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• Clinical Article •
Application of the IDEAL-IQ sequence in the quantitative evaluation of fat infiltration in the rotator cuff muscle group after supraspinatus tendon injury
XU Fenling  TIAN Zhaorong  TIAN Bo  GONG Rui  MA Fangfang  HU Jingbo  WANG Zhijun 

Cite this article as: XU F L, TIAN Z R, TIAN B, et al. Application of the IDEAL-IQ sequence in the quantitative evaluation of fat infiltration in the rotator cuff muscle group after supraspinatus tendon injury[J]. Chin J Magn Reson Imaging, 2024, 15(10): 115-122. DOI:10.12015/issn.1674-8034.2024.10.020.


[Abstract] Objective The study utilized the iteraterative decomposition of water and fat with echo asymmetry and least-squares estimation quantitation (IDEAL-IQ) method to quantitatively evaluate the relationship between the severity of supraspinatus tendon injuries and the degree of fat infiltration of the rotator cuff muscle group and subject characteristics.Materials and Methods A retrospective collection of 33 patients with partial supraspinatus tendon tears and 89 patients with complete tears confirmed by shoulder arthroscopy in our hospital from August 2022 to June 2024 was conducted. Conventional MRI and IDEAL-IQ sequence scans were performed. Two radiologists independently evaluated the MRI images of all subjects. Based on the supraspinatus tendon injury performance on conventional MRI images, the supraspinatus tendon in the fully tear group was divided into Patte 1 (Grade Ⅱ), Patte 2 (Grade Ⅲ), and Patte 3 (Grade Ⅳ) according to the Patte classification. The partial tear group was defined as Grade I. At the same time, the Goutallier score and Thomazeau atrophy grading were performed on the oblique sagittal plane. Fat fraction (FF) of supraspinatus muscle, infraspinatus muscle, subscapularis muscle and teres minor muscle were measured on the fat fraction image generated by IDEAL-IQ sequence using GE ADW 4.7 workstation post-processing software. Intra-observer and intra-observer consistency were evaluated by intra-class correlation coefficient (ICC) and Kappa consistency test. Kruskal-Wallis H test and One-Way ANOVA test were used to analyze the differences of FF values among different groups, and Bonferroni test was utilized for pairwise comparison between groups. Pearson correlation was used to analyze the correlation between rotator cuff muscle FF value and age and duration of symptoms (the correlation coefficient is r). Spearman correlation was used to analyze the correlation between supraspinatus tendon injury grade and rotator cuff muscle FF value, Goutallier grade and Thomazeau atrophy grade (the correlation coefficient is rs).Results (1) The FF values of the supraspinatus muscle, infraspinatus muscle, and subscapular muscle were significantly higher in Grade Ⅳ than those of the same muscles in Grade Ⅲ, Grade Ⅱ and Grade Ⅰ, with statistical significance (P<0.001, <0.001, 0.005, respectively). There was no significant difference in the FF value of the teres minor muscle among different grades (P=0.073). Results of intra-group comparision suggested that there was no significant difference in the FF values of the supraspinatus muscle, infraspinatus muscle, subscapularis muscle, and teres minor between Grade Ⅰ and Grade Ⅱ (P=0.026, 0.102). There was a significant difference in the FF value between Grade Ⅲ and Grade Ⅳ (P<0.001). (2) The FF values of supraspinatus, infraspinatus, subscapularis and teres minor were moderately correlated with age (with r values of 0.381, 0.339, 0.349, respectively, all P＜0.001), while FF values of subscapular muscle were weakly correlated with age (r=0.216, P=0.017). The FF values of supraspinatus, infraspinatus, subscapularis were moderately correlated with the duration of symptoms(with r values of 0.442, 0.412, 0.314, respectively, all P＜0.001), while FF values of teres minor were weakly correlated with symptom duration (r=0.277, P=0.002). The degree of injury of the supraspinatus tendon was significantly correlated with the FF value of the supraspinatus muscle (rs=0.740, P<0.001), was strongly correlated with the FF value of the infraspinatus muscle (rs=0.596, P<0.001), and was weakly correlated with the FF values of the subscapularis muscle and the teres minor muscle (with rs value of 0.257, 0.212, P=0.004, 0.019). There was a positive correlation between the degree of supraspinatus injury grade and Goutallier grade and Thomazeau grade (with rs value of 0.757, 0.737, all P<0.001). The FF value of supraspinatus muscle was significantly different in Goutallier grade and Thomazeau grade (all P<0.001).Conclusions 3.0 T MR IDEAL-IQ sequence could objectively assessed the degree of rotator cuff injury, and the quantified FF was positively correlated with supraspinatus injury grade, and associated with age and duration of symptoms.
[Keywords] supraspinatus；Patte classification；Goutallier grade；rotator cuff muscles；fat quantification；IDEAL-IQ；fat fraction；magnetic resonance imaging

XU Fenling1   TIAN Zhaorong2   TIAN Bo2   GONG Rui2   MA Fangfang1   HU Jingbo1   WANG Zhijun2*  

1 The First Clinical Medical College of Ningxia Medical University, Yinchuan 750001, China

2 Department of radiology, General Hospital of Ningxia Medical University, Yinchuan 750001, China

Corresponding author: WANG Z J, E-mail: wangzhijun2056@163.com

Conflicts of interest   None.

Received  2024-04-16
Accepted  2024-09-10
DOI: 10.12015/issn.1674-8034.2024.10.020
Cite this article as: XU F L, TIAN Z R, TIAN B, et al. Application of the IDEAL-IQ sequence in the quantitative evaluation of fat infiltration in the rotator cuff muscle group after supraspinatus tendon injury[J]. Chin J Magn Reson Imaging, 2024, 15(10): 115-122. DOI:10.12015/issn.1674-8034.2024.10.020.

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