ArticleBMC musculoskeletal disorders2026
Quantitative assessment of supraspinatus fatty infiltration on a novel MRI section: comparison with conventional methods.
Article in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAccurate quantification of fatty infiltration (FI) after rotator-cuff tear (RCT) is critical for therapeutic planning. The conventional Goutallier classification, based on the oblique-sagittal “Y-view,” is subjective, shows only moderate inter-observer agreement, and frequently underestimates the degree of infiltration when the tendon is severely retracted. Recently, evaluation at a more medial level—the suprascapular notch (“R-view”)—has been proposed because it better visualizes the retracted muscle belly, yet it has not been combined with quantitative analysis. PURPOSE: To determine (1) the agreement between quantitative FI (Fat%) measured on the R-view and the traditional Goutallier grade, and (2) the diagnostic value of this quantitative approach in patients with Patte stage 3 retraction.
methodsPatients who underwent arthroscopic rotator-cuff repair (ARCR) between 2022 and 2024 were retrospectively enrolled and stratified by Patte classification. On both the Y-view and the R-view, we measured supraspinatus cross-sectional area (CSA), Fat%, and Goutallier grade. Intraclass correlation coefficients (ICC) were calculated for reliability, receiver operating characteristic (ROC) curves were constructed for diagnostic performance, and the two views/methods were compared.
resultsA total of 192 patients were included. CSA was significantly larger on the R-view than on the Y-view (P < 0.05), whereas both Fat% and Goutallier grade were significantly lower (P < 0.05). Fat% and Goutallier grade were strongly correlated on both views (R = 0.781 vs. 0.826, P < 0.001). In Patte stage-3 patients, Fat% derived from the R-view achieved the highest diagnostic performance (Area Under the Curve(AUC), AUC = 0.73); the optimal cutoff was 56%, yielding 86% specificity and a Youden index(YI) of 0.41.
conclusionThe R-view more accurately depicts the true status of the retracted supraspinatus. Combining this imaging plane with quantitative Fat% measurement significantly improves objectivity and reliability in the assessment of FI, especially in cases of severe tendon retraction, and offers surgeons a superior pre-operative imaging strategy.
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