title: Recurrent superior labral anterior-to-posterior tears after surgery: detection and grading with CT arthrography.
abstract: OBJECTIVE
  To retrospectively evaluate the sensitivity and specificity of multidetector computed tomographic (CT) arthrography for the detection of recurrent superior labral anterior-to-posterior (SLAP) tears in the shoulder of patients who have previously undergone shoulder surgery and are clinically suspected of having a recurrent tear.
  
  
  METHODS
  The hospital ethics board did not require patient approval or informed consent for this retrospective review of case records. Multidetector CT arthrograms of 45 shoulders of 45 patients (35 men, 10 women; mean age, 29 years; age range, 21-38 years) who had undergone conventional arthroscopy within 30 days after the CT arthrographic examination were reviewed. Owing to the referral patterns at the authors' institution, all patients were professional athletes. Volumetric multidetector CT arthrography was performed by using a 16-detector CT scanner after the intraarticular injection of iodinated contrast material. All images were independently reviewed by two experienced musculoskeletal radiologists, with disagreements resolved by a third experienced musculoskeletal radiologist. The sensitivity and specificity of multidetector CT arthrography in the detection of any Snyder type II-IV tear was evaluated by using arthroscopy as the reference standard. The numbers and percentages of tears that were assigned the correct Snyder classification with multidetector CT arthrography were reported. Interobserver agreement regarding the correct Snyder classification with multidetector CT arthrography was determined by using kappa statistics.
  
  
  RESULTS
  With multidetector CT arthrography, recurrent SLAP tears were correctly identified in 35 of 37 patients (95% sensitivity), and the absence of these tears was correctly noted in seven of eight patients (88% specificity). Multidetector CT arthrography- and arthroscopy-derived tear grades were in agreement in 30 (81%) of 37 patients with recurrent SLAP tears. Interobserver agreement at multidetector CT arthrography was substantial (kappa = 0.76).
  
  
  CONCLUSIONS
  In the described highly selected patient population, multidetector CT arthrography was useful for evaluating recurrent SLAP tears.
authors.affiliation: Department of Clinical Sciences, Section of Radiological Sciences, University of Parma, Parma Hospital, Via Gramsci 14, 43100 Parma, Italy. massimo.defilippo@unipr.it
authors.forename: Massimo
authors.initials: M
authors.lastname: De Filippo
authors.forename: Philip A
authors.initials: PA
authors.lastname: Araoz
authors.forename: Francesco
authors.initials: F
authors.lastname: Pogliacomi
authors.forename: Alex
authors.initials: A
authors.lastname: Castagna
authors.forename: Dario
authors.initials: D
authors.lastname: Petriccioli
authors.forename: Nicola
authors.initials: N
authors.lastname: Sverzellati
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zompatori
mesh_terms: D000328:Adult; D001175:Arthrography / Q000379:methods*; D001265:Athletic Injuries / Q000145:classification / Q000000981:diagnostic imaging* / Q000601:surgery; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D009010:Monte Carlo Method; D012008:Recurrence; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012782:Shoulder / Q000000981:diagnostic imaging* / Q000601:surgery; D000070599:Shoulder Injuries; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media