Have an account? Please log in.
Text size: Small font Default font Larger font
.
Radiology Daily
Radiology Daily PracticalReviews.com Radiology Daily

3-T MR Arthrography Statistically More Sensitive Than Routine 3-T MRI

November 16, 2009
Written by: , Filed in: Musculoskeletal Radiology
  • Comments
.

The objective of a recent study was to determine if 3-T MR arthrography is a justifiable study to perform given the invasive and more time-consuming nature of the examination when compared with standard 3-T MRI.

The results have shown that when anterior labral tears, superior labrum anterior-to-posterior (SLAP) tears, and/or partial-thickness supraspinatus tendon tears are suspected by clinical history, 3-T MR arthrography has improved diagnostic capability compared with standard 3-T MRI.

Design/Participants
Retrospective analysis of 150 patients who were evaluated with both 3-T MRI and 3-T MR arthrography. Every patient had their findings confirmed by shoulder arthroscopy.

Methodology
Standard MRI of the shoulder used both T1- and T2-weighted sequences. MR arthrograms were performed using accepted standard techniques. Particular attention was given to evaluate the glenoid labrum and supraspinatus tendon.

MDCT and MR Update: Body and Musculoskeletal Imaging

University of California San Francisco, Department of Radiology and Biomedical Imaging
MDCT and MR Update: Body and Musculoskeletal Imaging program features helical multi-detector row CT (MDCT) and MRI as it applies to diseases in the chest, abdomen and pelvis, and musculoskeletal system. Newer and established cross-sectional methods are discussed. Click here to read more or order:

MDCT and MR Update: Body and Musculoskeletal Imaging

Results
With particular respect to anterior labral tears, SLAP tears, and partial-thickness supraspinatus tendon tears, 3-T MR arthrography demonstrated increased diagnostic sensitivity compared with regular 3-T MRI.

Conclusions
In 18% of patients evaluated for shoulder pathology, 3-T MR arthrography altered management through increased detection of anterior labral tears, SLAP tears, and partial-thickness supraspinatus tendon tears. For patients in whom any of these entities are suspected, routine 3-T shoulder MRI is superseded in accuracy by MR arthrographic evaluation.

Reviewer’s Comments
In standard radiology practice, certain procedures can be labor-intensive and difficult for both the patient and physician. MR arthrography is a well-accepted method in evaluating shoulder anatomy; however, the advent of stronger-field magnets and enhanced image acquisition techniques may obviate the need for arthrography in certain clinical situations.

Since shoulder pain is very common, it is imperative for the radiologist to suggest the best modality in evaluating suspected pathology. Although standard MRI is quick, Magee has demonstrated that in certain instances (i.e., anterior labral tears, SLAP tears, and partial-thickness supraspinatus tendon tears), MR arthrography has improved diagnostic capability.

Given the implications for orthopedic surgeons, this study demonstrates how radiologists can help direct clinical care, in addition to being diagnosticians—something to which all radiologists should aspire, in my opinion.

Author: Rahul Pawar, MD

Reference:
Magee T. 3-T MRI of the Shoulder: Is MR Arthrography Necessary?
AJR Am J Roentgenol; 2009;192 (January): 86-92:

MDCT and MR Update: Body and Musculoskeletal Imaging

University of California San Francisco, Department of Radiology and Biomedical Imaging
MDCT and MR Update: Body and Musculoskeletal Imaging program features helical multi-detector row CT (MDCT) and MRI as it applies to diseases in the chest, abdomen and pelvis, and musculoskeletal system. Newer and established cross-sectional methods are discussed. Click here to read more or order:

MDCT and MR Update: Body and Musculoskeletal Imaging

.

Permalink: http://www.radiologydaily.com/?p=2715

Tags: , , , , , , , , , , , , , , , , , , ,

  • Comments
.

Would you like to keep current with radiological news and information?

Post Your Comments and Responses

Comments are closed.