title: MR arthrography of the shoulder: optimizing pulse sequence protocols for the evaluation of cartilage and labrum.
abstract: OBJECTIVE
  To compare axial T1weighted fat-saturated (T1w fs) and T1w non-fs sequences, and coronal T1w-fs and T2w-fs sequences, for evaluation of cartilage and labrum using CT arthrography (CTA) as the reference.
  
  
  METHODS
  Patients had MR arthrography (MRA) and CTA of the shoulder on the same day. Cartilage was assessed for superficial and full thickness focal and diffuse damage. Labral lesions were graded for Bankart variants and SLAP lesions. CTA images were read for the same features. The diagnostic performance of MRA including area under the curve (AUC) was evaluated against CTA.
  
  
  RESULTS
  When comparing axial sequences, the diagnostic performance for cartilage lesion detection on T1w non-fs was 61.9% (sensitivity) 93.6% (specificity) and 89.5% (accuracy) with AUC 0.782, while that for T1w fs was 61.9%, 94.0%, 89.8% and 0.783. For labral assessment, it was 89.1%, 93.0%, 91.4% and 0.919 for T1w non-fs, and 89.9%, 94.0%, 92.6% and 0.922 for T1w fs. Comparing coronal sequences, diagnostic performance for cartilage was 42.5%, 97.5%, 89.8% and 0.702 for T1w fs, and 38.4%, 98.7%, 90.2%, and 0.686 for T2w fs. For the labrum it was 85.1%, 87.5%, 86.2%, and 0.868 for T1w fs, and 75.7%, 97.5%, 80.8% and 0.816 for T2w fs.
  
  
  CONCLUSIONS
  Axial T1w fs and T1w non-fs sequences are comparable in their ability to diagnose cartilage and labral lesions. Coronal T1w fs sequence offers slightly higher sensitivity but slightly lower specificity than T2w fs sequence for diagnosis of cartilage and labral lesions.
authors.affiliation: ASPETAR - Qatar Orthopaedic and Sports Medicine Hospital, Sport City Street, Near Khalifa Stadium, P.O. Box 29222, Qatar; Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building, 3rd Floor, Boston, MA 02118, United States. Electronic address: Ali.Guermazi@aspetar.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Guermazi
authors.affiliation: ASPETAR - Qatar Orthopaedic and Sports Medicine Hospital, Sport City Street, Near Khalifa Stadium, P.O. Box 29222, Qatar.
authors.forename: Nabil
authors.initials: N
authors.lastname: Jomaah
authors.affiliation: ASPETAR - Qatar Orthopaedic and Sports Medicine Hospital, Sport City Street, Near Khalifa Stadium, P.O. Box 29222, Qatar; Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building, 3rd Floor, Boston, MA 02118, United States; Department of Radiology, Bridgeport Hospital, Yale University School of Medicine, 267 Grant Street, Bridgeport, CT 06610, United States.
authors.forename: Daichi
authors.initials: D
authors.lastname: Hayashi
authors.affiliation: ASPETAR - Qatar Orthopaedic and Sports Medicine Hospital, Sport City Street, Near Khalifa Stadium, P.O. Box 29222, Qatar; Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building, 3rd Floor, Boston, MA 02118, United States.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Jarraya
authors.affiliation: Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building, 3rd Floor, Boston, MA 02118, United States.
authors.forename: Jose Roberto
authors.initials: JR
authors.lastname: Silva
authors.affiliation: Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, 650 Albany Street, Suite 200, Boston, MA 02118, United States.
authors.forename: Jingbo
authors.initials: J
authors.lastname: Niu
authors.affiliation: ASPETAR - Qatar Orthopaedic and Sports Medicine Hospital, Sport City Street, Near Khalifa Stadium, P.O. Box 29222, Qatar.
authors.forename: Emad
authors.initials: E
authors.lastname: Almusa
authors.affiliation: ASPETAR - Qatar Orthopaedic and Sports Medicine Hospital, Sport City Street, Near Khalifa Stadium, P.O. Box 29222, Qatar.
authors.forename: Philippe
authors.initials: P
authors.lastname: Landreau
authors.affiliation: ASPETAR - Qatar Orthopaedic and Sports Medicine Hospital, Sport City Street, Near Khalifa Stadium, P.O. Box 29222, Qatar; Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building, 3rd Floor, Boston, MA 02118, United States; Department of Radiology, University of Erlangen Nuremberg, Maximiliansplatz 1, D-91054 Erlangen, Germany.
authors.forename: Frank W
authors.initials: FW
authors.lastname: Roemer
mesh_terms: D000293:Adolescent; D000328:Adult; D002358:Cartilage, Articular / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D009942:Organometallic Compounds; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012785:Shoulder Joint / Q000473:pathology*
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine
keywords: CT arthrography; Cartilage; Labrum; MR arthrography