Quantitative assessment of fat infiltration in the rotator cuff muscles using water-fat MRI

Lorenzo Nardo, Dimitrios C. Karampinos, Drew A. Lansdown, Julio Carballido-Gamio, Sonia Lee, Roberto Maroldi, C. Benjamin Ma, Thomas M. Link, Roland Krug

Research output: Contribution to journalArticlepeer-review

68 Scopus citations


Purpose To evaluate a chemical shift-based fat quantification technique in the rotator cuff muscles in comparison with the semiquantitative Goutallier fat infiltration classification (GC) and to assess their relationship with clinical parameters. Materials and Methods The shoulders of 57 patients were imaged using a 3T MR scanner. The rotator cuff muscles were assessed for fat infiltration using GC by two radiologists and an orthopedic surgeon. Sequences included oblique-sagittal T1-, T2-, and proton density-weighted fast spin echo, and six-echo gradient echo. The iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) was used to measure fat fraction. Pain and range of motion of the shoulder were recorded. Results Fat fraction values were significantly correlated with GC grades (P < 0.0001, κ >0.9) showing consistent increase with GC grades (grade = 0, 0%-5.59%; grade = 1, 1.1%-9.70%; grade = 2, 6.44%-14.86%; grade = 3, 15.25%-17.77%; grade = 4, 19.85%-29.63%). A significant correlation between fat infiltration of the subscapularis muscle quantified with IDEAL versus 1) deficit in internal rotation (Spearman Rank Correlation Coefficient [SRC] = 0.39, 95% confidence interval [CI] 0.13-0.60, P < 0.01) and 2) pain (SRC coefficient = 0.313, 95% CI 0.049-0.536, P = 0.02) was found but was not seen between the clinical parameters and GC grades. Additionally, only quantitative fat infiltration measures of the supraspinatus muscle were significantly correlated with a deficit in abduction (SRC coefficient = 0.45, 95% CI 0.20-0.60, P < 0.01). Conclusion An accurate and highly reproducible fat quantification in the rotator cuff muscles using water-fat magnetic resonance imaging (MRI) techniques is possible and significantly correlates with shoulder pain and range of motion. J. Magn. Reson. Imaging 2014;39:1178-1185. © 2013 Wiley Periodicals, Inc.

Original languageEnglish (US)
Pages (from-to)1178-1185
Number of pages8
JournalJournal of Magnetic Resonance Imaging
Issue number5
StatePublished - Jan 1 2014


  • fat quantification
  • magnetic resonance imaging (MRI)
  • rotator cuff
  • shoulder
  • water-fat imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)


Dive into the research topics of 'Quantitative assessment of fat infiltration in the rotator cuff muscles using water-fat MRI'. Together they form a unique fingerprint.

Cite this