Fatty infiltration of the supraspinatus: A reliability study
Fatty infiltration of the supraspinatus: A reliability study
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DOI：
10.1016/j.jse.2008.12.014
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发表时间：
2009-07-01
影响因子：
3
通讯作者：
Walch, Gilles
中科院分区：
文献类型：
--
作者：
Williams, Matthew D.;Laedermann, Alexandre;Walch, Gilles
背景：肩袖脂肪浸润的 Goutallier 分类是公认的标准，但尚无关于哪种计算机断层扫描平面最能识别冈上肌脂肪浸润的建议。我们的目的是确定最可靠的平面来评估冈上肌脂肪浸润、评估切线征的可靠性以及将脂肪浸润和肌肉萎缩相关联。方法：由 3 名肩部外科医生使用 5 级 Goutallier 分类和单独的 3 级量表对 87 例计算机断层扫描中的脂肪浸润进行审查。在轴向评估冈上肌。冠状面和矢状面。切线符号用于评估肌肉萎缩。结果：轴平面对于 5 层和 3 层系统均产生最高的一致性。描述了一种客观的射线照相标记来可靠地确定 3 级脂肪浸润。切线符号对于肌肉萎缩的存在产生了极好的一致性。发现切线符号与脂肪浸润之间存在显着关系 (P < .0001)； 3 级和 4 级脂肪浸润与上旋肌萎缩有统计学相关性。结论：切线符号对于确定肌肉萎缩的存在和临床决策是可以接受的。正切线符号是高级脂肪浸润的指标。评估脂肪浸润时应使用轴向计算机断层扫描平面。证据级别：3级；诊断研究。 (C) 2009 年肩肘外科杂志董事会。
Background: The Goutallier classification of rotator cuff fatty infiltration is an accepted standard, yet no recommendations exist for which computed tomography plane is best to identify fatty infiltration of the supraspinatus. Our purpose was to determine the most reliable plane to evaluate supraspinatus fatty infiltration, assess reliability of the tangent sign, and to correlate fatty infiltration and muscle atrophy.Methods: Fatty infiltration in 87 Computed tomography scans was reviewed by 3 shoulder surgeons using the 5-tiered Goutallier classification and a separate 3-grade scale. The supraspinatus muscle was evaluated in the axial. coronal, and sagittal plane. The tangent sign was used to assess muscle atrophy.Results: The axial plane produced the highest agreement for both the 5-tiered and 3-tiered systems. An objective radiographic marker was described to reliably determine grade 3 fatty infiltration. The tangent sign produced excellent agreement for the presence of muscle atrophy. A significant relationship between the tangent sign and fatty infiltration was discovered (P < .0001); grades 3 and 4 fatty infiltration correlated statistically with supraspirtatus atrophy.Conclusion: The tangent sign is acceptable for determining the presence of muscle atrophy and clinical decision making. A positive tangent sign is an indicator of advanced fatty infiltration. The axial computed tomography plane should be used when evaluating fatty infiltration.Level of evidence: Level 3; Diagnostic study. (C) 2009 Journal of Shoulder and Elbow Surgery Board of Trustees.