MR arthrography in calcific tendinitis of the shoulder: diagnostic performance and pitfalls

Abstract Background: Multiple 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. Methods: Two 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. Results: The 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. Conclusion: MRA 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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Diagnostic performance of indirect MR arthrography for the diagnosis of rotator cuff tears at 3.0 T

Acta Radiologica ◽

10.1177/0284185114537817 ◽

2015 ◽

Vol 56 (6) ◽

pp. 720-726 ◽

Cited By ~ 8

Author(s):

Ji Hyun Lee ◽

Young Cheol Yoon ◽

Sukkyung Jee

Keyword(s):

Rotator Cuff ◽

Diagnostic Performance ◽

Mr Arthrography ◽

Rotator Cuff Tears ◽

3.0 T ◽

Indirect Mr Arthrography

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Accuracy of Pre- and Postcontrast, 3 T Indirect MR Arthrography Compared with Wrist Arthroscopy in the Diagnosis of Wrist Ligament Injuries

Journal of Wrist Surgery ◽

10.1055/s-0038-1661419 ◽

2018 ◽

Vol 07 (05) ◽

pp. 382-388 ◽

Cited By ~ 3

Author(s):

J. Besjakov ◽

A. Björkman ◽

N. Thomsen

Keyword(s):

Mr Imaging ◽

Diagnostic Performance ◽

Mr Arthrography ◽

Stage Iv ◽

Wrist Arthroscopy ◽

Diagnostic Study ◽

Level Of Evidence ◽

Articular Pathology ◽

Wrist Ligament ◽

Indirect Mr Arthrography

Background Magnetic resonance (MR) is the most important imaging technique to assess intra-articular pathology of the wrist. Among various MR imaging protocols, the diagnostic performance of indirect MR arthrography needs further investigation. Purpose The purpose of this study was to assess the diagnostic performance of pre- and postcontrast, 3 T indirect MR arthrography in the diagnosis of scapholunate intrinsic ligament (SLIL) and triangular fibrocartilage complex (TFCC) injuries, using wrist arthroscopy as reference standard. Patients and Methods We retrospectively evaluated consecutive patients with suspected SLIL or TFCC injury, who had indirect MR arthrography done before arthroscopy. Images were assessed independently by two senior radiologists. Results Arthroscopy of the 53 wrists demonstrated 16 Geissler stages II and III partial tears and 6 stage IV total SLIL ruptures. Central perforation of the TFCC was found in 24 wrists, and 12 wrists had an ulnar class 1B lesion. To detect any SLIL tear, accuracy was higher for the two observers using postcontrast indirect MR arthrography (0.77 and 0.72) than for precontrast MR imaging (0.60 and 0.60). No difference was found for total SLIL ruptures “0.85 and 0.89” versus “0.85 and 0.89.” To diagnose class 1B TFCC injuries, accuracy was higher using postcontrast indirect MR arthrography (0.85 and 0.75) than for precontrast MR imaging (0.70 and 0.72). No difference in accuracy was demonstrated for TFCC central tears “0.75 and 0.75” versus “0.70 and 0.77.” Conclusion Postcontrast images at 3 T indirect MR arthrography, compared with precontrast images, have an improved diagnostic performance for the overall detection of SLIL injuries and as well as class 1B TFCC tears. Level of Evidence This is a Level II, diagnostic study.

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