comparing 3d merge mri and 2d mri for rotator cuff tear evaluation and surgical planning; a cross-sectional prospective study

Objectives: accurate diagnosis and characterization of rotator cuff tendon (rct) tears are crucial for optimal treatment planning. this study compared the diagnostic performance of 3d multiple echo recombined gradient echo (merge) mri with conventional 2d mri for the assessment of rct tears and surgical planning.methods: sixty-two patients with suspected rct tear underwent shoulder mri using standard 2d and 3d merge protocols, followed by arthroscopic evaluation. rct tears were classified as crescent, longitudinal, or massive. the sensitivity, specificity, and accuracy of 3d merge and 2d mri were calculated using arthroscopy as the reference standard. inter-observer agreement was assessed using kappa statistics.results: arthroscopy confirmed crescent tears in 25 patients (40%), longitudinal tears in 9 patients (15%), and massive tears in 28 patients (45%). 3d merge mri demonstrated higher accuracy for tear shape classification compared to 2d mri (90.5% vs. 79.6%, p < 0.05). sensitivity and specificity were markedly improved with 3d merge mri, particularly for crescent tears (sensitivity 88.2% vs. 70.6%, specificity of 94.6% vs. 86.5%, p < 0.05). the inter-observer agreement was excellent for 3d merge mri (kappa = 0.91) and good for 2d mri (kappa = 0.76).conclusion: 3d merge mri exhibited superior diagnostic performance and reliability compared to 2d mri in characterizing rct tears. the enhanced accuracy of 3d merge mri may facilitate preoperative assessment and surgical decision-making for rct tears.