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ROTATOR MANŞET YIRTIKLARINDA BİSEPS TENDON PATOLOJİLERİNİN SAPTANMASINDA PREOPERATİF MR’IN ETKİNLİĞİ: MR VE İNTRAOPERATİF BULGULARIN KORELASYONU

Year 2022, Volume: 29 Issue: 1, 85 - 91, 01.03.2022
https://doi.org/10.17343/sdutfd.998025

Abstract

Amaç
Bu çalışmanın amacı rotator manşet yırtığı olan hastalarda
biseps lezyonlarını saptamada manyetik rezonans
görüntülemenin (MRG) doğruluğunu değerlendirmektir.
Gereç ve Yöntem
Ocak 2012 ile Şubat 2020 arasında opere edilen toplam
168 hasta çalışmaya dahil edildi. Tüm hastalara
rotator manşet yırtığı tanısı ile artroskopik cerrahi uygulandı.
Tüm hastalar genel anestezi altında ve plaj
sandalyesi pozisyonunda ameliyat edildi. Demografik
veriler ve ameliyat öncesi MRG bulguları kaydedildi.
Artroskopik bulgular standart referans olarak kabul
edildi ve preoperatif MRG kayıtları ile korele edildi.
Bulgular
Ameliyat öncesi görüntülerde 118 (%70.2) olguda tam
kat, 50 (%29.8) olguda parsiyel yırtık saptandı. Labrum/
SLAP lezyonları 18 (%10,7) olguda tespit edildi.
51 (%30.4) olguda biseps patolojisi bildirilmişti. Ameliyatlar
sırasında 41 (%24,4) olguda ameliyat öncesi
tespit edilen lezyonların yanı sıra ek patolojiler gözlemledik.
Rotator manşet ve labrum/SLAP onarımları
aynı cerrahi seanslarda yapıldı. Yeni tespit edilen lezyonların
çoğunluğu 26 (%15,5) vakada tespit edilen
biseps lezyonlarıydı. 41 (%24.2) olguda biseps lezyonları
için tenodez, tenoliz veya tenotomi uygulandı.
MRG negatif olan 26 olguda LHBT cerrahisi uygulandı.
Biseps lezyonları 77 (%45.8) olguda intraoperatif
olarak doğrulandı; MRG'nin bu lezyonları saptamadaki
doğruluğu %66,2 idi.
Sonuç
Biseps lezyonları omuzun sık görülen patolojileri arasındadır.
Ameliyat öncesi MRG omuzun değerlendirilmesinde
önemlidir, ancak MRG'nin biseps bozukluklarını
tespit etmedeki etkinliği sınırlı olabilir. LHBT
lezyonlarının tanı ve tedavisinde artroskopik cerrahi
önemli bir rol oynar.

References

  • 1-Morag Y, Bedi A, Jamadar DA. The rotator interval and long head biceps tendon: anatomy, function, pathology, and magnetic resonance imaging. Magn Reson Imaging Clin N Am. 2012; 20: 229-259.
  • 2-Lee JC, Guy S, Connell D, Saifuddin A, Lambert S. MRI of the rotator interval of the shoulder. Clin Radiol. 2007; 62: 416-423.
  • 3- Vangsness CT Jr, Jorgenson SS, Watson T, Johnson DL. The origin of the long head of the biceps from the scapula and glenoid labrum. An anatomical study of 100 shoulders. J Bone Joint Surg Br. 1994; 76: 951-954.
  • 4. Virk MS, Cole BJ. Proximal Biceps Tendon and Rotator Cuff Tears. Clin Sports Med. 2016; 35:153-161.
  • 5. Watson ST, Robbins CB, Bedi A, Carpenter JE, Gagnier JJ, Miller BS. Comparison of outcomes 1 year after rotator cuff repair with and without concomitant biceps surgery. Arthroscopy. 2017; 33: 1928–1936.
  • 6.Takahashi N, Sugaya H, Matsuki K, Miyauchi H, Matsumoto M, Tokai M, Onishi K, Hoshika S, Ueda Y. Hypertrophy of the extra-articular tendon of the long head of biceps correlates with the location and size of a rotator cuff tear. Bone Joint J. 2017; 99: 806-811.
  • 7. Singaraju VM, Kang RW, Yanke AB, McNickle AG, Lewis PB, Wang VM, Williams JM, Chubinskaya S, Romeo AA, Cole BJ. Biceps tendinitis in chronic rotator cuff tears: a histologic perspective. J Shoulder Elbow Surg. 2008; 17: 898-904.
  • 8. Beall DP, Williamson EE, Ly JQ, Adkins MC, Emery RL, Jones TP, et al. Association of biceps tendon tears with rotator cuff abnormalities: degree of correlation with tears of the anterior and superior portions of the rotator cuff. AJR Am J Roentgenol. 2003; 180: 633–639.
  • 9. Chen CH, Chen CH, Chang CH, Su CI, Wang KC, Wang IC, Liu HT, Yu CM, Hsu KY. Classification and analysis of pathology of the long head of the biceps tendon in complete rotator cuff tears. Chang Gung Med J. 2012; 35: 263-270.
  • 10. Toshiaki A, Itoi E, Minagawa H, et al. Cross-sectional area of the tendon and the muscle of the biceps brachii in shoulders with rotator cuff tears: a study of 14 cadaveric shoulders. Acta Orthop. 2005; 76: 509–512.
  • 11- Mohtadi NG, Vellet AD, Clark ML, Hollinshead RM, Sasyniuk TM, Fick GH, Burton PJ. A prospective, double-blind comparison of magnetic resonance imaging and arthroscopy in the evaluation of patients presenting with shoulder pain. J Shoulder Elbow Surg. 2004; 13: 258-265.
  • 12-Lafosse L, Reiland Y, Baier GP, Toussaint B, Jost B. Anterior and posterior instability of the long head of the biceps tendon in rotator cuff tears: a new classification based on arthroscopic observations. Arthroscopy. 2007; 23: 73–80.
  • 13. Popp D, Schöffl V. Superior labral anterior posterior lesions of the shoulder: Current diagnostic and therapeutic standards. World J Orthop. 2015; 6: 660-671.
  • 14. Cervilla V, Schweitzer ME, Ho C, Motta A, Kerr R, Resnick D. Medial dislocation of the biceps brachii tendon: appearance at MR imaging. Radiology. 1991; 180: 523-526.
  • 15.Baptista E, Malavolta EA, Gracitelli MEC, Alvarenga D, Bordalo-Rodrigues M, Ferreira Neto AA, de Barros N. Diagnostic accuracy of MRI for detection of tears and instability of proximal long head of biceps tendon: an evaluation of 100 shoulders compared with arthroscopy. Skeletal Radiol. 2019; 48: 1723-1733.
  • 16. Walch G, Nove-Josserand L, Levigne C, Renaud E. Tears of the supraspinatus tendon associated with "hidden" lesions of the rotator interval. J Shoulder Elbow Surg. 1994; 3: 353-360.
  • 17. Leroux T, Chahal J, Wasserstein D, et al. A systematic review and meta-analysis comparing clinical outcomes after concurrent rotator cuff repair and long head biceps tenodesis or tenotomy. Sports Health. 2015; 7: 303–307.
  • 18. Desai SS, Mata HK. Long Head of Biceps Tendon Pathology and Results of Tenotomy in Full-Thickness Reparable Rotator Cuff Tear. Arthroscopy. 2017; 33: 1971-1976.
  • 19. Lee RW, Choi SJ, Lee MH, Ahn JH, Shin DR, Kang CH, Lee KW. Diagnostic accuracy of 3T conventional shoulder MRI in the detection of the long head of the biceps tendon tears associated with rotator cuff tendon tears. Skeletal Radiol. 2016; 45: 1705-1715.
  • 20. Houtz CG, Schwartzberg RS, Barry JA, Reuss BL, Papa L. Shoulder MRI accuracy in the community setting. J Shoulder Elbow Surg. 2011; 20:537-542.
  • 21. Kang Y, Lee JW, Ahn JM, Lee E, Kang HS. Instability of the long head of the biceps tendon in patients with rotator cuff tear: evaluation on magnetic resonance arthrography of the shoulder with arthroscopic correlation. Skeletal Radiol. 2017; 46: 1335-1342.
  • 22. Razmjou H, Fournier-Gosselin S, Christakis M, Pennings A, ElMaraghy A, Holtby R. Accuracy of magnetic resonance imaging in detecting biceps pathology in patients with rotator cuff disorders: comparison with arthroscopy. J Shoulder Elbow Surg. 2016; 25: 38-44.
  • 23. Dubrow SA, Streit JJ, Shishani Y, Robbin MR, Gobezie R. Diagnostic accuracy in detecting tears in the proximal biceps tendon using standard nonenhancing shoulder MRI. Open Access J Sports Med. 2014; 5: 81-87.

EFFICACY OF PREOPERATIVE MRI IN DETECTING BICEPS TENDON PATHOLOGIES IN ROTATOR CUFF TEARS: CORRELATION OF MRI AND INTRAOPERATIVE FINDINGS

Year 2022, Volume: 29 Issue: 1, 85 - 91, 01.03.2022
https://doi.org/10.17343/sdutfd.998025

Abstract

Objective
The aim of this study is to evaluate the accuracy
of magnetic resonance imaging (MRI) in detecting
biceps lesions in patients with rotator cuff tears.
Material and Methods
A total of 168 patients operated on between January
2012 and February 2020 were included in the study.
All the patients underwent arthroscopic surgery
with the diagnosis of rotator cuff tears. All patients
were operated on under general anesthesia and
in the beach chair position. Demographic data and
preoperative MRI findings were recorded. Arthroscopic
findings were accepted as the standard reference and
correlated with preoperative MRI records.
Results
In preoperative images, full-thickness rotator cuff
tears were identified in 118 (70.2%) cases and partialthickness
tears in 50 (29.8%) cases. Labrum/SLAP
lesions were detected in 18 (10.7%) cases. Biceps
disorders were reported in 51 (30.4%) cases. During
the surgeries, we observed additional pathologies in
41 (24.4%) cases besides the preoperatively detected
lesions. Rotator cuff and labrum/SLAP repairs were
performed in the same surgical sessions. The majority
of newly detected lesions were biceps lesions, being
identified in 26 (15.5%) cases. In 41 (24.2%) cases
tenodesis, tenolysis, or tenotomy were performed
for biceps lesions. LHBT surgery was performed in
26 cases with negative MRI. Biceps lesions were
confirmed in 77 (45.8%) cases intraoperatively;
therefore, the accuracy of MRI in detecting these
lesions was 66.2%.
Conclusion
Biceps lesions are among the common pathologies
of the shoulder. Preoperative MRI is important in
evaluation of the shoulder, but the efficacy of MRI may
be limited in detecting biceps disorders. Arthroscopic
surgery is crucial in diagnosis and treatment of LHBT
lesions.

References

  • 1-Morag Y, Bedi A, Jamadar DA. The rotator interval and long head biceps tendon: anatomy, function, pathology, and magnetic resonance imaging. Magn Reson Imaging Clin N Am. 2012; 20: 229-259.
  • 2-Lee JC, Guy S, Connell D, Saifuddin A, Lambert S. MRI of the rotator interval of the shoulder. Clin Radiol. 2007; 62: 416-423.
  • 3- Vangsness CT Jr, Jorgenson SS, Watson T, Johnson DL. The origin of the long head of the biceps from the scapula and glenoid labrum. An anatomical study of 100 shoulders. J Bone Joint Surg Br. 1994; 76: 951-954.
  • 4. Virk MS, Cole BJ. Proximal Biceps Tendon and Rotator Cuff Tears. Clin Sports Med. 2016; 35:153-161.
  • 5. Watson ST, Robbins CB, Bedi A, Carpenter JE, Gagnier JJ, Miller BS. Comparison of outcomes 1 year after rotator cuff repair with and without concomitant biceps surgery. Arthroscopy. 2017; 33: 1928–1936.
  • 6.Takahashi N, Sugaya H, Matsuki K, Miyauchi H, Matsumoto M, Tokai M, Onishi K, Hoshika S, Ueda Y. Hypertrophy of the extra-articular tendon of the long head of biceps correlates with the location and size of a rotator cuff tear. Bone Joint J. 2017; 99: 806-811.
  • 7. Singaraju VM, Kang RW, Yanke AB, McNickle AG, Lewis PB, Wang VM, Williams JM, Chubinskaya S, Romeo AA, Cole BJ. Biceps tendinitis in chronic rotator cuff tears: a histologic perspective. J Shoulder Elbow Surg. 2008; 17: 898-904.
  • 8. Beall DP, Williamson EE, Ly JQ, Adkins MC, Emery RL, Jones TP, et al. Association of biceps tendon tears with rotator cuff abnormalities: degree of correlation with tears of the anterior and superior portions of the rotator cuff. AJR Am J Roentgenol. 2003; 180: 633–639.
  • 9. Chen CH, Chen CH, Chang CH, Su CI, Wang KC, Wang IC, Liu HT, Yu CM, Hsu KY. Classification and analysis of pathology of the long head of the biceps tendon in complete rotator cuff tears. Chang Gung Med J. 2012; 35: 263-270.
  • 10. Toshiaki A, Itoi E, Minagawa H, et al. Cross-sectional area of the tendon and the muscle of the biceps brachii in shoulders with rotator cuff tears: a study of 14 cadaveric shoulders. Acta Orthop. 2005; 76: 509–512.
  • 11- Mohtadi NG, Vellet AD, Clark ML, Hollinshead RM, Sasyniuk TM, Fick GH, Burton PJ. A prospective, double-blind comparison of magnetic resonance imaging and arthroscopy in the evaluation of patients presenting with shoulder pain. J Shoulder Elbow Surg. 2004; 13: 258-265.
  • 12-Lafosse L, Reiland Y, Baier GP, Toussaint B, Jost B. Anterior and posterior instability of the long head of the biceps tendon in rotator cuff tears: a new classification based on arthroscopic observations. Arthroscopy. 2007; 23: 73–80.
  • 13. Popp D, Schöffl V. Superior labral anterior posterior lesions of the shoulder: Current diagnostic and therapeutic standards. World J Orthop. 2015; 6: 660-671.
  • 14. Cervilla V, Schweitzer ME, Ho C, Motta A, Kerr R, Resnick D. Medial dislocation of the biceps brachii tendon: appearance at MR imaging. Radiology. 1991; 180: 523-526.
  • 15.Baptista E, Malavolta EA, Gracitelli MEC, Alvarenga D, Bordalo-Rodrigues M, Ferreira Neto AA, de Barros N. Diagnostic accuracy of MRI for detection of tears and instability of proximal long head of biceps tendon: an evaluation of 100 shoulders compared with arthroscopy. Skeletal Radiol. 2019; 48: 1723-1733.
  • 16. Walch G, Nove-Josserand L, Levigne C, Renaud E. Tears of the supraspinatus tendon associated with "hidden" lesions of the rotator interval. J Shoulder Elbow Surg. 1994; 3: 353-360.
  • 17. Leroux T, Chahal J, Wasserstein D, et al. A systematic review and meta-analysis comparing clinical outcomes after concurrent rotator cuff repair and long head biceps tenodesis or tenotomy. Sports Health. 2015; 7: 303–307.
  • 18. Desai SS, Mata HK. Long Head of Biceps Tendon Pathology and Results of Tenotomy in Full-Thickness Reparable Rotator Cuff Tear. Arthroscopy. 2017; 33: 1971-1976.
  • 19. Lee RW, Choi SJ, Lee MH, Ahn JH, Shin DR, Kang CH, Lee KW. Diagnostic accuracy of 3T conventional shoulder MRI in the detection of the long head of the biceps tendon tears associated with rotator cuff tendon tears. Skeletal Radiol. 2016; 45: 1705-1715.
  • 20. Houtz CG, Schwartzberg RS, Barry JA, Reuss BL, Papa L. Shoulder MRI accuracy in the community setting. J Shoulder Elbow Surg. 2011; 20:537-542.
  • 21. Kang Y, Lee JW, Ahn JM, Lee E, Kang HS. Instability of the long head of the biceps tendon in patients with rotator cuff tear: evaluation on magnetic resonance arthrography of the shoulder with arthroscopic correlation. Skeletal Radiol. 2017; 46: 1335-1342.
  • 22. Razmjou H, Fournier-Gosselin S, Christakis M, Pennings A, ElMaraghy A, Holtby R. Accuracy of magnetic resonance imaging in detecting biceps pathology in patients with rotator cuff disorders: comparison with arthroscopy. J Shoulder Elbow Surg. 2016; 25: 38-44.
  • 23. Dubrow SA, Streit JJ, Shishani Y, Robbin MR, Gobezie R. Diagnostic accuracy in detecting tears in the proximal biceps tendon using standard nonenhancing shoulder MRI. Open Access J Sports Med. 2014; 5: 81-87.
There are 23 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Ahmet Çağdaş Biçen 0000-0002-0711-9376

Meric Unal 0000-0001-9576-5994

Ahmet Ekin 0000-0001-9302-9475

Mustafa Ozkan 0000-0003-1097-6608

Publication Date March 1, 2022
Submission Date September 20, 2021
Acceptance Date October 12, 2021
Published in Issue Year 2022 Volume: 29 Issue: 1

Cite

Vancouver Biçen AÇ, Unal M, Ekin A, Ozkan M. EFFICACY OF PREOPERATIVE MRI IN DETECTING BICEPS TENDON PATHOLOGIES IN ROTATOR CUFF TEARS: CORRELATION OF MRI AND INTRAOPERATIVE FINDINGS. Med J SDU. 2022;29(1):85-91.

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