One-shot CT and MR arthrography of the shoulder with a mixture of iodinated and paramagnetic contrast agents using arthroscopy as a gold standard.
OBJECTIVE
Our aim was to perform computed tomography arthrography (CTA) and magnetic resonance arthrography (MRA) of the shoulder as a one-shot examination and to evaluate its value on the basis of arthroscopy as a gold standard.


METHODS
Fifteen men and 16 women with planned arthroscopy for chronic (n=17) or traumatic tear of the rotator cuff (n=8), congenital atraumatic (n=1) or traumatic glenohumeral instability (n=2), traumatic tear of the rotator cuff with glenohumeral instability (n=1), or "frozen shoulder" (n=2) underwent plain helical CT in neutral position and intra-articular CT-guided injection of a mixture of iodinated and paramagnetic contrast agents (gadodiamide at 1:250 and iobitridol 350 at 1:5 in 20 ml of saline solution). CT helical scans in intra- and extrarotation and T1-weighted MRA scans in the neutral position were obtained. CTA and MRA were evaluated separately and jointly (CTA-MRA) in different blinded sessions, giving a 0-3 score to the agreement of CTA, MRA, and CTA-MRA with arthroscopy.


RESULTS
The injected volume of the solution ranged from 10 to 24 ml. No side effects were observed. CTA obtained a score of 2.33+/-0.62, MRA 2.47+/-0.52, and CTA-MRA 2.67+/-0.49. Significant differences were found for CTA-MRA versus CTA (p=0.0281) and MRA (p=0.0277). There was no significant difference for CTA versus MRA.


CONCLUSIONS
CTA and MRA can be performed as a one-shot exam. CTA-MRA seems to give more information than CTA or MRA separately.
Aliprandi
A
A
Servizio di Radiologia, Policlinico San Donato, Università di Milano, Via Morandi 30, I-20097 San Donato Milanese (MI), Italy. a.aliprandi@grupposandonato.it
Fausto
A
A
Quarenghi
M
M
Modestino
S
S
Randelli
P
P
Sardanelli
F
F
D000328:Adult; D000368:Aged; D001182:Arthroscopy; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; C093233:iobitridol; D007472:Iohexol; C064925:gadodiamide; D019786:Gadolinium DTPA