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Dynamic Three-Dimensional Shoulder Mri during Active Motion for Investigation of Rotator Cuff Diseases.

Type
Articles dans des revues avec comité de lecture
Author
TEMPELAERE, Christine
12951 Université Paris Descartes - Faculté de Médecine [UPD5 Médecine]
484605 LBM/institute de Biomécanique humaine Georges Charpak
PIERRART, Jérôme
12951 Université Paris Descartes - Faculté de Médecine [UPD5 Médecine]
484605 LBM/institute de Biomécanique humaine Georges Charpak
LEFEVRE-COLAU, Marie-Martine
300123 CHU Cochin [AP-HP]
VUILLEMIN, Valérie
179025 Hôpital Européen Georges Pompidou
CUENOD, Charles-André
179025 Hôpital Européen Georges Pompidou
HANSEN, Ulrich
235079 Department of Mechanical Engineering [Imperial College London]
MIR, Olivier
12951 Université Paris Descartes - Faculté de Médecine [UPD5 Médecine]
SCALLI, Wafa
484605 LBM/institute de Biomécanique humaine Georges Charpak
GREGORY, Thomas
235079 Department of Mechanical Engineering [Imperial College London]

URI
http://hdl.handle.net/10985/17995
DOI
10.1371/journal.pone.0158563
Date
2016
Journal
PLoS One

Abstract

BACKGROUND: MRI is the standard methodology in diagnosis of rotator cuff diseases. However, many patients continue to have pain despite treatment, and MRI of a static unloaded shoulder seems insufficient for best diagnosis and treatment. This study evaluated if Dynamic MRI provides novel kinematic data that can be used to improve the understanding, diagnosis and best treatment of rotator cuff diseases. METHODS: Dynamic MRI provided real-time 3D image series and was used to measure changes in the width of subacromial space, superior-inferior translation and anterior-posterior translation of the humeral head relative to the glenoid during active abduction. These measures were investigated for consistency with the rotator cuff diseases classifications from standard MRI. RESULTS: The study included: 4 shoulders with massive rotator cuff tears, 5 shoulders with an isolated full-thickness supraspinatus tear, 5 shoulders with tendinopathy and 6 normal shoulders. A change in the width of subacromial space greater than 4mm differentiated between rotator cuff diseases with tendon tears (massive cuff tears and supraspinatus tear) and without tears (tendinopathy) (p = 0.012). The range of the superior-inferior translation was higher in the massive cuff tears group (6.4mm) than in normals (3.4mm) (p = 0.02). The range of the anterior-posterior translation was higher in the massive cuff tears (9.2 mm) and supraspinatus tear (9.3 mm) shoulders compared to normals (3.5mm) and tendinopathy (4.8mm) shoulders (p = 0.05). CONCLUSION: The Dynamic MRI enabled a novel measure; 'Looseness', i.e. the translation of the humeral head on the glenoid during an abduction cycle. Looseness was better able at differentiating different forms of rotator cuff disease than a simple static measure of relative glenohumeral position.

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