Cargando…

Cross-Sectional Area of the Rotator Cuff Muscles in MRI – Is there Evidence for a Biomechanical Balanced Shoulder?

OBJECTIVE: To provide in-vivo evidence for the common biomechanical concept of transverse and craniocaudal force couples in the shoulder that are yielded by both the rotator cuff muscles (RCM) and the deltoid and to quantitatively evaluate and correlate the cross-sectional areas (CSA) of the corresp...

Descripción completa

Detalles Bibliográficos
Autores principales: Bouaicha, Samy, Slankamenac, Ksenija, Moor, Beat K., Tok, Sina, Andreisek, Gustav, Finkenstaedt, Tim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918939/
https://www.ncbi.nlm.nih.gov/pubmed/27336464
http://dx.doi.org/10.1371/journal.pone.0157946
_version_ 1782439180811370496
author Bouaicha, Samy
Slankamenac, Ksenija
Moor, Beat K.
Tok, Sina
Andreisek, Gustav
Finkenstaedt, Tim
author_facet Bouaicha, Samy
Slankamenac, Ksenija
Moor, Beat K.
Tok, Sina
Andreisek, Gustav
Finkenstaedt, Tim
author_sort Bouaicha, Samy
collection PubMed
description OBJECTIVE: To provide in-vivo evidence for the common biomechanical concept of transverse and craniocaudal force couples in the shoulder that are yielded by both the rotator cuff muscles (RCM) and the deltoid and to quantitatively evaluate and correlate the cross-sectional areas (CSA) of the corresponding RCM as a surrogate marker for muscle strength using MRI. MATERIALS AND METHODS: Fifty patients (mean age, 36 years; age range, 18–57 years; 41 male, 9 female) without rotator cuff tears were included in this retrospective study. Data were assessed by two readers. The CSA (mm(2)) of all rotator cuff muscles was measured on parasagittal T1-weighted FSE sequence at two different positions (at the established “y-position” and at a more medial slice in the presumably maximal CSA for each muscle, i.e., the “set position”). The CSA of the deltoid was measured on axial intermediate-weighted FSE sequences at three positions. CSA measurements were obtained using 1.5 Tesla MR-arthrographic shoulder. Pearson’s correlation for the corresponding CSA of the force couple as well as was the intraclass correlation coefficient for the inter- and intra-reader agreement was calculated. RESULTS: The mean CSA was 770 mm(2) (±167) and 841 mm(2) (±191) for the supraspinatus (in the y- and set-positions, respectively) and 984 mm(2) (±241) and 1568 mm(2) (±338) for the infraspinatus. The mean CSA was 446 mm(2) (±129) and 438 mm(2) (±128) for the teres minor (in the y- and set-positions, respectively) and 1953 mm(2) (±553) and 2343 mm(2) (±587) for the subscapularis. The three measurements of the deltoid revealed a CSA of 3063 mm(2) (±839) for the upper edge, 3829 mm(2) (±836) for the lower edge and 4069 mm(2) (±937) for the middle of the glenoid. At the set position Pearson’s correlation of the transverse force couple (subscapularis/infraspinatus) showed a moderate positive correlation of r = 0.583 (p<0.0001) and a strong correlation when the CSA of the teres minor was added to the infraspinatus CSA (r = 0.665, p = 0.0008) and a strong positive correlation of the craniocaudal force couple (supraspinatus/deltoid) that ranged from r = 0.565–0.698 (p<0.0001). Inter-reader agreement (ranged from 0.841 to 0.997, p = 0.0007) and intra-reader agreement were excellent (ranged from 0.863 to 0.999, p = 0.0006). CONCLUSION: The significant correlation of the CSA of the RCM that form the transverse (subscapularis/infraspinatus-teres minor) and craniocaudal (supraspinatus/deltoid) force couple measured by MR-arthrography supports the biomechanical concept of a dynamically balanced shoulder in patients with an intact rotator cuff.
format Online
Article
Text
id pubmed-4918939
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-49189392016-07-08 Cross-Sectional Area of the Rotator Cuff Muscles in MRI – Is there Evidence for a Biomechanical Balanced Shoulder? Bouaicha, Samy Slankamenac, Ksenija Moor, Beat K. Tok, Sina Andreisek, Gustav Finkenstaedt, Tim PLoS One Research Article OBJECTIVE: To provide in-vivo evidence for the common biomechanical concept of transverse and craniocaudal force couples in the shoulder that are yielded by both the rotator cuff muscles (RCM) and the deltoid and to quantitatively evaluate and correlate the cross-sectional areas (CSA) of the corresponding RCM as a surrogate marker for muscle strength using MRI. MATERIALS AND METHODS: Fifty patients (mean age, 36 years; age range, 18–57 years; 41 male, 9 female) without rotator cuff tears were included in this retrospective study. Data were assessed by two readers. The CSA (mm(2)) of all rotator cuff muscles was measured on parasagittal T1-weighted FSE sequence at two different positions (at the established “y-position” and at a more medial slice in the presumably maximal CSA for each muscle, i.e., the “set position”). The CSA of the deltoid was measured on axial intermediate-weighted FSE sequences at three positions. CSA measurements were obtained using 1.5 Tesla MR-arthrographic shoulder. Pearson’s correlation for the corresponding CSA of the force couple as well as was the intraclass correlation coefficient for the inter- and intra-reader agreement was calculated. RESULTS: The mean CSA was 770 mm(2) (±167) and 841 mm(2) (±191) for the supraspinatus (in the y- and set-positions, respectively) and 984 mm(2) (±241) and 1568 mm(2) (±338) for the infraspinatus. The mean CSA was 446 mm(2) (±129) and 438 mm(2) (±128) for the teres minor (in the y- and set-positions, respectively) and 1953 mm(2) (±553) and 2343 mm(2) (±587) for the subscapularis. The three measurements of the deltoid revealed a CSA of 3063 mm(2) (±839) for the upper edge, 3829 mm(2) (±836) for the lower edge and 4069 mm(2) (±937) for the middle of the glenoid. At the set position Pearson’s correlation of the transverse force couple (subscapularis/infraspinatus) showed a moderate positive correlation of r = 0.583 (p<0.0001) and a strong correlation when the CSA of the teres minor was added to the infraspinatus CSA (r = 0.665, p = 0.0008) and a strong positive correlation of the craniocaudal force couple (supraspinatus/deltoid) that ranged from r = 0.565–0.698 (p<0.0001). Inter-reader agreement (ranged from 0.841 to 0.997, p = 0.0007) and intra-reader agreement were excellent (ranged from 0.863 to 0.999, p = 0.0006). CONCLUSION: The significant correlation of the CSA of the RCM that form the transverse (subscapularis/infraspinatus-teres minor) and craniocaudal (supraspinatus/deltoid) force couple measured by MR-arthrography supports the biomechanical concept of a dynamically balanced shoulder in patients with an intact rotator cuff. Public Library of Science 2016-06-23 /pmc/articles/PMC4918939/ /pubmed/27336464 http://dx.doi.org/10.1371/journal.pone.0157946 Text en © 2016 Bouaicha et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Bouaicha, Samy
Slankamenac, Ksenija
Moor, Beat K.
Tok, Sina
Andreisek, Gustav
Finkenstaedt, Tim
Cross-Sectional Area of the Rotator Cuff Muscles in MRI – Is there Evidence for a Biomechanical Balanced Shoulder?
title Cross-Sectional Area of the Rotator Cuff Muscles in MRI – Is there Evidence for a Biomechanical Balanced Shoulder?
title_full Cross-Sectional Area of the Rotator Cuff Muscles in MRI – Is there Evidence for a Biomechanical Balanced Shoulder?
title_fullStr Cross-Sectional Area of the Rotator Cuff Muscles in MRI – Is there Evidence for a Biomechanical Balanced Shoulder?
title_full_unstemmed Cross-Sectional Area of the Rotator Cuff Muscles in MRI – Is there Evidence for a Biomechanical Balanced Shoulder?
title_short Cross-Sectional Area of the Rotator Cuff Muscles in MRI – Is there Evidence for a Biomechanical Balanced Shoulder?
title_sort cross-sectional area of the rotator cuff muscles in mri – is there evidence for a biomechanical balanced shoulder?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918939/
https://www.ncbi.nlm.nih.gov/pubmed/27336464
http://dx.doi.org/10.1371/journal.pone.0157946
work_keys_str_mv AT bouaichasamy crosssectionalareaoftherotatorcuffmusclesinmriisthereevidenceforabiomechanicalbalancedshoulder
AT slankamenacksenija crosssectionalareaoftherotatorcuffmusclesinmriisthereevidenceforabiomechanicalbalancedshoulder
AT moorbeatk crosssectionalareaoftherotatorcuffmusclesinmriisthereevidenceforabiomechanicalbalancedshoulder
AT toksina crosssectionalareaoftherotatorcuffmusclesinmriisthereevidenceforabiomechanicalbalancedshoulder
AT andreisekgustav crosssectionalareaoftherotatorcuffmusclesinmriisthereevidenceforabiomechanicalbalancedshoulder
AT finkenstaedttim crosssectionalareaoftherotatorcuffmusclesinmriisthereevidenceforabiomechanicalbalancedshoulder