Quantification of Fatty Degeneration Within the Supraspinatus Muscle by Using a 2-Point Dixon Method on 3-T MRI

OBJECTIVE. The objective of this study was to quantify fatty degeneration of the supraspinatus muscle by using a 2-point Dixon technique on 3-T MRI and to evaluate the correlation of muscular atrophy and fat fraction values among different severities of rotator cuff tears across differing ages and sexes. SUBJECTS AND METHODS. Patients with shoulder pain (n = 359) were evaluated by shoulder MRI on a 3-T unit, including a 2-point Dixon sequence for quantification of muscle atrophy and fatty degeneration within the supraspinatus muscle. Two board-certified musculoskeletal radiologists evaluated the degree of rotator cuff tears in three groups: full-thickness tear (n = 63), partial tear (n = 54), and no tear (n = 242). In quantitative analysis, we measured signal intensity values of in-phase images (S-In) and fat images (S-Fat) within the supraspinatus muscle, and the fat fraction was calculated as S-Fat / S-In. The Thomazeau occupation ratio was used as a quantitative index of muscular atrophy. Fat fraction and muscle atrophy were evaluated among these groups. RESULTS. Fat fraction values were changed with the degree of rotator cuff tears and were (mean +/- SD) 0.258 +/- 0.123 among patients with full-thickness tears, 0.166 +/- 0.067 among patients with partial tears, and 0.128 +/- 0.061 among patients with no tears, with statistically significant differences (p < 0.001). The values were higher in female than in male patients in all groups. The Pearson correlation coefficient was 0.348 between age and fat fraction value, and 0.664 between muscular atrophy rate and fat fraction value. CONCLUSION. An increase in supraspinatus fatty degeneration was statistically significantly correlated with severity of supraspinatus tears and moderately correlated with muscular atrophy. Fatty degeneration tends to progress more rapidly than muscular atrophy in female patients, with statistically significant sex differences.