Scholarlink

Background <p>Accurate quantification of fatty infiltration (FI) after rotator-cuff tear (RCT) is critical for therapeutic planning. The conventional Goutallier classification, based on the oblique-sagittal “Y-view,” is subjective, shows only moderate inter-observer agreement, and frequently underestimates the degree of infiltration when the tendon is severely retracted. Recently, evaluation at a more medial level—the suprascapular notch (“R-view”)—has been proposed because it better visualizes the retracted muscle belly, yet it has not been combined with quantitative analysis.</p> Purpose <p>To determine (1) the agreement between quantitative FI (Fat%) measured on the R-view and the traditional Goutallier grade, and (2) the diagnostic value of this quantitative approach in patients with Patte stage 3 retraction.</p> Methods <p>Patients who underwent arthroscopic rotator-cuff repair (ARCR) between 2022 and 2024 were retrospectively enrolled and stratified by Patte classification. On both the Y-view and the R-view, we measured supraspinatus cross-sectional area (CSA), Fat%, and Goutallier grade. Intraclass correlation coefficients (ICC) were calculated for reliability, receiver operating characteristic (ROC) curves were constructed for diagnostic performance, and the two views/methods were compared.</p> Results <p>A total of 192 patients were included. CSA was significantly larger on the R-view than on the Y-view (<i>P</i> &lt; 0.05), whereas both Fat% and Goutallier grade were significantly lower (<i>P</i> &lt; 0.05). Fat% and Goutallier grade were strongly correlated on both views (<i>R</i> = 0.781 vs. 0.826, <i>P</i> &lt; 0.001). In Patte stage-3 patients, Fat% derived from the R-view achieved the highest diagnostic performance (Area Under the Curve(AUC), AUC = 0.73); the optimal cutoff was 56%, yielding 86% specificity and a Youden index(YI) of 0.41.</p> Conclusion <p>The R-view more accurately depicts the true status of the retracted supraspinatus. Combining this imaging plane with quantitative Fat% measurement significantly improves objectivity and reliability in the assessment of FI, especially in cases of severe tendon retraction, and offers surgeons a superior pre-operative imaging strategy.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Quantitative assessment of supraspinatus fatty infiltration on a novel MRI section: comparison with conventional methods

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年3月20日

查看全文
  • Donger Hai,
  • Dingyou Wang,
  • Feng Tong,
  • Jing Song,
  • Zhaowei Wang,
  • Xilong Ma,
  • Jun Ma

摘要

Background

Accurate quantification of fatty infiltration (FI) after rotator-cuff tear (RCT) is critical for therapeutic planning. The conventional Goutallier classification, based on the oblique-sagittal “Y-view,” is subjective, shows only moderate inter-observer agreement, and frequently underestimates the degree of infiltration when the tendon is severely retracted. Recently, evaluation at a more medial level—the suprascapular notch (“R-view”)—has been proposed because it better visualizes the retracted muscle belly, yet it has not been combined with quantitative analysis.

Purpose

To determine (1) the agreement between quantitative FI (Fat%) measured on the R-view and the traditional Goutallier grade, and (2) the diagnostic value of this quantitative approach in patients with Patte stage 3 retraction.

Methods

Patients who underwent arthroscopic rotator-cuff repair (ARCR) between 2022 and 2024 were retrospectively enrolled and stratified by Patte classification. On both the Y-view and the R-view, we measured supraspinatus cross-sectional area (CSA), Fat%, and Goutallier grade. Intraclass correlation coefficients (ICC) were calculated for reliability, receiver operating characteristic (ROC) curves were constructed for diagnostic performance, and the two views/methods were compared.

Results

A total of 192 patients were included. CSA was significantly larger on the R-view than on the Y-view (P < 0.05), whereas both Fat% and Goutallier grade were significantly lower (P < 0.05). Fat% and Goutallier grade were strongly correlated on both views (R = 0.781 vs. 0.826, P < 0.001). In Patte stage-3 patients, Fat% derived from the R-view achieved the highest diagnostic performance (Area Under the Curve(AUC), AUC = 0.73); the optimal cutoff was 56%, yielding 86% specificity and a Youden index(YI) of 0.41.

Conclusion

The R-view more accurately depicts the true status of the retracted supraspinatus. Combining this imaging plane with quantitative Fat% measurement significantly improves objectivity and reliability in the assessment of FI, especially in cases of severe tendon retraction, and offers surgeons a superior pre-operative imaging strategy.