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首页> 外文期刊>AJR: American Journal of Roentgenology : Including Diagnostic Radiology, Radiation Oncology, Nuclear Medicine, Ultrasonography and Related Basic Sciences >3-T MRI of the shoulder: is MR arthrography necessary?
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3-T MRI of the shoulder: is MR arthrography necessary?

机译：肩部3-T MRI：是否需要MR关节造影？

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摘要

OBJECTIVE: The purpose of this study is to report the diagnostic sensitivity of 3-T conventional MRI versus MR arthrography of the shoulder in the same patient population. MATERIALS AND METHODS: One hundred fifty consecutive conventional shoulder MRI and MR arthrography examinations performed on patients 50 years or younger who subsequently underwent arthroscopy were reviewed retrospectively by consensus reading by two musculoskeletal radiologists. All patients selected for arthroscopy had abnormal findings on clinical examination and MRI or MR arthrography. All 150 patients were referred from one orthopedic group. All patients consented to undergo both MRI and MR arthrography. None had undergone prior shoulder surgery. Full- or partial-thickness supraspinatus tendon tears, superior labral anterior-to-posterior (SLAP) tears, and anterior or posterior labral tears were assessed. RESULTS: Three full-thickness and nine partial-thickness supraspinatus tendon tears, seven SLAP tears, six anterior labral tears, and two posterior labral tears were seen on MR arthrography but not on conventional MRI. All additional MR arthrography findings were confirmed at arthroscopy. On conventional MRI, sensitivities and specificities compared with arthroscopy were as follows: anterior labral tear, 83% sensitivity and 100% specificity; posterior labral tear, 84% and 100%; SLAP tear, 83% and 99%; supraspinatus tendon tear, 92% and 100%; partial-thickness articular surface tear, 68% and 100%; and partial-thickness bursal surface tear, 84% and 100%. On MR arthrography, sensitivities and specificities compared with arthroscopy were as follows: anterior labral tear, 98% sensitivity and 100% specificity; posterior labral tear, 95% and 100%; SLAP tear, 98% and 99%; supraspinatus tendon tear, 100% and 100%; partial-thickness articular surface tear, 97% and 100%; and partial-thickness bursal surface tear, 84% and 100%. MR arthrography showed a statistical improvement in sensitivity (p<0.05) for detection of partial-thickness articular surface supraspinatus tears, anterior labral tears, and SLAP tears at 3 T. CONCLUSION: In this series, MR arthrography showed statistically significant increased sensitivity for detection of partial-thickness articular surface supraspinatus tears, anterior labral tears, and SLAP tears compared with conventional MRI at 3 T. On the basis of the above findings, we perform 3-T MR arthrography on patients for whom anterior labral tears, SLAP tears, and partial-thickness supraspinatus tendon tears are suspected clinically.
机译：目的：本研究的目的是报告同一患者人群中3-T常规MRI与MR肩关节造影的诊断敏感性。材料与方法：两名肌肉骨骼放射科医生对50岁或以下，随后接受关节镜检查的患者进行了150次连续的常规肩部MRI和MR关节镜检查，以进行回顾性回顾。选择进行关节镜检查的所有患者在临床检查和MRI或MR关节造影上均发现异常。 150名患者全部来自一个骨科组。所有患者均同意接受MRI和MR关节造影。没有人曾接受过肩部手术。评估了全厚度或部分厚度的棘上肌腱撕裂，上唇上唇前后裂（SLAP）以及前唇或后唇裂。结果：在MR关节造影上发现了3个全层和9个部分厚度的上棘上肌腱撕裂，7个SLAP撕裂，6个前唇裂和2个后唇裂，但在常规MRI上未见。关节镜检查证实了所有其他MR关节镜检查结果。在常规MRI上，与关节镜相比，敏感性和特异性如下：前唇裂，敏感性为83％和特异性为100％;后唇撕裂分别为84％和100％; SLAP撕裂分别为83％和99％;棘上肌腱撕裂，分别为92％和100％;局部厚度的关节表面撕裂分别为68％和100％;以及部分厚度的法氏囊表面撕裂分别为84％和100％。在MR关节造影上，与关节镜相比，敏感性和特异性如下：前唇撕裂，敏感性为98％和特异性为100％;后唇撕裂，分别为95％和100％; SLAP撕裂率分别为98％和99％;棘上肌腱撕裂100％和100％;局部厚度的关节表面撕裂分别为97％和100％;以及部分厚度的法氏囊表面撕裂分别为84％和100％。 MR关节造影显示在3 T时检测部分厚度的关节表面上棘突，前唇撕裂和SLAP撕裂的敏感性有统计学上的提高（p <0.05）。结论：在本系列中，MR关节造影显示出统计学上显着提高的检测敏感性在3 T时与常规MRI相比，部分厚度的关节表面上棘上眼泪，前唇前泪和SLAP泪的影响。基于以上发现，我们对前唇前泪，SLAP眼泪，临床上怀疑有部分厚度的棘上肌腱撕裂。

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