title: Variants of the superior labrum and labro-bicipital complex: a comparative study of shoulder specimens using MR arthrography, multi-slice CT arthrography and anatomical dissection.
abstract: The purpose of the present study was to evaluate the anatomical variability of the superior labrum and to compare the value of MR arthrography and multi-slice CT arthrography in the diagnosis of variants of the labro-bicipital complex. Forty-three human shoulder specimens (age range and mean age at death, 61-89 years and 78.3 years) were examined with the use of MR arthrography and multi-slice CT arthrography prior to joint exploration and macroscopic inspection of the superior labrum and labro-bicipital complex. Two radiologists evaluated MR and CT arthrograms, and the results were compared with macroscopic assessments. Anatomical dissection of all shoulder specimens revealed a sublabral recess in 32/43 (74%) cases. The attachment of the superior labrum was categorised as type 1 in ten (23%) cases, as type 2 in eight (19%), as type 3 in ten (23%), and as type 4 in 14 (33%) cases. One superior labrum showed detachment consistent with a superior labral anteroposterior (SLAP) type 3 lesion. On MR arthrography and CT arthrography the attachment of the superior labrum was categorised in concordance with macroscopic assessments in 79% and 84% of cases, respectively. The anteroposterior extension of sublabral recesses was accurately determined with MR and CT arthrography in 59% and 81% of cases, respectively. The attachment of the superior labrum shows considerable variability. Thus, exact depiction of variants is essential in order to avoid the false positive diagnosis of a superior labral tear (SLAP or Andrews lesion). Both, MR arthrography and multi-slice CT arthrography were effective in the detection and classification of sublabral recesses.
authors.affiliation: Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675, Munich, Germany. waldt@roe.med.tu-muenchen.de
authors.forename: Simone
authors.initials: S
authors.lastname: Waldt
authors.forename: Stefan
authors.initials: S
authors.lastname: Metz
authors.forename: Andreas
authors.initials: A
authors.lastname: Burkart
authors.forename: Dirk
authors.initials: D
authors.lastname: Mueller
authors.forename: Melanie
authors.initials: M
authors.lastname: Bruegel
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Rummeny
authors.forename: Klaus
authors.initials: K
authors.lastname: Woertler
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001175:Arthrography / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008432:Mathematical Computing; D008875:Middle Aged; D012015:Reference Standards; D017006:Rotator Cuff / Q000033:anatomy & histology* / Q000601:surgery; D012680:Sensitivity and Specificity; D012785:Shoulder Joint / Q000033:anatomy & histology* / Q000601:surgery; D012984:Software; D036542:Tomography, Spiral Computed / Q000379:methods*