Direct MR arthrography of the shoulder: is exercise prior to imaging beneficial or detrimental?
OBJECTIVE
To define the beneficial and detrimental effects of adding exercise to direct magnetic resonance (MR) shoulder arthrography.


METHODS
Direct, intraarticular, gadolinium arthrography of the shoulder was performed in 41 patients, who underwent 1.5-T MR imaging before and after 1 minute of arm swinging. Fourteen milliliters of dilute gadolinium solution was injected. Two readers blinded to exercise independently graded the randomly distributed images with a five-point scale for capsular contrast material resorption; extraarticular contrast material leakage; rotator cuff, glenoid labrum, and anterior capsule conspicuity; and partial-thickness or full-thickness rotator cuff tear and labral tear detectability. The sign test was performed to evaluate the significance of differences between preexercise and postexercise grading for each reader. A second review was performed, with direct side-by-side comparison of preexercise and postexercise images.


RESULTS
There was evidence of increased capsular resorption after exercise but no alteration in the depiction of the rotator cuff tendons or glenoid labrum. There was no significant extraarticular contrast material leakage after exercise and no alteration in depiction of the anterior capsule. There was no difference in the detectability of rotator cuff or labral tears.


CONCLUSIONS
Exercise with direct shoulder MR arthrography has no beneficial or detrimental effect on image quality or on the depiction of rotator cuff or labral tears.
Brenner
M L
ML
Department of Radiology, Orthopedic Surgery, Wilford Hall Medical Center, 759th MDTS/MTRD, 2200 Bergquist Dr, Suite 1, Lackland AFB, TX 78236-5300, USA.
Morrison
W B
WB
Carrino
J A
JA
Nusser
C A
CA
Sanders
T G
TG
Howard
R F
RF
Meier
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage; D005119:Extravasation of Diagnostic and Therapeutic Materials; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007270:Injections, Intra-Articular; D017746:Joint Capsule / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion / Q000502:physiology*; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000473:pathology; D000070636:Rotator Cuff Injuries; D012540:Scapula / Q000473:pathology; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000473:pathology*; D016037:Single-Blind Method
D003287:Contrast Media; D019786:Gadolinium DTPA