title: Evaluation of the glenoid labrum with 3-T MRI: is intraarticular contrast necessary?
abstract: OBJECTIVE
  The purpose of this study was to evaluate the diagnostic accuracy of 3-T MRI versus 3-T MR arthrography for assessing labral abnormalities in the shoulder using arthroscopy as the gold standard.
  
  
  METHODS
  Forty-two patients (28 men, 14 women; mean age, 33 years) underwent MR arthrography and conventional MRI of the same shoulder. Two patients underwent bilateral shoulder examinations, for a total of 44 shoulder examinations. Twenty-two shoulders underwent arthroscopy. The results of arthroscopy were used as the reference standard. Three musculoskeletal radiologists prospectively and independently interpreted MRI and MR arthrography examinations. Differences in performance of conventional MRI and MR arthrography were analyzed for statistical significance by the two-tailed McNemar test.
  
  
  RESULTS
  Of the 22 arthroscopies performed, 26 labral tears were found in 18 shoulders and four shoulders were normal with respect to the labrum. There were 12 superior, nine posterior, and five anterior labral tears identified at arthroscopy. By consensus review, conventional MRI identified nine of 12 superior (sensitivity, 75%; specificity, 100%), seven of nine posterior (sensitivity, 78%; specificity, 92%), and three of five anterior (sensitivity, 60%; specificity, 94%) labral tears. MR arthrography identified nine of 12 superior (sensitivity, 75%; specificity, 100%), eight of nine posterior (sensitivity, 89%; specificity, 100%), and five of five anterior (sensitivity, 100%; specificity, 100%) labral tears.
  
  
  CONCLUSIONS
  Although the power of our preliminary study is small, the results suggest that intraarticular contrast material is helpful in diagnosing labral tears in the shoulder, particularly tears of the anterior labrum. Our preliminary results suggest that MR arthrography adds value for diagnosing labral tears in the shoulder compared with conventional MRI even at 3 T.
authors.affiliation: Department of Musculoskeletal Radiology, Hospital of the University of Pennsylvania, Philadelphia, 19104, USA. nancy.major@uphs.upenn.edu
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Major
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Browne
authors.forename: Taymon
authors.initials: T
authors.lastname: Domzalski
authors.forename: Roger L
authors.initials: RL
authors.lastname: Cothran
authors.forename: Clyde A
authors.initials: CA
authors.lastname: Helms
mesh_terms: D000328:Adult; D001175:Arthrography; D001182:Arthroscopy; D002358:Cartilage, Articular / Q000293:injuries*; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D005682:Gadolinium; D006571:Heterocyclic Compounds / Q000008:administration & dosage; D006801:Humans; D007270:Injections, Intra-Articular; D008279:Magnetic Resonance Imaging; D008297:Male; D009942:Organometallic Compounds / Q000008:administration & dosage; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D000070599:Shoulder Injuries; D055815:Young Adult
chemical_list: D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C062402:gadoteridol; D005682:Gadolinium