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[Image and report quality of outpatient MRI examinations : Evaluation of organizational, technical and report-related parameters in patients with arthroscopically secured rotator cuff rupture].

Der Orthopäde 2022 Februrary
BACKGROUND: MRI is commonly used to diagnose and assess prognosis for rotator cuff (RM) pathology in addition to history and clinical examination.

AIM: This study investigates the image and report quality of shoulder MRIs with regard to prognosis-relevant parameters in outpatients who subsequently underwent surgical treatment for RM rupture.

MATERIALS AND METHODS: Using a defined questionnaire, both the MR images and the original reports of 94 patients were evaluated by an experienced radiologist with regard to referral information, MRI technology and quality of the MRI reports.

RESULTS: Questions or comments on RC were noted in 39% (general practitioners) and 48% (orthopaedics/UCH) of referrals. In MRI reports with the diagnosis "complete rupture of the RC", no information on the size of the defect was available in 47% of cases. In 18 and 30% of the reports, respectively, a fatty infiltration of the RM musculature or atrophy of the musculature was mentioned. When a partial RC rupture (n = 25) was diagnosed; the depth diameter (< or > 50% of the tendon thickness) was determined in only one case. The protocol recommendations valid today for MRI diagnostics of the shoulder were implemented in 60% of the examinations. According to the evaluating radiologist, 93-97% of the available MRI examinations were able to answer prognostic-relevant questions of an RC rupture.

DISCUSSION: The questions by physicians referring to the MRI examination of a shoulder with a subsequently arthroscopically verified RC rupture were predominantly unspecific or insufficient. In the radiological reports of these MRI examinations, prognosis-relevant parameters could not be extracted in sufficient form and number, although the MRI technique would have allowed this.

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