Indirect magnetic resonance arthrography of the shoulder; a reliable diagnostic tool for investigation of suspected labral pathology

Fallahi, Farshid, Green, Nick, Gadde, Sarat, Jeavons, Lisa, Armstrong, Patrick and Jonker, Leon ORCID: https://orcid.org/0000-0001-5867-4663 (2013) Indirect magnetic resonance arthrography of the shoulder; a reliable diagnostic tool for investigation of suspected labral pathology. Skeletal Radiology, 42 (9). pp. 1225-1233.

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Abstract

Purpose: Indirect magnetic resonance arthrography (I-MRA) confers significant logistical advantages over direct MRA and does not require articular injection. In this study, we determined the diagnostic performance of I-MRA in relation to conventional MRI and arthroscopy or surgery in detecting tears of the glenoid labrum, including Bankart lesions and superior labral antero-posterior (SLAP) tears in a standard clinical setting.

Patients and methods: Ninety-one symptomatic patients underwent conventional MRI and I-MRA of the affected shoulder, followed by either arthroscopy or open surgery. The scans were interpreted independently by two experienced radiology consultants with a special interest in musculoskeletal radiology. Using the surgical findings as the standard of reference, sensitivity, specificity, and diagnostic accuracy of conventional non-contrast MRI and I-MRA in the detection of labral tears were calculated.

Results: The sensitivity of I-MRA was 95 and 97 %, respectively, for two radiologists as opposed to 79 and 83 % for conventional MRI. For both radiologists, the specificity of I-MRA, as well as MRI, was 91 % for detection of labral tears of all types. Accuracy of diagnosis was 93 and 95 %, respectively, for two radiologists with indirect MRA, compared to 84 and 86 % with non-contrast MRI.

Conclusions: This retrospective study shows that I-MRA is a highly accurate and sensitive method for the detection of labral tears. The data obtained supports the use of I-MRA as standard practice in patients with shoulder instability due to suspected labral pathology where further investigative imaging is indicated.

Item Type:	Article
Journal / Publication Title:	Skeletal Radiology
Publisher:	Springer Verlag (Germany) for International Skeletal Society
ISSN:	1432-2161
Departments:	Academic Departments > Medical & Sport Sciences (MSS) > Health and Medical Sciences
Additional Information:	Leon Jonker, North Cumbria University Hospitals NHS Trust and Honorary Research Fellow at University of Cumbria, UK.
Depositing User:	Anna Lupton
Date Deposited:	25 Oct 2017 13:04
Last Modified:	12 Jan 2024 11:46
URI:	https://insight.cumbria.ac.uk/id/eprint/3347

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