Magnetic resonance rotator cuff fat fraction and its relationship with tendon tear severity and subject characteristics

Sonia Lee, Robert M. Lucas, Drew A. Lansdown, Lorenzo Nardo, Andrew Lai, Thomas M. Link, Roland Krug, C. Benjamin Ma

Research output: Contribution to journalArticlepeer-review

42 Scopus citations


Background: Compared with the Goutallier classification, chemical shift-based magnetic resonance (MR) fat quantification has superior reliability and accuracy in evaluation of muscle fatty infiltration. We used this method to assess the relationship between rotator cuff (RC) muscle fat fractions, tendon disease severity, and subject characteristics. Methods: In total, 182 subjects with shoulder symptoms underwent shoulder MR imaging including additional sequences for fat quantitation. Then, fat fraction maps were manually segmented, and custom software was used to compute the fat fraction. Goutallier scores were also obtained. The relationship between fat fraction and tendon tear severity and subject characteristics was assessed with descriptive statistics, analysis of variance, Student t test of different subgroups, and simple and multiple linear regression analysis. Results: Statistically higher supraspinatus fat fractions were observed in subgroups with tendon tears >3 cm, retraction >1 cm, age >50 years, body mass index (BMI) >30, higher Goutallier score, female gender, and longer symptom duration. A significant linear relationship was seen between RC fat fraction and tendon disease severity, age, and BMI but not symptom duration. Multiple regression models with fat fraction and tendon disease, age, BMI, and gender were significant for all 4 muscles (P < .001). The slope of fatty infiltration increase with age was reduced after adjustment for tendon disease, BMI, and gender. Conclusion: RC fat fraction assessed by chemical shift MR demonstrated a significant linear relationship with tendon tear severity, age, BMI, and gender but not with symptom duration.

Original languageEnglish (US)
Pages (from-to)1442-1451
Number of pages10
JournalJournal of Shoulder and Elbow Surgery
Issue number9
StatePublished - Jan 1 2015
Externally publishedYes


  • Diagnostic Study
  • Fatty infiltration
  • Level III
  • MRI evaluation
  • Muscle degeneration
  • Rotator cuff tear
  • Tear size

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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