Abstract：
UNASSIGNED: Magnetic resonance (MR) imaging is the most common modality for assessment of the rotator cuff before and after surgery. Several classifications have been described aiming to define main tear characteristics. However, there is still confusion when it comes to the reliability of those classifications.
UNASSIGNED: (1) To identify all MR classifications available in the literature for preoperative assessment of rotator cuff tears, (2) to summarize available data on the reliability of identified classifications, and (3) to assess the methodological quality of reliability studies.
UNASSIGNED: Systematic review; Level of evidence, 4.
UNASSIGNED: This systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. All studies reporting MR assessment in patients with a superior or posterosuperior rotator cuff tear were included. After identification of the available MR criteria, reliability studies were analyzed. Descriptive statistics were used to summarize findings. Methodological quality was assessed using the Quality Appraisal of Reliability Studies checklist.
UNASSIGNED: A total of 75 studies were included in this review. Eight categories of outcomes could be identified. Of the total, 62 studies reported interobserver reliability whereas 32 reported intraobserver reliability of some of the identified criteria. Each category reflected a variety of reliability, ranging from poor to excellent agreement. MR proved to be a reliable imaging modality to detect the structural integrity of the posterosuperior cuff, especially in cases of full-thickness tear; it was also reliable in terms of tear width and length and muscle atrophy based on a tangent sign or Thomazeau classification. All other classifications did not prove acceptable reliability. Methodological quality was high for 23 articles and moderate for 14.
UNASSIGNED: Preoperative MR is a reliable imaging modality to identify full-thickness tears, measure tear size and morphology, and identify muscle atrophy with tangent sign or Thomazeau classification. All other outcomes and classifications did not show acceptable reliability; therefore, caution is needed when using them for preoperative evaluation of a rotator cuff tear.
UNASSIGNED: (1) To identify all MR classifications available in the literature for preoperative assessment of rotator cuff tears, (2) to summarize available data on the reliability of identified classifications, and (3) to assess the methodological quality of reliability studies.
UNASSIGNED: Systematic review; Level of evidence, 4.
UNASSIGNED: This systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. All studies reporting MR assessment in patients with a superior or posterosuperior rotator cuff tear were included. After identification of the available MR criteria, reliability studies were analyzed. Descriptive statistics were used to summarize findings. Methodological quality was assessed using the Quality Appraisal of Reliability Studies checklist.
UNASSIGNED: A total of 75 studies were included in this review. Eight categories of outcomes could be identified. Of the total, 62 studies reported interobserver reliability whereas 32 reported intraobserver reliability of some of the identified criteria. Each category reflected a variety of reliability, ranging from poor to excellent agreement. MR proved to be a reliable imaging modality to detect the structural integrity of the posterosuperior cuff, especially in cases of full-thickness tear; it was also reliable in terms of tear width and length and muscle atrophy based on a tangent sign or Thomazeau classification. All other classifications did not prove acceptable reliability. Methodological quality was high for 23 articles and moderate for 14.
UNASSIGNED: Preoperative MR is a reliable imaging modality to identify full-thickness tears, measure tear size and morphology, and identify muscle atrophy with tangent sign or Thomazeau classification. All other outcomes and classifications did not show acceptable reliability; therefore, caution is needed when using them for preoperative evaluation of a rotator cuff tear.
摘要：
■磁共振（MR）成像是手术前后评估肩袖的最常见方式。已经描述了旨在定义主要撕裂特性的几种分类。然而,当谈到这些分类的可靠性时，仍然存在混淆。
■(1)为了确定文献中所有可用于肩袖撕裂术前评估的MR分类，（2）总结有关已识别分类的可靠性的可用数据，(3)评估可靠性研究的方法学质量。
■系统评价；证据水平，4.
■本系统评价是按照PRISMA（系统评价和荟萃分析的首选报告项目）指南进行的。包括所有报告MR评估的患者肩袖上或后上撕裂的研究。在确定可用的MR标准后，对可靠性研究进行了分析。描述性统计用于总结发现。方法质量使用可靠性研究质量评估清单进行评估。
■本综述共纳入75项研究。可以确定八类成果。在总数中，62项研究报告了观察者间的可靠性，而32项研究报告了某些已确定标准的观察者间的可靠性。每个类别都反映了各种可靠性，从糟糕到极好的协议。MR被证明是检测后上袖带结构完整性的可靠成像方式，尤其是在全层撕裂的情况下；根据切线符号或Thomazeau分类，在撕裂宽度和长度以及肌肉萎缩方面也是可靠的。所有其他分类均未证明可接受的可靠性。方法学质量高23篇，中等14篇。
■术前MR是一种可靠的成像方式，可以识别全层撕裂，测量泪液大小和形态，并用正切符号或Thomazeau分类识别肌肉萎缩。所有其他结果和分类均未显示出可接受的可靠性；因此，使用它们进行肩袖撕裂的术前评估时需要谨慎。
■(1)为了确定文献中所有可用于肩袖撕裂术前评估的MR分类，（2）总结有关已识别分类的可靠性的可用数据，(3)评估可靠性研究的方法学质量。
■系统评价；证据水平，4.
■本系统评价是按照PRISMA（系统评价和荟萃分析的首选报告项目）指南进行的。包括所有报告MR评估的患者肩袖上或后上撕裂的研究。在确定可用的MR标准后，对可靠性研究进行了分析。描述性统计用于总结发现。方法质量使用可靠性研究质量评估清单进行评估。
■本综述共纳入75项研究。可以确定八类成果。在总数中，62项研究报告了观察者间的可靠性，而32项研究报告了某些已确定标准的观察者间的可靠性。每个类别都反映了各种可靠性，从糟糕到极好的协议。MR被证明是检测后上袖带结构完整性的可靠成像方式，尤其是在全层撕裂的情况下；根据切线符号或Thomazeau分类，在撕裂宽度和长度以及肌肉萎缩方面也是可靠的。所有其他分类均未证明可接受的可靠性。方法学质量高23篇，中等14篇。
■术前MR是一种可靠的成像方式，可以识别全层撕裂，测量泪液大小和形态，并用正切符号或Thomazeau分类识别肌肉萎缩。所有其他结果和分类均未显示出可接受的可靠性；因此，使用它们进行肩袖撕裂的术前评估时需要谨慎。
