2025 ISAKOS Congress in Munich, Germany

2025 ISAKOS Biennial Congress Paper


Three-Dimensional MRI of the Shoulder: Enabling Precise Visualization of Rotator Cuff Tear Morphology

Keisuke Tsukada, MD, PhD., Kaga, Iatabashi-Ku JAPAN
Youichi Yasui, MD, PhD, Tokyo JAPAN
Keisuke Yonezawa, MD., Itabashi-ku, Tokyo JAPAN
Takuma Hagihara, MD., Itabashi-ku, Tokyo JAPAN
Hirotaka Kawano, Prof, Tokyo JAPAN
Wataru Miyamoto, MD, Tokyo JAPAN

Department of Orthopaedic Surgery, Teikyo University School of Medicine, Itabashi-ku, Tokyo, JAPAN

FDA Status Not Applicable

Summary

This study compared the accuracy of regular MRI and 3D-MRI in assessing rotator cuff tear morphology against actual surgical findings. Involving 28 patients, the results showed a significantly higher conformity rate for 3D-MRI (96%) compared to regular MRI (57% and 42% for two evaluators). The findings suggest that 3D-MRI improves accuracy in preoperative planning for rotator cuff repair.

Abstract

Background

Preoperative planning for arthroscopic rotator cuff repair often estimates injury site, size, and morphology from 2D MRI images, which can diverge from actual injury due to the surgeon's interpretation. Improved imaging technology and our institution's establishment of a gapless 3D-MRI technique in 2019 have led to potential accuracy improvements in preoperative planning using detailed 3D images of the rotator cuff.

Purpose

The purpose of this study is to compare the rotator cuff tear estimates from regular MRI and 3D-MRI with actual surgical findings, illuminating the evaluation accuracy.

Methods

This prospective study includes 28 cases who underwent cuff repair at our institution between June 2021 and May 2023 and provided preoperative consent. We used a 3.0T MRI (Siemens, Magnetom Skyra) for regular MRI and our institution's 3D-MRI technique. We constructed 3D images of the rotator cuff, humeral head, and scapula from the MRI 3D volume data using a medical imaging workstation (Ziosoft , Ziostation 2). Two evaluators estimated the rotator cuff tear morphology from randomly presented 3D images and regular MRI, with estimates compared to surgical findings for conformity evaluation.

Results

Surgical findings showed tear morphologies as Transverse in 7 cases, Anterior L in 2, Tongue-Shaped in 4, V-shaped in 3, and U-shaped in 12. Conformity rates were 96% (27/28) for 3D images and 57% (16/28) for regular MRI by Evaluator A, and 96% (27/28) for 3D images and 42% (12/28) for regular MRI by Evaluator B. Shoulder joint 3D images significantly improved evaluation accuracy.

Conclusions

Our findings suggest that 3D images from 3D-MRI can accurately represent rotator cuff tear morphology, potentially enhancing preoperative planning accuracy.