Superior Labrum Anterior-Posterior (SLAP) Tears: Evaluation of Three MR Signs on T2-weighted Images

Tuite, Michael J.; Cirillo, R; Smet, Arthur A. De; Orwin, John F.

doi:10.1148/radiology.215.3.r00jn26841

Cited by 76 publications

(44 citation statements)

References 19 publications

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“…Prior investigations using conventional MR imaging procedures (i.e., without the use of intra-articular contrast) performed with midand high-field-strength MR systems to identify tears of the glenoid labrum reported sensitivities that ranged from 44% to 95% and specificities that ranged from 63% to 91% (6,12,13,30,31). Differences in protocols and techniques, along with known interpretation pitfalls for the labrum, probably contributed to these wide variances in sensitivities and specificities (2,14).…”

Section: Discussionmentioning

confidence: 99%

“…The radiologists were not provided instructions or guidance with regard to specific criteria to use in interpreting the MR images, nor were concessions made for the low-field-strength MR images. However, standard, previously described, well-accepted interpretation criteria were used (1)(2)(3)(4)(5)(12)(13)(14)19). A partial rotator cuff tear was designated as an incomplete tendon defect that was outlined by high signal intensity on MR images with T2-weighted contrast.…”

Section: Interpretation Of the Mr Imagesmentioning

confidence: 99%

“…MAGNETIC RESONANCE (MR) IMAGING is regarded as a useful and accurate technique for diagnosing shoulder disorders, including rotator cuff disease and lesions of the glenoid labrum (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). MR imaging of the shoulder has been predominantly performed by using wholebody MR systems operating at high-field-strengths (1.0 -1.5 Tesla) or, more recently, utilizing low-fieldstrength (0.2-0.35 Tesla) scanners (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16).…”

mentioning

confidence: 99%

“…MR imaging of the shoulder has been predominantly performed by using wholebody MR systems operating at high-field-strengths (1.0 -1.5 Tesla) or, more recently, utilizing low-fieldstrength (0.2-0.35 Tesla) scanners (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). In 2001, Shellock et al (3) studied the diagnostic capabilities of an extremity MR system for identifying shoulder pathology.…”

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confidence: 99%

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Assessment of the rotator cuff and glenoid labrum using an extremity MR system: MR results compared to surgical findings from a multi‐center study

Zlatkin¹,

Hoffman²,

Shellock

2004

Magnetic Resonance Imaging

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Purpose: To conduct a multi-center assessment of the use of a 0.2-T, extremity MR system (E-scan; General Electric Lunar Corp. and Esaote, Genoa, Italy) for identifying tears of the rotator cuff and glenoid labrum. Materials and Methods:A retrospective study was performed involving 160 patients (age range, 15-84 years old) from five facilities in the United States, comparing shoulder MR imaging to surgical findings. MR imaging of the shoulder was conducted as follows: shoulder coil; T1-weighted spin echo, coronal-oblique and axial images; short Tau inversion recovery (STIR), coronal-oblique images and axial images; and T2-weighted spin echo, coronal-oblique and sagittal-oblique images. The MR examinations were interpreted in an independent, prospective manner by two radiologists with extensive musculoskeletal MRI experience. Arthroscopic (N ϭ 103) or open surgical (N ϭ 57) procedures were performed within a mean of 53 days after MR imaging.Results: Surgical findings demonstrated rotator cuff tears in 131 patients and labral tears in 60 patients. For the rotator cuff, the sensitivity, specificity, positive predictive value, and negative predictive value were 90%, 93%, 98%, and 68%, respectively. For the labrum, the sensitivity, specificity, positive predictive value, and negative predictive value were 55%, 100%, 100%, and 82%, respectively. Conclusions:There was good agreement when MR results obtained using the extremity MR system were compared to surgical findings for identifying rotator cuff tears, while the sensitivity of MR imaging for determining labral tears was relatively poor. Nevertheless, these findings were comparable to those reported in the peer-reviewed literature for MR systems operating at mid-, and high-field-strengths. MAGNETIC RESONANCE (MR) IMAGING is regarded as a useful and accurate technique for diagnosing shoulder disorders, including rotator cuff disease and lesions of the glenoid labrum (1-16). MR imaging of the shoulder has been predominantly performed by using wholebody MR systems operating at high-field-strengths (1.0 -1.5 Tesla) or, more recently, utilizing low-fieldstrength (0.2-0.35 Tesla) scanners (1-16). In 2001, Shellock et al (3) studied the diagnostic capabilities of an extremity MR system for identifying shoulder pathology. This investigation compared MR examinations to surgical findings in 47 patients and reported good agreement with regard to determining tears of the rotator cuff and glenoid labrum. In fact, the diagnostic performance of the extremity MR system was reported to compare favorably to that of whole-body, mid-and high-field-strength MR scanners for a variety of musculoskeletal applications (17,18).Performing MR examinations of the shoulder using the extremity MR system offers distinct advantages over conventional MR systems, including reduced start-up costs, more convenient siting and installation, lower maintenance fees, and greater patient comfort and safety (17,18). Importantly, these advantageous features permit the extremity MR system to be readily utilized...

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Section: Discussionmentioning

confidence: 99%

Section: Interpretation Of the Mr Imagesmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Assessment of the rotator cuff and glenoid labrum using an extremity MR system: MR results compared to surgical findings from a multi‐center study

Zlatkin¹,

Hoffman²,

Shellock

2004

Magnetic Resonance Imaging

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“…Second, although using useful clinical examination tests and imaging studies, the diagnosis and characterization of SLAP lesions is best performed arthroscopically examination. 2,13,26,[29][30][31][32] In this study, we did not perform arthroscopic examination; we only performed nonoperative treatment (rehabilitation). Therefore, the characteristics of SLAP lesions was not verified.…”

Section: )mentioning

confidence: 99%

Return to Play of Elite Overhead Athletes with Superior Labral Anterior Posterior Tears only after Rehabilitation

Park¹,

Hong²,

Lee³

et al. 2017

Clinics in Shoulder and Elbow

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Background: Although there have been multiple reports on surgical outcomes of superior labral anterior to posterior (SLAP) lesions in overhead athletes, only a few reports exist in the literature about the results of nonoperative treatment in elite (collegiate or professional) overhead athletes. To determine the clinical outcomes of nonoperative treatment of SLAP lesions in elite overhead athletes. Methods: Between January 2006 and December 2011, 69 patients were selected. Initial arthroscopic SLAP repair was performed in 19 patients and of the 50 patients who underwent nonsurgical treatment, such as range of motion gain and periscapular muscle strengthening, 14 patients were converted to surgical treatment; 5 patients were lost to follow-up. Medical records of 31 elite overhead athletes who underwent nonsurgical treatment were retrospectively reviewed. Four clinical outcome measures were used: visual analogue scale (VAS) for pain, VAS for satisfaction, American Shoulder and Elbow Surgeons (ASES) score, and subjective feeling of recovery. Results: The average follow-up period was 35.9 months (range, 24-62 months). The VAS for pain decreased from 6.5 to 2.2 (p<0.01) and VAS for satisfaction was 7.6. The ASES score increased from 54.1 to 85.9 (p<0.01). The overall average value of subjective feeling of recovery was 72%. Twenty-three out of 31 elite athletes (74.2%) returned to play after rehabilitation; these 23 athletes performed at the same or higher levels after rehabilitation. Conclusions: Nonsurgical treatment in elite overhead athletes with SLAP lesion should be considered as a treatment option. (Clin Shoulder Elbow 2017;20(2):77-83)

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Evaluation of the rotator cuff and glenoid labrum using a 0.2‐Tesla extremity magnetic resonance (MR) system: MR results compared to surgical findings

Shellock

Bert²,

Fritts

et al. 2001

Magnetic Resonance Imaging

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The purpose of this investigation was to evaluate the diagnostic capabilities of magnetic resonance imaging (MRI) performed using a dedicated-extremity MR system in detecting lesions of the rotator cuff and glenoid labrum. This retrospective study compared the MR results obtained in 47 patients that underwent MRI using a 0.2-Tesla extremity MR system (E-scan) to the surgical findings. MR images of the shoulder were obtained as follows: shoulder coil, T1-weighted, coronal-oblique and axial images; short Tau inversion recovery (STIR), coronal-oblique images; and T2-weighted, coronal-oblique, sagittal-oblique, and axial images. The MR examinations were interpreted by three highly experienced, musculoskeletal radiologists. Open surgical (N ‫؍‬ 26) or arthroscopic (N ‫؍‬ 21) procedures were performed within a mean time of 33 days after MRI. The surgical findings revealed rotator cuff tears in 28 patients and labral lesions in 9 patients. For the rotator cuff tears, the sensitivity, specificity, positive predictive value, and negative predictive value were 89%, 100%, 100%, and 90%, respectively. For the labral lesions, the sensitivity, specificity, positive predictive value, and negative predictive value were 89%, 95%, 80%, and 97%, respectively. The findings indicated that there was good agreement comparing the MR results obtained using the low-field extremity MR system to the surgical findings for determination of lesions of the rotator cuff and glenoid labrum. Notably, the statistical values determined for the use of this MR system were comparable to those reported in the peerreviewed literature for the use of whole-body, mid-and high-field-strength MR systems.

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Superior Labrum Anterior-Posterior (SLAP) Tears: Evaluation of Three MR Signs on T2-weighted Images

Abstract: Laterally curved and posterior high signal intensities are specific signs for distinguishing a SLAP tear from a normal-variant superior sublabral recess.

Cited by 76 publications

References 19 publications

Assessment of the rotator cuff and glenoid labrum using an extremity MR system: MR results compared to surgical findings from a multi‐center study

Assessment of the rotator cuff and glenoid labrum using an extremity MR system: MR results compared to surgical findings from a multi‐center study

Return to Play of Elite Overhead Athletes with Superior Labral Anterior Posterior Tears only after Rehabilitation

Evaluation of the rotator cuff and glenoid labrum using a 0.2‐Tesla extremity magnetic resonance (MR) system: MR results compared to surgical findings

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