Metal artefacts severely hamper magnetic resonance imaging of the rotator cuff tendons after rotator cuff repair with titanium suture anchors

Femke Schröder, Rianne Huis in't Veld, Lydia den Otter, Sjoerd M. van Raak, Bennie ten Haken, Anne J.H. Vochteloo

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Abstract

Background
The rate of retear after rotator cuff surgery is 17%. Magnetic resonance imaging (MRI) scans are used for confirmative diagnosis of retear. However, because of the presence of titanium suture anchors, metal artefacts on the MRI are common. The present study evaluated the diagnostic value of MRI after rotator cuff tendon surgery with respect to assessing the integrity as well as the degeneration and atrophy of the rotator cuff tendons when titanium anchors are in place.

Methods
Twenty patients who underwent revision surgery of the rotator cuff as a result of a clinically suspected retear between 2013 and 2015 were included. The MRI scans of these patients were retrospectively analyzed by four specialized shoulder surgeons and compared with intra-operative findings (gold standard). Sensitivity and interobserver agreement among the surgeons in assessing retears as well as the Goutallier and Warner classification were examined.

Results
In 36% (range 15% to 50%) of the pre-operative MRI scans, the observers could not review the rotator cuff tendons. When the rotator cuff tendons were assessable, a diagnostic accuracy with a mean sensitivity of 0.84 (0.70 to 1.0) across the surgeons was found, with poor interobserver agreement (kappa = 0.12).

Conclusions
Metal artefacts prevented accurate diagnosis from MRI scans of rotator cuff retear in 36% of the patients studied.
Original languageEnglish
Number of pages7
JournalJournal of Shoulder and Elbow Surgery
DOIs
Publication statusPublished - Jun-2017
Externally publishedYes

Keywords

  • diagnostic value
  • shoulder
  • Rotator cuff
  • MRI
  • Interobserver agreement
  • Metal artefacts

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