Accuracy of MRI with Cinematic 3D Volume Rendering Reconstruction in Helping the Diagnosis of Partial Thickness Subscapularis Tendon Tear

OBJECTIVES: This study aimed to figure the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy in diagnosis of rotator cuff tears (RCT) using magnetic resonance imaging (MRI) with additional Cinematic three-dimension volume rendering (3D VR) reconstruction. MATERIALS AND METHODS: A retrospective review of the all-ar throscopic proven cases of RCT, provisionally diagnosed via clinical and MRI findings since May 2020 to Mar 2021, were collected. Cinematic 3D VR re construction of the rotator cuffs was performed subsequently from the MRI images. The accuracy of MRI with Cinematic 3D VR reconstruction as com pared to the conventional MRI alone was calculated. RESULTS: Fifty-seven subjects were enrolled into the study, included 35 male and 22 female subjects. The average age was 60.58 ± 9.52 years old. Majority of the surgery side was right shoulder (56.1%). Fifty-two cases (91.23%) had supraspinatus tendon tear; 22 cases of full-thickness tear (42.3%) and 30 cases of partial-thickness tear (57.7%). Two cases had no treatment for supraspinatus tendon, 3 cases underwent debridement, and 47 cases received arthroscopic repair of supraspinatus tendon. Thirty-nine subscapularis tendon tear cases (68.42%) consisted of 4 cases of full-thickness tear (10.26%) and 35 cases of partial-thickness tear (61.4%). Seventeen cases underwent debridement, 17 cases underwent single row repair of the subscapularis tendon, and 5 cases received double row repair. Detecting of partial-thickness torn supraspinatus tendon, MRI with 3D VR revealed no further benefit from conventional MRI alone, in terms of any improving sensitivity, specificity, PPV, NPV or even accuracy. However, sensitivity, PPV and accuracy for depicting subscapularis tendon tear were increased. The full-thickness tear of both supraspinatus and subscapularis tendons showed no significant difference of sensitivity, specificity, PPV, NPV and accuracy between MRI with 3D VR and MRI alone. CONCLUSION: The use of MRI with 3D VR technique may aid in detection of partial-thickness subscapularis tendon tear, increased sensitivity, PPV and accuracy, as compared to conventional MRI alone. Further new 3D reconstruction techniques should be promising for improving post processing time consume and be more user friendly, resulting in clearly recognized rotator cuff tear for both radiologists and orthopedists.