Ultrasound: Can it replace MRI in the evaluation of the rotator cuff tears?

ObjectiveTo assess ultrasound accuracy in rotator cuff tears detection with delineation of the extent of the injury (partial/full thickness tear) compared to MRI.MethodsForty patients were referred with clinical suspicion of rotator cuff tear. Human ethics committee approval was obtained. Ultrasound and MRI were done for all patients by 2 different radiologists being blind to the results of the other examination to minimize the bias. Surgery or arthroscopy was considered when conservative treatment failure for 6 months, or when rotator cuff repair was indicated.ResultsUltrasound detected different tendon pathologies (tendinitis, partial and full thickness tears), in addition to the causal factors. Compared to MRI, ultrasound sensitivity for tendinitis detection was 85% with 86% NPV and 90% accuracy, while for partial thickness tears, its sensitivity, specificity, PPV, NPV and accuracy were 88%, 89%, 94%, 80% and 83% respectively. But in full thickness tears its sensitivity and specificity were 100% each.ConclusionUltrasound and MRI are comparable in both sensitivity and specificity. Since US is less expensive and more available, it could be considered as the screening method when rotator cuff integrity is the main question, if well-trained radiologists and high resolution equipments are available.