Share：
Share this content in WeChat
X
[Chinese][PDF]5297
• 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.

[1]
JUN Y C, MOON Y L, BHARDWAJ H D, et al. The volume of subscapularis muscle remains unaffected by supraspinatus tendon tears: three-dimensionally reconstructed magnetic resonance imaging analysis[J]. Clin Shoulder Elb, 2019, 22(1): 3-8. DOI: 10.5397/cise.2019.22.1.3.
[2]
XING Q J, ZHAO D F, DAI W W, et al. Effect of partial-thickness tear of supraspinatus on the distribution of tendon stress: finite element analysis[J]. J Pract Orthop, 2018, 24(6): 519-522. DOI: 10.13795/j.cnki.sgkz.2018.06.009.
[3]
WANG J R, TANG Y, LV X L, et al. Tectoridin inhibits osteoclastogenesis and bone loss in a murine model of ovariectomy-induced osteoporosis[J/OL]. Exp Gerontol, 2020, 140: 111057 [2024-02-15]. https://pubmed.ncbi.nlm.nih.gov/32798609/. DOI: 10.1016/j.exger.2020.111057.
[4]
ZHANG Z. Measurement of fat content in adult lumbar vertebrae and paraspinal muscles by 3.0T MR IDEAL-IQ sequence and its correlation with age and sex[D].Qingdao: Qingdao University, 2020. DOI: 10.27262/d.cnki.gqdau.2020.000745.
[5]
YANG Y M, QIU L H, GU X P, et al. Monitoring rotator cuff muscle fatty infiltration progression by magnetic resonance imaging T1 mapping: correlation with direct evaluation findings in rats[J]. Am J Sports Med, 2022, 50(4): 1078-1087. DOI: 10.1177/03635465211069976.
[6]
LEE D, HONG K T, LEE W, et al. Threshold-based quantification of fatty degeneration in the supraspinatus muscle on MRI as an alternative method to Goutallier classification and single-voxel MR spectroscopy[J/OL]. BMC Musculoskelet Disord, 2020, 21(1): 362 [2023-09-11]. https://pubmed.ncbi.nlm.nih.gov/32517756/. DOI: 10.1186/s12891-020-03400-4.
[7]
WEN L /Y), HE Q, XING Y Q, et al. Research progress of muscle fat infiltration after rotator cuff injury[J]. J Clin Orthop, 2023, 26(6): 902-908. DOI: 10.3969/j.issn.1008-0287.2023.06.043.
[8]
LI Y T, XIONG Y, HOU B W, et al. Detection of erosions and fat metaplasia of the sacroiliac joints in patients with suspected sacroiliitis using a chemical shift-encoded sequence (IDEAL-IQ)[J/OL]. Eur J Radiol, 2023, 158: 110641 [2024-01-11]. https://pubmed.ncbi.nlm.nih.gov/36495683/. DOI: 10.1016/j.ejrad.2022.110641.
[9]
YANG Z, LIU C L, SHI Z J, et al. IDEAL-IQ combined with intravoxel incoherent motion diffusion-weighted imaging for quantitative diagnosis of osteoporosis[J/OL]. BMC Med Imaging, 2024, 24(1): 155 [2023-09-11]. https://www.x-mol.com/paper/1803853833069719552?adv. DOI: 10.1186/s12880-024-01326-0.
[10]
ZHOU F, SHENG B, LV F R. Quantitative analysis of vertebral fat fraction and R2* in osteoporosis using IDEAL-IQ sequence[J/OL]. BMC Musculoskelet Disord, 2023, 24(1): 721 [2023-11-23]. https://www.x-mol.com/paper/1702328821414121472?adv. DOI: 10.1186/s12891-023-06846-4.
[11]
LANSDOWN D A, MORRISON C, ZAID M B, et al. Preoperative IDEAL (Iterative Decomposition of Echoes of Asymmetrical Length) magnetic resonance imaging rotator cuff muscle fat fractions are associated with rotator cuff repair outcomes[J]. J Shoulder Elbow Surg, 2019, 28(10): 1936-1941. DOI: 10.1016/j.jse.2019.05.018.
[12]
WIESER K, JOSHY J, FILLI L, et al. Changes of supraspinatus muscle volume and fat fraction after successful or failed arthroscopic rotator cuff repair[J]. Am J Sports Med, 2019, 47(13): 3080-3088. DOI: 10.1177/0363546519876289.
[13]
GUO S Y, ZHU Y M, SONG G Y, et al. Assessment of tendon retraction in large to massive rotator cuff tears: a modified patte classification based on 2 coronal sections on preoperative magnetic resonance imaging with higher specificity on predicting reparability[J]. Arthroscopy, 2020, 36(11): 2822-2830. DOI: 10.1016/j.arthro.2020.06.023.
[14]
FUCHS B, WEISHAUPT D, ZANETTI M, et al. Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging[J]. J Shoulder Elbow Surg, 1999, 8(6): 599-605. DOI: 10.1016/s1058-2746(99)90097-6.
[15]
GOUTALLIER D, POSTEL J M, BERNAGEAU J, et al. Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan[J]. Clin Orthop Relat Res, 1994(304): 78-83.
[16]
THOMAZEAU H, ROLLAND Y, LUCAS C, et al. Atrophy of the supraspinatus belly. Assessment by MRI in 55 patients with rotator cuff pathology[J]. Acta Orthop Scand, 1996, 67(3): 264-268. DOI: 10.3109/17453679608994685.
[17]
WANG Y, ZHA Y F, XING D. Quantitative MRI study of the relationship between fat content in lumbar paravertebral muscles and disc degeneration[J]. Chin J Magn Reson Imag, 2018, 9(11): 819-824. DOI: 10.12015/issn.1674-8034.2018.11.004.
[18]
HORIUCHI S, NOZAKI T, TASAKI A, et al. Reliability of MR quantification of rotator cuff muscle fatty degeneration using a 2-point Dixon technique in comparison with the goutallier classification: validation study by multiple readers[J]. Acad Radiol, 2017, 24(11): 1343-1351. DOI: 10.1016/j.acra.2017.03.026.
[19]
JEONG H J, KWON J, RHEE S M, et al. New quantified measurement of fatty infiltration of the rotator cuff muscles using magnetic resonance imaging[J]. J Orthop Sci, 2020, 25(6): 986-991. DOI: 10.1016/j.jos.2020.01.003.
[20]
LEE S, LUCAS R M, LANSDOWN D A, et al. Magnetic resonance rotator cuff fat fraction and its relationship with tendon tear severity and subject characteristics[J]. J Shoulder Elbow Surg, 2015, 24(9): 1442-1451. DOI: 10.1016/j.jse.2015.01.013.
[21]
SCHANDA J E, EIGENSCHINK M, LAKY B, et al. Rotator cuff delamination is associated with increased tendon retraction and higher fatty muscle infiltration: a comparative study on arthroscopy and magnetic resonance imaging[J]. Arthroscopy, 2022, 38(7): 2131-2141. DOI: 10.1016/j.arthro.2021.12.028.
[22]
LEVIN J M, JOHNSON J, TABARESTANI T, et al. Association between supraspinatus tendon retraction, histologic myofiber size, and supraspinatus muscle atrophy on MRI[J]. Am J Sports Med, 2023, 51(8): 1997-2004. DOI: 10.1177/03635465231173697.
[23]
DONG K K. Study on the relationship between the position and shape of degenerative rotator cuff injury and fat infiltration and muscle atrophy in Chinese[D].Jinan: Shandong University, 2021. DOI: 10.27272/d.cnki.gshdu.2021.001069.
[24]
SAHAI A, JONES D L, HUGHES M, et al. Fibroadipogenic progenitor cell response peaks prior to progressive fatty infiltration after rotator cuff tendon tear[J]. J Orthop Res, 2022, 40(12): 2743-2753. DOI: 10.1002/jor.25321.
[25]
KIM S C, SHIM S B, KIM W J, et al. Preoperative rotator cuff tendon integrity, tear size, and muscle atrophy and fatty infiltration are associated with structural outcomes of arthroscopic revision rotator cuff repair[J]. Knee Surg Sports Traumatol Arthrosc, 2022, 30(6): 2029-2038. DOI: 10.1007/s00167-021-06732-3.
[26]
NI Y B. Quantitative study on rotator cuff injury based on integrated MRI and IDEAL-IQ technology[D].Yinchuan: Ningxia Medical University, 2023. DOI: 10.27258/d.cnki.gnxyc.2023.000218.
[27]
KONG B Y, KIM S H, KIM D H, et al. Suprascapular neuropathy in massive rotator cuff tears with severe fatty degeneration in the infraspinatus muscle[J]. Bone Joint J, 2016, 98-B(11): 1505-1509. DOI: 10.1302/0301-620X.98B11.37928.
[28]
GIBBONS M C, SILLDORFF M, OKUNO H, et al. The effect of tenotomy, neurotomy, and dual injury on mouse rotator cuff muscles: consequences for the mouse as a preclinical model[J]. J Orthop Res, 2024, 42(6): 1170-1179. DOI: 10.1002/jor.25786.
[29]
WIESER K, GRUBHOFER F, HASLER A, et al. Muscle degeneration induced by sequential release and denervation of the rotator cuff tendon in sheep[J/OL]. Orthop J Sports Med, 2021, 9(8): 23259671211025302 [2024-03-11]. https://pubmed.ncbi.nlm.nih.gov/34423059/. DOI: 10.1177/23259671211025302.
[30]
LIU J Y, JIANG X. Diagnosis and treatment of suprascapular neuropathy with massive rotator cuff tear[J]. Chin J Orthop, 2018, 38(17): 1055-1062. DOI: 10.3760/cma.j.issn.0253-2352.2018.17.004.
[31]
ESHIMA K, OHZONO H, GOTOH M, et al. Effect of suprascapular nerve injury on muscle and regenerated enthesis in a rat rotator cuff tear model[J]. Clin Shoulder Elb, 2023, 26(2): 131-139. DOI: 10.5397/cise.2022.01207.
[32]
COLLIN P, TRESEDER T, LÄDERMANN A, et al. Neuropathy of the suprascapular nerve and massive rotator cuff tears: a prospective electromyographic study[J]. J Shoulder Elbow Surg, 2014, 23(1): 28-34. DOI: 10.1016/j.jse.2013.07.039.
[33]
SHI L L, BOYKIN R E, LIN A, et al. Association of suprascapular neuropathy with rotator cuff tendon tears and fatty degeneration[J]. J Shoulder Elbow Surg, 2014, 23(3): 339-346. DOI: 10.1016/j.jse.2013.06.011.
[34]
SASAKI Y, OCHIAI N, NAKAJIMA A, et al. Histological analysis and biomechanical evaluation of fatty infiltration after rotator cuff tear and suprascapular nerve injury in a rat model[J]. J Orthop Sci, 2018, 23(5): 834-841. DOI: 10.1016/j.jos.2018.04.004.
[35]
BARRAGAN ECHENIQUE D M, DOLAN M T, KOH J L, et al. Infraspinatus muscle fiber moment arms during abduction: a biomechanical comparison of values for intact rotator cuff, supraspinatus tear, superior capsular reconstruction, and reverse total shoulder arthroplasty[J/OL]. Orthop J Sports Med, 2022, 10(5): 23259671221098378 [2024-01-10]. https://pubmed.ncbi.nlm.nih.gov/35651480/. DOI: 10.1177/23259671221098378.
[36]
LAWRENCE R L, VELUSWAMY B, DOBBEN E A, et al. Predictors of infraspinatus muscle degeneration in individuals with an isolated supraspinatus tendon tear[J]. Skeletal Radiol, 2023, 52(4): 695-703. DOI: 10.1007/s00256-022-04201-7.
[37]
GILBERT F, MEFFERT R H, SCHMALZL J, et al. Grade of retraction and tendon thickness correlates with MR-spectroscopically measured amount of fatty degeneration in full thickness supraspinatus tears[J/OL]. BMC Musculoskelet Disord, 2018, 19(1): 197 [2023-05-10]. https://pubmed.ncbi.nlm.nih.gov/30037322/. DOI: 10.1186/s12891-018-2096-5.
[38]
OH J H, RHEE S M, PARK J H, et al. Quantitative magnetic resonance imaging assessment of the infraspinatus and teres minor in massive rotator cuff tear and its significance in clinical outcome after rotator cuff repair[J]. J Shoulder Elbow Surg, 2022, 31(1): 56-62. DOI: 10.1016/j.jse.2021.06.001.
[39]
LEE D, LEE J, OH J H, et al. Effect of subscapularis repair on joint contact forces based on degree of posterior-superior rotator cuff tear severity in reverse shoulder arthroplasty[J/OL]. Front Bioeng Biotechnol, 2023, 11: 1229646 [2024-02-05]. https://pubmed.ncbi.nlm.nih.gov/38130822/. DOI: 10.3389/fbioe.2023.1229646.
[40]
TAMURA T, TOKUNAGA T, KARASUGI T, et al. The remaining teres minor and subscapularis may contribute to preventing superior migration of the humeral head and progression of osteoarthritic change in rotator cuff tears[J]. JSES Int, 2023, 7(4): 561-567. DOI: 10.1016/j.jseint.2023.03.005.
[41]
KÄLIN P S, HUBER F A, HAMIE Q M, et al. Quantitative MRI of visually intact rotator cuff muscles by multiecho Dixon-based fat quantification and diffusion tensor imaging[J]. J Magn Reson Imaging, 2019, 49(1): 109-117. DOI: 10.1002/jmri.26223.
[42]
YOON T H, KIM S J, CHOI Y R, et al. Comparison of the goutallier classification of fatty infiltration for the subscapularis with a novel modified classification[J/OL]. Orthop J Sports Med, 2023, 11(8): 23259671231174428 [2024-02-05]. https://pubmed.ncbi.nlm.nih.gov/37576456/. DOI: 10.1177/23259671231174428.
[43]
PARK J H, LEE K Y, RHEE S M, et al. A correlation study of clinical outcomes by quantification of fatty degeneration of the subscapularis: partial vs. whole cross-section[J]. Clin Shoulder Elb, 2018, 21(2): 67-74. DOI: 10.5397/cise.2018.21.2.67.

PREV Evaluation of the value of PI-RADS v2.1 and multiparametric MRI-derived biomarkers in detecting clinically significant prostate cancer in transition zone
NEXT The value of the magnetic resonance mDIXON-Quant technique in the assessment of alterations in the proton density fat fraction of the infrapatellar fat pad in knee osteoarthritis
  


LINK


Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn