title: Comparison of 3D turbo spin-echo SPACE sequences with conventional 2D MRI sequences to assess the shoulder joint.
abstract: OBJECTIVE
  To determine the accuracy and reliability of three-dimensional (3D) T1- and proton density (PD)-weighted turbo spin-echo (TSE) sampling perfection with application-optimized contrasts using different flip-angle evolution (SPACE) compared with conventional 2D sequences in assessment of the shoulder-joint.
  
  
  METHODS
  Ninety-three subjects were examined on a 3-T MRI system with both conventional 2D-TSE sequences in T1-, T2- and PD-weighting and 3D SPACE sequences in T1- and PD-weighting. All examinations were assessed independently by two reviewers for common pathologies of the shoulder-joint. Agreement between 2D- and 3D-sequences and inter-observer-agreement was evaluated using kappa-statistics.
  
  
  RESULTS
  Using conventional 2D TSE sequences as standard of reference, sensitivity, specificity, and accuracy values of 3D SPACE were 81.8%, 95.1%, and 93.5% for injuries of the supraspinatus-tendon (SSP), 81.3%, 93.5%, and 91.4% for the cartilage layer and 82.4%, 98.5%, and 97.5% for the long biceps tendon. Concordance between 2D and 3D was almost perfect for tendinopathies of the SSP (κ=0.85), osteoarthritis (κ=1), luxation of the biceps tendon (κ=1) and adjacent bone marrow (κ=0.92). Inter-observer-agreement was generally higher for conventional 2D TSE sequences (κ, 0.23-1.0), when compared to 3D SPACE sequences (κ, -0.33 to 1.0) except for disorders of the long biceps tendon and supraspinatus tendon rupture.
  
  
  CONCLUSIONS
  Because of substantial and almost perfect concordance with conventional 2D TSE sequences for common shoulder pathologies, MRI examination-time can be reduced by nearly 40% (up to 11 min) using 3D-SPACE without loss of information.
authors.affiliation: Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany. Electronic address: jost.kloth@med.uni-heidelberg.de.
authors.forename: Jost Karsten
authors.initials: JK
authors.lastname: Kloth
authors.affiliation: Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany. Electronic address: marianne.winterstein@med.uni-heidelberg.de.
authors.forename: Marianne
authors.initials: M
authors.lastname: Winterstein
authors.affiliation: Orthopedic and Trauma Surgery, University Hospital Heidelberg, Schlierbacher Landstraße 200a, D-69118 Heidelberg, Germany. Electronic address: michael.akbar@med.uni-heidelberg.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Akbar
authors.affiliation: Siemens Healthcare, Erlangen, Germany. Electronic address: esther.meyer@siemens.com.
authors.forename: Esther
authors.initials: E
authors.lastname: Meyer
authors.affiliation: Siemens Healthcare, Erlangen, Germany. Electronic address: dominik.paul@siemens.com.
authors.forename: Dominik
authors.initials: D
authors.lastname: Paul
authors.affiliation: Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany. Electronic address: hans-ulrich.kauczor@med.uni-heidelberg.de.
authors.forename: Haus-Ulrich
authors.initials: HU
authors.lastname: Kauczor
authors.affiliation: Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany. Electronic address: marcandre.weber@med.uni-heidelberg.de.
authors.forename: Marc-André
authors.initials: MA
authors.lastname: Weber
mesh_terms: D000328:Adult; D016880:Anisotropy; D016477:Artifacts; D064368:Healthy Volunteers; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012785:Shoulder Joint / Q000033:anatomy & histology*; D013997:Time Factors
keywords: Comparative studies; Magnetic resonance imaging; Rotator cuff; Shoulder; Space; Three-dimensional sequences