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ORIGINAL RESEARCH article

Front. Sports Act. Living

Sec. Injury Prevention and Rehabilitation

Volume 7 - 2025 | doi: 10.3389/fspor.2025.1688162

This article is part of the Research TopicAdvancing Musculoskeletal Injury Management in Sports Medicine Through MRI InnovationsView all 4 articles

Evaluation of IVIM and FACT Imaging for Early Detection of Rotator Cuff Muscle Degeneration and Physiotherapy Exercise Effects

Provisionally accepted
Ling  TengLing Teng1Mingru  HuangMingru Huang2Hongyue  TaoHongyue Tao1Xiao  ZhangXiao Zhang2Sijia  FengSijia Feng2Xiner  DuXiner Du2Zhiwei  QinZhiwei Qin3Xiangwen  LiXiangwen Li1Yiwen  HuYiwen Hu1Changyan  LiuChangyan Liu1Yuxue  XieYuxue Xie1Shuang  ChenShuang Chen1*
  • 1Huashan Hospital Fudan University Department of Radiology, Shanghai, China
  • 2Huashan Hospital Fudan University Department of Sports Medicine, Shanghai, China
  • 3Shanghai United Imaging Healthcare Co Ltd, Shanghai, China

The final, formatted version of the article will be published soon.

Abstract Background: This study investigated novel magnetic resonance imaging (MRI) techniques, including intravoxel incoherent motion (IVIM) and fat analysis & calculation technique (FACT) to detect early pathologic changes in rotator cuff (RC) muscle in patients with shoulder pain and evaluate rehabilitation effects. Methods: MRI examinations, including IVIM and FACT, and clinical scores were collected in patients with unilateral shoulder pain at baseline (n=48) and 3-month follow-up (n=42) after physiotherapy exercise. The contralateral shoulder served as control. IVIM-derived parameters (apparent diffusion coefficient, ADC; diffusion coefficient, D; pseudo-diffusion coefficient, D*; perfusion fraction, f; and their product, fD*) and FACT-derived parameters (fat fraction, FF) were measured in four RC muscles. Clinical assessment included Constant Score (CS), the American Shoulder and Elbow Surgeons (ASES), and the Visual Analog Scale (VAS). Differences in imaging parameters were compared between the affected and the contralateral shoulder. Changes in imaging parameters and clinical scores after exercise rehabilitation were analyzed between baseline and 3-month follow-up. Correlation analysis was conducted between the change in imaging values and the change in clinical scores. Results: At baseline, D* values of the affected sides in four RC muscles were lower compared to the contralateral sides (p<0.05). f and fD* values of the affected sides were higher and lower respectively, compared to the contralateral sides and showed a difference in infraspinatus and subscapularis (p = 0.03 and p = 0.04). No significant differences for FF and other IVIM-derived parameters in either muscle were observed. After the physiotherapy exercise, all of the clinical scores showed significant improvements compared to the baseline (all p<0.05). Regarding imaging parameters, only D* values showed a significant increase in the supraspinatus muscle (p < 0.05). Additionally, the change in D* and f correlated with CS, ASES scores and VAS scores respectively. FF showed a decreasing trend but lacking significance (p>0.05). Conclusion: Capillary flow impairment (reflected by D*) appears more prominent than fat infiltration (reflected by FF) in the early RC muscle degeneration. IVIM-derived parameters, particularly D* may assist clinicians in detecting early-stage muscle degeneration and provide a non-invasive method for monitoring rehabilitation outcomes.

Keywords: Magnetic Resonance Imaging, Shoulder, Rotator Cuff, Muscle, IVIM

Received: 18 Aug 2025; Accepted: 09 Oct 2025.

Copyright: © 2025 Teng, Huang, Tao, Zhang, Feng, Du, Qin, Li, Hu, Liu, Xie and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Shuang Chen, chenshuang6898@126.com

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