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

Abstract

Although the MR arthrographic findings were similar for type II SLAP lesion and sublabral recess, laterally curved high signal intensity on oblique coronal images, concomitant anterosuperior labral tear, and anteroposterior extension of high signal intensity on axial images were helpful findings in the diagnosis of type II SLAP lesion.

Superior labral tears: repair versus biceps tenodesis

“…[22][23][24] The normal anatomic variations can make MRI findings confusing, but perilabral cysts and coronal images with contrast extension under the superior labrum and extending laterally into the substance of the labrum are most commonly associated with true SLAP lesions (Fig. 1).…”

“…1). 2,[22][23][24]46 Arthroscopy is considered the gold standard for diagnosing SLAP tears. However, arthroscopy can be misleading without knowledge of normal anatomic variants, physical examination, patient history, and MRI findings.…”

Die SLAP-Läsion als Präarthrose?

“…Eine Unsicherheit hinsichtlich der Beurteilung besteht dabei zum einen aufgrund der Artefakte durch eingebrachte Fadenanker, zum anderen in der Validität der Technik, da zur Beurteilung die zur Diagnosestellung der SLAP-Läsion bekannten Kriterien angewandt wurden [21,22] und diese möglicherweise nicht ohne Änderung auf die postoperative Beurteilung umgesetzt werden können. Insbesondere die Koexistenz eines sublabralen Recessus stellt eine bekannte differenzialdiagnostische Problematik dar [10,23]. Interessanterweise konnten wir in dieser Gruppe feststellen, dass in all diesen 6 Fällen eine Chondralläsion vorlag.…”

Superior Labral Anteroposterior Tears: Accuracy and Interobserver Reliability of Multidetector CT Arthrography for Diagnosis

“…and 2 (Y.J.K.) analyzed images with consensus and without knowledge of arthroscopic results in regard to the following factors ( Fig 1 , Fig E1 [online]), which were known as fi ndings of SLAP type II lesions (9)(10)(11)(12): (a) a lateral curved sublabral contrast material deposit on an oblique coronal image, (b) a globular or irregular-shaped sublabral contrast material deposit on an oblique coronal image, (c) widening of the space in the region of the sublabral contrast material deposit on an oblique coronal image, and (d) anteroposterior extension of the sublabral contrast material deposit on an axial image. After imaging analysis, arthrographic procedures were placed in random order and were reviewed independently without prior knowledge of clinical histories and arthroscopic fi ndings.…”

“…Third, although arthroscopy is the best current standard, it is operator dependent and has interoberver or even intraobserver variability ( 28 ). Moreover, the differentiation between sublabral recesses and SLAP type II lesions has been deemed to be diffi cult even at arthroscopy even when the operator is well experienced frequently showed anteroposterior extension of sublabral contrast material deposits on an axial image than it did in a study by Jin et al ( 12 ). This may have been owing to the thin section thickness without intersection gap in multidetector CT arthrography that enabled visualization of even a shallow sublabral contrast material deposit on an axial image, as opposed to MR arthrography, which usually has a 3-mm section thickness and some intersection gap.…”