[A prospective study on the detection of lesions of the labrum glenoidale by indirect MR arthrography of the shoulder].
OBJECTIVE
Aim of this prospective study was the evaluation of signal-alterations of anatomic shoulder structures before and after intravenous application of Gd-DTPA. Furthermore the tested clinical value of indirect MR-arthrography in detecting labrum lesions was tested.


METHODS
52 patients with suspected shoulder injury were examined on a 1.5 T system: Sequences were T1-weighted axial and oblique-coronary, additionally oblique-coronary T2-weighted, PD-weighted- and axial FLASH-2D-Sequences. After intravenous injection of contrast medium T1-weighted sequences were repeated. Signal-intensities (SI) of anatomic structures were measured by ROI-technique, the percentual contrast-enhancement (CE) and alterations in SNR (signal-noise-ratio) and CNR (contrast-noise-ratio) were calculated. Labrum tears were graded by three observers, their results could be confirmed by arthroscopy or open surgery in 24 patients.


RESULTS
Contrast-enhancement was shown in all structures, most remarkable in the joint cavity. In pathologic findings of the labrum the SI and CE were significantly higher compared to intact strictures (p < 0.05). Sensitivity and specificity in the detection of labrum tears were 70% and 71.4% without contrast media, respectively 100% and 71.4% with indirect arthrography.


CONCLUSIONS
The indirect arthrography improves the signal parameters of the structures. The detection of labrum lesions is improved, but still remains difficult.
Mäurer
J
J
Strahlenklinik und Poliklinik, Medizinische Fakultät Charité, Humboldt-Universität zu Berlin. Juergen.Maeurer@planet-interhom.de
Rudolph
J
J
Lorenz
M
M
Hidajat
N
N
Schröder
R
R
Südkamp
N P
NP
Felix
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D001175:Arthrography / Q000379:methods; D002358:Cartilage, Articular / Q000293:injuries / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012540:Scapula / Q000293:injuries / Q000473:pathology*; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000473:pathology
D003287:Contrast Media; D019786:Gadolinium DTPA
Prospektive Studie zum Nachweis von Läsionen des Labrum glenoidale mit der indirekten MR-Arthrographie der Schulter.