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Coracoacromial ligament thickness and Rotator Cuff Tendinopathy : validition and reproducibility of two measures methods using MRI based imaging.
ESSKA Academy. Pages L. May 11, 2018; 218050
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Abstract
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Objectives: Etiopathogeny of rotator cuff tendinopathy (RCT) remains a discuss problem. Relationships between coracoacromial arch and rotator cuff tendinopathy have been already described. However, coracoacromial ligament thickness (CAL) thickness has not been studied. The aim of this study was to describe and validate two methods of CAL thickness measurement using MRI or Magnetic Resonance Arthrography (MRA)imaging .

Methods: Thirty patients were divided in 3 groups, similar for age, sex and shoulder side. RCT group (n=20) has been studied using MRI (group 1: n=10) or MRA (group 2 n=10). RCT groups have been compared to a control group (group 3 n=10), explored using MRI for another shoulder pathology than RCT or rotator cuff tear. CAL thickness (CALT) measurements were made on coronal views using FAT-SAT T2 weighted images. Direct measurement of CALT was defined by the distance (in mm) between superior and inferior side of the CAL. Indirect measurement of CALT was made using ratio (AH/CH) defined by the distance (AH) (in mm) between inferior cortical part of acromion to the superior cortical border oh humeral head, divided by the distance (CH) (in mm) between CAL inferior side to the superior cortical border of humeral head. Each measure has been done twice for each patient, by two independents observers. Intra- and interobserver correlation and concordance tests were performed by Pearson's correlation. Interobserver measures have been compared using Wilcoxon test at 0.05 alpha level.

Results: No significant difference was found between interobserver measures: MRI vs. MRA, direct measure of CALT, indirect measure of CALT. Direct and indirect CALT measurements were accurate and reproducible (correlation efficiency(r): intraobserver: 0.84-0.64; interobserver: 0. 96- 1; 0. 80-0.86). Direct and indirect CALT measurements were significantly higher in RCT groups than in control group (respectively, in mean: 2.39 vs. 0.98 mm and 1.39 vs. 1.17) (p = 0,028).

Conclusions: Direct or indirect CALT measurements were accurate and reproducible, using both MRI and MRA. CAL was thicker in patients with RCT than in the control group with rotator cuff disease.

Keywords:
coracoacromial ligament thickness, MRI imaging, Rotator cuff tendinopathy
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