Magnetic resonance imaging without contrast as a diagnostic method for partial injury of the long head of the biceps tendon☆

Nascimento, Alexandre Tadeu do; Claudio, Gustavo Kogake

doi:10.1016/j.rboe.2016.12.003

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Original article • Rev. bras. ortop. 52 (1) • Jan-Feb 2017 • https://doi.org/10.1016/j.rboe.2016.12.003 copy

Magnetic resonance imaging without contrast as a diagnostic method for partial injury of the long head of the biceps tendon^{^☆} ☆ Study conducted at the Hospital Orthoservice, Grupo de Ombro e Cotovelo, São José dos Campos, SP, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE:

To evaluate the use of magnetic resonance imaging (MRI) without contrast as a diagnostic method of partial lesions of the long head of the biceps, using arthroscopic surgery as the gold standard.

METHODS:

We evaluated data from MRI and arthroscopic surgical findings of patients operated due to rotator cuff and SLAP injuries. MRI without contrast of at least 1.5 T, with a radiologist report, was used as a criterion for the detection of long head of the biceps injury. All cases were operated by the same surgeon at this hospital.

RESULTS:

This study evaluated data from 965 patients, 311 women (32%) and 654 men (68%), with a mean age of 45 years, who underwent arthroscopic surgery for rotator cuff and SLAP repair from September 2012 to September 2015. Overall, the sensitivity and specificity of MRI was 0.22 (CI: 0.17-0.26) and 0.98 (CI: 0.96-0.99), respectively.

CONCLUSIONS:

MRI has a low sensitivity and high specificity for detection of partial tears of the long head of the biceps tendon.

Keywords:
Sensitivity and specificity; Rotator cuff; Magnetic resonance imaging

	No IO lesion	IO lesion	Total
No MRI lesion	615	263	878
MRI lesion	14	73	87
Total	629	336	965
Sensitivity	22%	CI (0.17–0.26)^*
Specificity	98%	CI (0.96–0.99)^*
Accuracy	71%	CI (0.68–0.74)^*
Positive predictive value	84%	CI (0.74–0.91)^*
Negative predictive value	70%	CI (0.67–0.73)^*
Positive likelihood ratio	9.8	CI (5.6–17.0)^*
Negative likelihood ratio	0.8	CI (0.76–0.85)^*
Diagnostic odds ratio	12.2	CI (6.8–22.0)^*

	No IO lesion	IO lesion	Total
No MRI lesion	117	9	126
MRI lesion	4	3	7
Total	121	12	133
Sensitivity	25%	CI (0.08–0.53)^*
Specificity	97%	CI (0.92–0.98)^*
Accuracy	90%	CI (0.85–0.95)^*
Positive predictive value	43%	CI (0.11–0.79)^*
Negative predictive value	93%	CI (0.86–0.96)^*
Positive likelihood ratio	7.56	CI (1.9–29.9)^*
Negative likelihood ratio	0.78	CI (0.56–1.08)^*
Diagnostic odds ratio	9.75	CI (1.9–50.4)^*

	No IO lesion	IO lesion	Total
No MRI lesion	364	110	474
MRI lesion	5	34	39
Total	369	144	513
Sensitivity	24%	CI (0.17–0.31)^*
Specificity	99%	CI (0.97–0.99)^*
Accuracy	78%	CI (0.74–0.82)^*
Positive predictive value	87%	CI (0.72–0.95)^*
Negative predictive value	77%	CI (0.73–0.80)^*
Positive likelihood ratio	17.4	CI (6.9–43.7)^*
Negative likelihood ratio	0.77	CI (0.7–0.85)^*
Diagnostic odds ratio	22.5	CI (8.6–58.9)^*

	No IO lesion	IO lesion	Total
No MRI lesion	125	90	215
MRI lesion	5	29	34
Total	130	119	249
Sensitivity	24%	CI (0.17–0.32)^*
Specificity	96%	CI (0.91–0.98)^*
Accuracy	62%	CI (0.56–0.68)^*
Positive predictive value	85%	CI (0.68–0.94)^*
Negative predictive value	58%	CI (0.51–0.64)^*
Positive likelihood ratio	6.34	CI (2.53–15.8)^*
Negative likelihood ratio	0.79	CI (0.70–0.87)^*
Diagnostic odds ratio	8.05	CI (3.0–21.6)^*

	No IO lesion	IO lesion	Total
No MRI lesion	9	54	63
MRI lesion	0	7	7
Total	9	61	70
Sensitivity	11%	CI (0.05–0.21)^*
Specificity	100%	CI (0.7–1.0)^*
Accuracy	23%	CI (0.13–0.33)^*
Positive predictive value	100%	CI (0.56–1.0)^*
Negative predictive value	14%	CI (0.07–0.26)^*
Positive likelihood ratio	NC
Negative likelihood ratio	0.89	CI (0.8–0.96)^*
Diagnostic odds ratio	NC

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] * Corresponding author. E-mails: dr.nascimento@icloud.com, jangadamed@hotmail.com (A.T. Nascimento).

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Magnetic resonance imaging without contrast as a diagnostic method for partial injury of the long head of the biceps tendon☆ ☆ Study conducted at the Hospital Orthoservice, Grupo de Ombro e Cotovelo, São José dos Campos, SP, Brazil

ABSTRACT

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSIONS:

Magnetic resonance imaging without contrast as a diagnostic method for partial injury of the long head of the biceps tendon^{^☆} ☆ Study conducted at the Hospital Orthoservice, Grupo de Ombro e Cotovelo, São José dos Campos, SP, Brazil