions of the supraspinatus muscle show heterogeneous distributions: a cadaveric study
Introduction Rotator cuff tears are common in the older population. Atrophy and fat infiltration develop un-evenly in torn supraspinatus (SSP) muscles leading to pre- and post-surgical complications. The purpose of the current study was twofold: first, to implement a volumetric and quantitative magn...
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Published in | Archives of orthopaedic and trauma surgery Vol. 142; no. 7; pp. 1395 - 1403 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
Berlin/Heidelberg
Springer Berlin Heidelberg
01.07.2022
Springer Nature B.V |
Subjects | |
Online Access | Get full text |
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Summary: | Introduction
Rotator cuff tears are common in the older population. Atrophy and fat infiltration develop un-evenly in torn supraspinatus (SSP) muscles leading to pre- and post-surgical complications. The purpose of the current study was twofold: first, to implement a volumetric and quantitative magnetic resonance imaging (MRI) approach to quantify the degree of muscle atrophy and fat infiltration within the SSP muscle and its four sub-regions (AS, PS, AD, and PD); second to compare 3-D MRI outcomes to the standard 2-D assessment and investigate their relationship with tear size.
Materials and methods
Fifteen cadaveric shoulders were obtained and MRI performed. Quantitative 3-D outcomes included SSP muscle volume, fossa volume, fat-free muscle volume, and fat fraction for the whole SSP muscle and its four sub-regions. 2-D and qualitative measurements included tear size, 2-D fat infiltration using the Goutallier classification, tangent sign, and occupation ratio.
Results
Linear regression outcomes with tear size were not significant for both cross-sectional area (
r
= − 0.494,
p
= 0.061) and occupation ratio (
r
= − 0.011,
p
= 0.969). Tear size negatively correlated with fat-free muscle volume for both AS and PS sub-regions (AS:
r
= − 0.78,
p
< 0.001; PS:
r
= − 0.68,
p
= 0.005, respectively) while showing no significant correlation with fat fraction outcomes. AD and PD sub-regions positively correlated with tear size and fat fraction outcomes (AD:
r
= 0.70,
p
= 0.017; PD:
r
= 0.52,
p
= 0.045, respectively), while no significant correlation was observed between tear size and fat-free muscle volumes.
Conclusion
Quantitative 3-D volumetric assessment of muscle degeneration resulted in better outcomes compared to the standard 2-D evaluation. The superficial supraspinatus muscle sub-regions primarily presented muscle atrophy, while the deep sub-regions were mainly affected by fat infiltration. 3-D assessments could be used pre-surgically to determine the best course of treatment and to estimate the muscles’ regenerative capacity and function. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1434-3916 0936-8051 1434-3916 |
DOI: | 10.1007/s00402-021-03765-8 |