Indirect MR Arthrography of the Shoulder: Use of Abduction and External Rotation to Detect Full- and Partial-Thickness Tears of the Supraspinatus Tendon

Abstract

Indirect MR arthrography with supplementary images obtained with patients in the ABER position significantly improved sensitivity and increased diagnostic confidence for partial-thickness tears of the supraspinatus tendon. Interobserver agreement was improved for both full- and partial-thickness tears.

Rotator cuff tears noncontrast MRI compared to MR arthrography

“…While Yagci et al [4] analyzed the efficacy of indirect MR arthrography and noncontrast MRI for suspected rotator cuff abnormalities, the study was based on a small number of patients, without statistical comparison between the two techniques (except for the interobserver agreement). Previous studies have revealed that indirect MR arthrography is highly accurate in diagnosing overall and full-thickness tears of SSP-ISP tendons [4,9,[12][13][14]24]. In contrast, the correct diagnoses of a partial-thickness tear remains difficult despite the use of intravenous contrast media [12,14,24].…”

“…When compared with noncontrast MR imaging (MRI), a number of authors have observed improved sensitivity in the diagnosis of glenoid labral lesions with indirect MR arthrography in a relatively small number of populations [6,10,11]. Although there have been several reports concerning the diagnostic performance of indirect MR arthrography for rotator cuff tears [4,[12][13][14][15], the incremental value of intravenous paramagnetic contrast media injection for the diagnosis of rotator cuff tears in comparison with noncontrast MRI remains unclear. Therefore, the purpose of this study was to compare the diagnostic accuracy of indirect MR arthrography with that of noncontrast MRI for the diagnosis of rotator cuff lesions in a large population using a 3.0 T MR scanner.…”

Shoulder MRI accuracy in the community setting

“…2,5,6,[11][12][13][14]19,[21][22][23]25,27,28,30,32 The accuracy of MRI for diagnosing full and partial rotator cuff tears has been 61-97% and 59-79%, respectively. With MRI arthrography, these accuracy values have been reported to be 78-100% and 95%.…”

Rotator cuff tears: should abduction and external rotation (ABER) positioning be performed before image acquisition? A CT arthrography study

“…Imaging has an impact on detection and therapeutic management. It has been shown on different imaging techniques that ABER positioning during image acquisition improved the detection and characterisation of partial tears [18][19][20][21][22]. However, the technique has not been broadly accepted in daily practice because of (i) prolonged MR imaging times, (ii) Fig.…”

“…Although limited in the assessment of bursal-sided tears, CT arthrography has been shown to be accurate in the detection of small articular-sided lesions, given its excellent spatial resolution [16,17]. It has been shown that an abduction external rotation (ABER) positioning during image acquisition improved the detection and characterization of articular-sided partial tears by direct or indirect MR arthrography as well as by CT arthrography [18][19][20][21][22]. However, the additional image acquisition in the ABER position is not always performed in routine practice, because of prolonged MRI imaging times, increased motion artefacts, higher CT radiation doses or interpretation issues related to anatomical changes in ABER.…”