Diagnosis of glenoid labral tears using 3-tesla MRI vs. 3-tesla MRA: a systematic review and meta-analysis

Ajuied, Adil; McGarvey, Ciaran; Harb, Ziad; Smith, Christian; Houghton, Russell; Corbett, Steven A

doi:10.1007/s00402-018-2894-0

Cited by 30 publications

(18 citation statements)

References 23 publications

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“…Another meta-analysis demonstrated that MRA was superior to MRI for the detection of SLAP lesions [19]. A recent meta-analysis from 2018, involving 10 studies, revealed that 3.0 T MRA improved sensitivity for the diagnosis of anterior and posterior labral tears, but reduced specificity in the diagnosis of SLAP tears [20].…”

Section: Introductionmentioning

confidence: 99%

Imaging modality for measuring the presence and extent of the labral lesions of the shoulder: a systematic review and meta-analysis

Liu

Cheng

Dong

et al. 2019

BMC Musculoskelet Disord

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BackgroundMultiple published studies quantitatively analysing the diagnostic value of MRI, MR arthrography (MRA) and CT arthrography (CTA) for labral lesions of the shoulder have had inconsistent results. The aim of this meta-analysis was to systematically compare the diagnostic performance of MRI, MRA, CTA and CT.MethodsTwo databases, PubMed and EMBASE, were used to retrieve studies targeting the accuracy of MRI, MRA, CTA and CT in detecting labral lesions of the shoulder. After carefully screening and excluding studies, the studies that met the inclusion criteria were used for a pooled analysis, including calculation of sensitivity and specificity with 95% confidence intervals (CIs) and the area under the hierarchical summary receiver operating characteristic (HSROC) curves.ResultsThe retrieval process identified 2633 studies, out of which two reviewers screened out all but 14 studies, involving a total of 1216 patients who were deemed eligible for inclusion in the meta-analysis. The results assessing the diagnostic performance of MRI vs. MRA for detecting labral lesions showed a pooled sensitivity of 0.77 (95% CI 0.70–0.84) vs. 0.92 (95% CI 0.84–0.96), a specificity of 0.95 (95% CI 0.85–0.98) vs. 0.98 (95% CI 0.91–0.99), and an area under the HSROC curve of 3.78 (95% CI 2.73–4.83) vs. 6.01 (95% CI 4.30–7.73), respectively.ConclusionMRA was suggested for use in patients with chronic shoulder symptoms or a pathologic abnormality. MRI is by far the first choice recommendation for the detection of acute labral lesions. CT should be a necessary supplemental imaging technique when there is highly suspected glenoid bone damage.

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Section: Introductionmentioning

confidence: 99%

Imaging modality for measuring the presence and extent of the labral lesions of the shoulder: a systematic review and meta-analysis

Liu

Cheng

Dong

et al. 2019

BMC Musculoskelet Disord

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“…A diagnosis was made and supported high-quality 3-T MRI scans, which have been proven to provide good utility in diagnosing these injuries. 1 For each affected shoulder, the size and location of the tear were documented. Labral tears were classified in terms of the location as anterior, posterior, or combined anterior and posterior.…”

Section: Methodsmentioning

confidence: 99%

Effect of Anterior Glenoid Labral Tears and Glenoid Bone Loss at the NFL Combine on Future NFL Performance

Mannava

et al. 2018

Orthopaedic Journal of Sports Medicine

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Background:Anterior glenohumeral instability is a common abnormality in the young, athletic population, especially in those participating in contact or collision sports.Purpose:To examine the effect of anterior labral tears, their associated injuries, and their management on future National Football League (NFL) performance.Study Design:Cohort study; Level of evidence, 3.Methods:A retrospective review of all NFL Combine participants from 2009 to 2015 was performed using medical and imaging reports compiled at the NFL Combine. These notes and images were reviewed and analyzed for involved structures, associated injuries, and evidence of previous surgical interventions. The respective NFL draft position, number of NFL games played, number of NFL games started, and NFL snap percentage for each player’s first 2 seasons were collected and compared with a control group and within subgroups.Results:Of the 2285 players at the NFL Combine between 2009 and 2015, there were 206 (9%) anterior labral tears confirmed by magnetic resonance imaging, 20 of which were bilateral, for a total of 226 affected shoulders. There were 908 players who fit the criteria for inclusion in the control group. Overall, there were no significant differences between players with anterior labral tears and the control players in terms of draft position (P = .259), games played in their first 2 NFL seasons (P = .391), games started in their first 2 NFL seasons (P = .486), or snap percentage in their first (P = .268) and second (P = .757) NFL seasons. In general, sustaining a concomitant injury with an anterior labral tear (superior labrum from anterior to posterior [SLAP] tear, glenoid bone loss, Hill-Sachs lesion, rotator cuff tear, humeral avulsion of the glenohumeral ligament, and anterior tear combined with posterior tear) negatively affected a player’s NFL draft position when compared with those with an isolated anterior labral tear (P = .003). There was no significant difference between operative and nonoperative management for anterior labral tears in terms of any performance metric.Conclusion:A history of anterior labral tears was not significantly associated with future NFL performance. While players with isolated injuries were drafted significantly earlier than those with concomitant injuries, combined injuries did not affect players’ games played, games started, or snap percentage in their first 2 NFL seasons. Glenoid bone loss did significantly decrease draft position; however, the severity of bone loss did not affect draft position, and there were no significant associations between glenoid bone loss and games played, games started, or snap percentage.

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“…Where 3T imaging is available, the additional diagnostic yield of MRAs over conventional MRIs may be less pronounced. Conventional MRI at 3T has comparable accuracy to MRAs at 3T for rotator cuff tears, though MRAs have greater sensitivity for labral tears [16][17][18]. Magee [19] reported that the likelihood of finding an additional finding on MRA is small (6%) if an initial non-arthrographic conventional MRI was abnormal.…”

Section: Impact Of Increased Magnet Field Strength On Mrimentioning

confidence: 99%

Direct MR arthrography of the shoulder: current practice in the UK

et al. 2020

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There is wide variation in the technique and type of contrast used for MR arthrography of shoulder. In this article, we discuss the current practice in UK and the reason for the change over the last few years. Keywords Arthrogram • Shoulder • UK Direct MR arthrograms (MRA) utilise distension of the joint capsule to separate intra-capsular structures and hence improve visualisation, when compared to conventional non-arthrographic MRI. Clinical applications of direct MRA were first described in the shoulder, which remains one of the primary joints imaged with this technique. Although MRA of the shoulder is performed in many centres across the UK, there is variation in the way this study is performed, including whether gadolinium-based contrast agents (GdCAs), saline or other agents are used to distend the joint space. An online survey was conducted of musculoskeletal radiologists in the UK to ascertain current practise in MRA of the shoulder, changes in practice in the last 5 years, and reasons for such changes. There have been recent concerns regarding gadolinium deposition in the brain and other tissues following enhanced MRI studies. In this commentary, we discuss the issues surrounding GdCA use in shoulder arthrograms, with reference to the literature and our survey findings.

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Diagnosis of glenoid labral tears using 3-tesla MRI vs. 3-tesla MRA: a systematic review and meta-analysis

Abstract: IV.

Cited by 30 publications

References 23 publications

Imaging modality for measuring the presence and extent of the labral lesions of the shoulder: a systematic review and meta-analysis

Imaging modality for measuring the presence and extent of the labral lesions of the shoulder: a systematic review and meta-analysis

Effect of Anterior Glenoid Labral Tears and Glenoid Bone Loss at the NFL Combine on Future NFL Performance

Direct MR arthrography of the shoulder: current practice in the UK

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