Preliminary study of 1.5-T MR arthrography of the shoulder with 3D isotropic intermediate-weighted turbo spin echo.
OBJECTIVE
The purpose of this study was to assess the performance of a near-isotropic 3D turbo spin-echo sequence in comparison with a standard 2D protocol and with arthroscopy in direct 1.5-T MR arthrography of the shoulder.


METHODS
Dilute gadolinium was injected into three cadaver shoulders, and 3D turbo spin-echo and 2D sequences were evaluated with respect to the signal-to-noise and contrast-to-noise ratios of key tissues. In a prospective study, the 3D intermediate-weighted fat-suppressed sequence (reformatted in three planes) was added to shoulder MR arthrography of 43 consecutively registered patients, 13 of whom later underwent arthroscopy. Two radiologists independently graded the 3D and 2D images in separate sessions to visualize normal anatomic features and to detect pathologic changes in the labrum, cartilage, cuff, and glenohumeral ligaments, assigning confidence levels to their readings. One reader repeated the readings of images of 10 patients. Reports of subsequent arthroscopy were available for 13 patients.


RESULTS
The sequences performed comparably with respect to signal-to-noise and contrast-to-noise ratios in the cadavers. The 3D images suffered from mildly increased blurring, but the readers were significantly more confident in assessing the proximal biceps tendon and curved portions of the labrum and in their findings of partial tears of the articular side of the supraspinatus tendon and posterior labral tears on the 3D images. A larger number of partial-thickness cartilage defects were found on 2D images.


CONCLUSIONS
The 3D turbo spin-echo sequence is a promising technique that can be used in shoulder arthrography with image quality and results comparable to those of traditional 2D techniques. Use of the 3D technique may result in greater anatomic detail in evaluating small obliquely oriented structures, including the curved portions of the labrum and the intraarticular portion of the biceps tendon.
Radiology Department, New York University School of Medicine, NYU Hospital for Joint Diseases, 301 E 17th St, 6th Fl, New York, NY 10003-3899, USA. leon.rybak@nyumc.org
Leon D
LD
Rybak
Renata
R
La Rocca Vieira
Michael
M
Recht
Timothy
T
Shepard
Graham
G
Wiggins
James
J
Babb
Christian
C
Glaser
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001175:Arthrography / Q000379:methods*; D002102:Cadaver; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D021621:Imaging, Three-Dimensional; D007270:Injections, Intra-Articular; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D012782:Shoulder / Q000033:anatomy & histology*; D055815:Young Adult
D003287:Contrast Media; D005682:Gadolinium