January 9, 2009 — MR arthrography of the
shoulder allows physicians to better identify tears and provides patients with
an accurate diagnosis to determine whether or not surgery is needed, according
to a study performed at Neuroskeletal Imaging in Merritt Island, Florida.
The study included 150
patients who underwent both 3T MRI and MR arthrography examinations of the
shoulder. “We did the study to see if MR, which is noninvasive, works as well as
MR arthrography, an invasive procedure that some patients are fearful of having
since contrast has to be injected into the shoulder,” said Thomas Magee, MD,
lead author of the study. The study found that MR arthrography was more
accurate for making a diagnosis. Sensitivity on conventional MRI for anterior
labral tears was 83%; for posterior labral tears was 84%; for SLAP tears was
83%; for supraspinatus tendon tears was 92%; and for partial-thickness articular
surface tears was 68%. Sensitivity on MR arthrography on the other hand was
significantly higher. Sensitivity for anterior labral tears was 98%; for
posterior labral tears was 95%; for SLAP tears was 98%; for supraspinatus tendon
tears was 100%; and for partial-thickness articular surface tears was 97%. “With
MR arthrography we were able to see things with a high degree of accuracy in the
shoulder,” said Dr. Magee.
“Resolution and picture
quality using 3T MRI is high in the shoulder, except for lesions that are hidden
without distention (swelling) of the joint. During MR arthrography, the
distention of the joint allowed us to uncover lesions that could not be seen on
conventional MRI,” said Dr. Magee.
“The performance of MR
arthrograms allows us to see additional, pertinent surgical lesions and provides
a better road map for surgeons. Patients should have MR arthrography before
surgery to provide an accurate diagnosis, determining whether or not they really
even need surgery,” he said.
“If an MR arthrogram is
normal, it is very likely to be normal during surgery,” said Dr. Magee.
— A news release from The American
Roentgen Ray Society (ARRS).