Evidence map›Paper›PMID 37014406›Full record

ArticleEuropean radiology2023

Zero echo time MRI in shoulder MRI protocols for the diagnosis of rotator cuff calcific tendinopathy improves identification of calcific deposits compared to conventional MR sequences but remains sub-optimal compared to radiographs.

Ulysse Puel, Charles Lombard, Gabriela Hossu, Mathias Louis, Alain Blum, Pedro Augusto Gondim Teixeira, Romain Gillet

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Article in European radiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
4.4field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Ulysse PuelGuilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, 29 Avenue du Marechal de Lattre de Tassigny, 54000, Nancy, France.
Charles LombardGuilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, 29 Avenue du Marechal de Lattre de Tassigny, 54000, Nancy, France.
Gabriela HossuUniversité de Lorraine, INSERM, IADI, Nancy, France.
Mathias LouisGuilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, 29 Avenue du Marechal de Lattre de Tassigny, 54000, Nancy, France.
Alain BlumGuilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, 29 Avenue du Marechal de Lattre de Tassigny, 54000, Nancy, France.
Pedro Augusto Gondim TeixeiraGuilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, 29 Avenue du Marechal de Lattre de Tassigny, 54000, Nancy, France.
Romain GilletGuilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, 29 Avenue du Marechal de Lattre de Tassigny, 54000, Nancy, France. romain_gillet3@hotmail.com.ORCID http://orcid.org/0000-0002-1350-1694
Inserm · FRHôpital Saint Charles · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare the diagnostic performance of standard MRI and standard MRI + ZTE images for the detection of rotator cuff calcific tendinopathy (RCCT) and to describe the artifacts encountered with ZTE images, using computed radiography (CR) as a reference.

methodsIn a retrospective study, patients with suspicion of rotator cuff tendinopathy who underwent standard MRI + ZTE images after radiography were enrolled between June 2021 and June 2022. Images were independently analyzed for calcific deposit presence and ZTE images artifacts, by two radiologists. Diagnostic performance was calculated individually with MRI + CR as the reference standard.

resultsA total of 46 RCCT subjects (27 women; mean age, 55.3 years ± 12.4) and 51 control subjects (27 men; mean age, 45.5 ± 12.9) were evaluated. For both readers, there was an increase in the sensitivity for the identification of calcific deposits of MRI + ZTE compared to MRI (77% (95% CI: 64.5-86.8) and 75.4% (95% CI: 62.7-85.5) versus 57.4% (95% IC: 44.1-70) and 47.5% (95% IC: 34.6-60.7), for R1 and R2, respectively). Specificity was quite similar for both readers and both imaging techniques and ranged from 96.6% (95% IC: 93.3-98.5) to 98.7% (95% IC: 96.3-99.7). Hyperintense joint fluid (62.8% of patients), long head of the biceps tendon (in 60.8%), and subacromial bursa (in 27.8%) on ZTE were considered artifactual.

conclusionThe addition of ZTE images to a standard MRI protocol improved MRI diagnostic performance of RCCT, but with a suboptimal detection rate and a relatively high frequency of artifactual soft tissue signal hyperintensity. KEY POINTS: • Adding ZTE images to standard shoulder MRI improves the MR-based detection of rotator cuff calcific tendinopathy, but half of the calcification unseen with standard MRI remained unseen with ZTE MRI. On ZTE images, joint fluid and long head biceps tendon were hyperintense in about 60% of the shoulders, as well as the subacromial bursa in about 30%, without calcific deposit on conventional radiographs. • The detection rate of calcific deposits using ZTE images was dependent on the disease phase. In the calcific stage, it reached 100% in this study but remained at a maximum of 80.7% in the resorptive phase.

Indexed as

Rotator CuffTendinopathyAdultFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedRadiographyRetrospective StudiesShoulderCalcificationMagnetic resonance imagingRotator cuffShoulderZTE MRI

Identifiers

PMID37014406
OpenAlexW4362521589

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.