Vandevenne J E, Vanhoenacker F, Beaulieu C F, Bergman A G, Butts Pauly K, Dillingham M F, Lang P K
Department of Radiology, University Hospital Antwerp, Edegem-Antwerp, Belgium.
Acta Radiol. 2008 Oct;49(8):918-27. doi: 10.1080/02841850802291242.
Magnetic resonance (MR) arthrography frequently involves joint injection under imaging guidance followed by MR imaging in static positions.
To evaluate if MR arthrography of the shoulder joint can be performed in a comprehensive fashion combining the MR-guided injection procedure, static MR imaging, and dynamic motion MR imaging in a single test.
Twenty-three shoulder joints were injected with Gd-DTPA2- under MR guidance. Static MR imaging was performed and included a three-point Dixon method to achieve water-selective images. Dynamic motion MR imaging with and without applying pressure to the upper arm was used to evaluate glenohumeral joint instability. In 10 cases, surgical correlation was available.
The all-in-one MR arthrography technique was successful in all patients, and took an average time of 65 min. All but one glenohumeral injection procedure were performed with a single needle pass, and no complications were observed. Out of eight labrum tears seen with static MR imaging, seven were confirmed at surgery. In 10 cases, dynamic motion MR imaging correlated well with the surgeon's intraoperative evaluation for presence and direction of instability.
MR arthrography of the shoulder joint using a vertically open magnet can be performed as a single comprehensive test, including the injection and the static and dynamic motion MR imaging. Good diagnostic accuracy for intraarticular lesions and glenohumeral instability was found in a small sample.
磁共振(MR)关节造影通常包括在成像引导下进行关节注射,然后在静态位置进行MR成像。
评估肩关节MR关节造影能否通过在单次检查中结合MR引导注射程序、静态MR成像和动态运动MR成像以全面的方式进行。
在MR引导下,对23个肩关节注射钆喷酸葡胺。进行了静态MR成像,包括采用三点Dixon法以获取水选择性图像。使用对上臂施加压力和不施加压力的动态运动MR成像来评估盂肱关节不稳。10例患者有手术对照。
一体化MR关节造影技术在所有患者中均获成功,平均耗时65分钟。除1例盂肱关节注射操作外,其余均一针完成,未观察到并发症。在静态MR成像发现的8例盂唇撕裂中,7例在手术中得到证实。10例中,动态运动MR成像与外科医生术中对不稳的存在及方向的评估相关性良好。
使用垂直开放式磁体的肩关节MR关节造影可作为一项单一的综合检查进行,包括注射以及静态和动态运动MR成像。在小样本中发现对关节内病变和盂肱关节不稳具有良好的诊断准确性。