Assessment of the superior labrum of the shoulder joint with CT-arthrography and MR-arthrography: correlation with anatomical dissection

Bresler, F.; Blum, Alain; Braun, Marc; Simon, Jean-Marie; Cossin, M.; Régent, D; Molé, Daniel

doi:10.1007/bf01628117

Cited by 26 publications

(12 citation statements)

References 17 publications

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“…The other two findings were presence of concomitant anterosuperior labral tear and anteroposterior extension of high signal intensity on axial images. The first three findings were previously reported to be useful for the differential diagnosis of type II SLAP lesion and sublabral recess [6][7][8][9].…”

Section: Image Evaluationmentioning

confidence: 95%

“…However, because these two conditions have similar and overlapping findings on MR arthrography and have many variations, it is often difficult to reach an accurate diagnosis. In particular, it can be difficult to differentiate type II SLAP lesion from deep superior sublabral recess on CT and MR arthrography [9]. Therefore, we reviewed previously reported and additional MR arthrographic findings to determine their usefulness in the differential diagnosis of type II SLAP lesion and superior sublabral recess confirmed at arthroscopy.…”

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confidence: 99%

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MR Arthrography in the Differential Diagnosis of Type II Superior Labral Anteroposterior Lesion and Sublabral Recess

Jin

Ryu²,

Kwon³

et al. 2006

American Journal of Roentgenology

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Section: Image Evaluationmentioning

confidence: 95%

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confidence: 99%

MR Arthrography in the Differential Diagnosis of Type II Superior Labral Anteroposterior Lesion and Sublabral Recess

Jin

Ryu²,

Kwon³

et al. 2006

American Journal of Roentgenology

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“…Magnetic resonance imaging is not dependable enough due to insufficient intraarticular contrast. Moreover, the value of CT arthrography even with spiral-CT remains debatable [11,32,60,61].…”

Section: Superior Labral Lesionsmentioning

confidence: 99%

“…4) [7,8,9,10,11,12]. Knowledge of these normal variations is necessary in order to avoid excessive labral tear diagnoses.…”

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confidence: 99%

Gleno-humeral instabilities

Blum¹,

Coudane

Molé

2000

European Radiology

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The purpose of this review is to highlight the most efficient imaging exploratory techniques depicting shoulder instability, to describe its various forms and to point out the findings which can simulate instability. In anterior recurrent dislocation, surgery is indicated and the procedure essentially depends on the importance of glenoid rim lesions. In this case, a standard X-ray evaluation is usually sufficient. The CT arthrography or MRI techniques give more specific details as to the severity of the lesions, particularly soft tissues alterations; however, these data do not alter standard therapeutic protocol. In fixed posterior dislocations, CT scan represents the most pertinent technique to evaluate the size of the humeral head defect and to determine the therapeutic follow-up. In subtle forms of instability, diagnosis or instability direction are not clearly assessed clinically and standard X-ray evaluation is usually unremarkable. In this case, further exploration, such as CT arthrography, MR imaging or MR arthrography, are recommended to confirm the diagnosis of instability and to evaluate its direction. The technique of choice is undoubtedly MR arthrography. Atraumatic voluntary painless subluxations associated with hyperlaxity of the shoulder do not require any specific exploratory method because the findings are generally limited to a capacious axillary pouch.

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“…[2][3][4][5][6] At present, magnetic resonance arthrography (MRA) of shoulder is well proven and useful technique for diagnosis of intraarticular lesions. 5,11 However it is still expensive and metal in the vicinity interferes with the true signal.…”

Section: Introductionmentioning

confidence: 99%

Multidetector CT arthrography in shoulder instability and its comparison with MR arthrography and arthroscopy

et al. 2017

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INTRODUCTIONShoulder instability is a common problem with annual incidence between 0.084%-1.7%.1 There are 46%-100% incidence of recurrent dislocation for patients aged less than 40 years without surgical intervention, which decreases to 7%-15% after surgical stablization.1 To improve the pre-operative planning and post-operative result of surgery, exact diagnosis of pathology and anatomy of labroligamentous structure is essential.Conventional computerized tomographic arthrography (CTA) has limited soft tissue contrast and spatial resolution which has led to it being replaced by conventional and contrast enhanced magnetic resonance imaging (MRI) of shoulder.2-6 At present, magnetic resonance arthrography (MRA) of shoulder is well proven and useful technique for diagnosis of intraarticular lesions.5,11 However it is still expensive and metal in the vicinity interferes with the true signal.Since multidetector CT (MDCT) was introduced in 1988, cross-sectional imaging has been revolutionized by the ABSTRACT Background: Purpose of this study was to compare diagnostic effectiveness of MDCT arthrography (MDCTA) in shoulder instability and pain in throwing and its comparison to MR arthrography (MRA) and arthroscopy taking arthroscopy as gold standard. Methods: 20 patients with history of recurrent shoulder dislocation in activity were included in this study. After detailed clinical examination, each patient underwent MDCT-MR arthrography in one sitting followed by diagnostic arthroscopy within 6 weeks. Results were compared with the help of statistician. Results: At arthroscopy, 10 Bankart's lesions, 7 Hill Sachs lesion, 6 SLAP lesion, 1 ALPSA, 1 capsular laxity, 1 partial subscapularis tear and 1 supraspinatus fraying were visualized in 20 shoulders. For Bankart's lesion MDCT has sensitivity 80%, specificity 100%, positive predictive value (PPV) 100% and negative predictive value (NPV) 83.3%. MRA has sensitivity of 90%, specificity 100%, PPV 100% and NPV 90.9%. For SLAP lesions sensitivity, specificity, PPV and NPV for MDCTA and MRA are 88.3%, 100%, 100%, 93.3%. For Hill-Sachs lesion; sensitivity, specificity, PPV and NPV for MDCTA are all 100% and for MRA they are 85.7%, 100%, 100%, 92.8% respectively. For ALPSA; sensitivity is 100%, specificity is 95%, PPV is 50% and NPV is 100% both for MDCTA and MRA. К value for MRA is 0.60 and for CTA is 0.55 suggesting moderate agreement. Conclusions: Considering availability, cost, time consumption, superior detection of bony lesions and comparable detection of soft tissue lesions; MDCTA can be used as single investigation of choice in shoulder instability pain.

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Assessment of the superior labrum of the shoulder joint with CT-arthrography and MR-arthrography: correlation with anatomical dissection

Cited by 26 publications

References 17 publications

MR Arthrography in the Differential Diagnosis of Type II Superior Labral Anteroposterior Lesion and Sublabral Recess

MR Arthrography in the Differential Diagnosis of Type II Superior Labral Anteroposterior Lesion and Sublabral Recess

Gleno-humeral instabilities

Multidetector CT arthrography in shoulder instability and its comparison with MR arthrography and arthroscopy

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