Department of Musculoskeletal Radiology, Hospital of the University of Pennsylvania, Philadelphia, 19104, USA.
AJR Am J Roentgenol. 2011 May;196(5):1139-44. doi: 10.2214/AJR.08.1734.
The purpose of this study was to evaluate the diagnostic accuracy of 3-T MRI versus 3-T MR arthrography for assessing labral abnormalities in the shoulder using arthroscopy as the gold standard.
Forty-two patients (28 men, 14 women; mean age, 33 years) underwent MR arthrography and conventional MRI of the same shoulder. Two patients underwent bilateral shoulder examinations, for a total of 44 shoulder examinations. Twenty-two shoulders underwent arthroscopy. The results of arthroscopy were used as the reference standard. Three musculoskeletal radiologists prospectively and independently interpreted MRI and MR arthrography examinations. Differences in performance of conventional MRI and MR arthrography were analyzed for statistical significance by the two-tailed McNemar test.
Of the 22 arthroscopies performed, 26 labral tears were found in 18 shoulders and four shoulders were normal with respect to the labrum. There were 12 superior, nine posterior, and five anterior labral tears identified at arthroscopy. By consensus review, conventional MRI identified nine of 12 superior (sensitivity, 75%; specificity, 100%), seven of nine posterior (sensitivity, 78%; specificity, 92%), and three of five anterior (sensitivity, 60%; specificity, 94%) labral tears. MR arthrography identified nine of 12 superior (sensitivity, 75%; specificity, 100%), eight of nine posterior (sensitivity, 89%; specificity, 100%), and five of five anterior (sensitivity, 100%; specificity, 100%) labral tears.
Although the power of our preliminary study is small, the results suggest that intraarticular contrast material is helpful in diagnosing labral tears in the shoulder, particularly tears of the anterior labrum. Our preliminary results suggest that MR arthrography adds value for diagnosing labral tears in the shoulder compared with conventional MRI even at 3 T.
本研究旨在评估 3T MRI 与 3T MR 关节造影术在评估肩关节盂唇异常方面的诊断准确性，以关节镜检查作为金标准。
42 例患者（28 名男性，14 名女性；平均年龄 33 岁）接受了同肩关节的 MR 关节造影和常规 MRI 检查。2 例患者接受了双侧肩关节检查，共计 44 个肩关节检查。22 个肩关节接受了关节镜检查。关节镜检查结果被用作参考标准。3 名肌肉骨骼放射科医生前瞻性地独立解读 MRI 和 MR 关节造影检查结果。采用双侧 McNemar 检验对常规 MRI 和 MR 关节造影术的性能差异进行统计学显著性分析。
在进行的 22 例关节镜检查中，18 个肩关节中发现 26 个盂唇撕裂，4 个肩关节盂唇正常。关节镜下发现 12 个上盂唇撕裂、9 个后盂唇撕裂和 5 个前盂唇撕裂。经共识审查，常规 MRI 识别出 12 个上盂唇撕裂中的 9 个（敏感性 75%，特异性 100%）、9 个后盂唇撕裂中的 7 个（敏感性 78%，特异性 92%）和 5 个前盂唇撕裂中的 3 个（敏感性 60%，特异性 94%）。MR 关节造影术识别出 12 个上盂唇撕裂中的 9 个（敏感性 75%，特异性 100%）、9 个后盂唇撕裂中的 8 个（敏感性 89%，特异性 100%）和 5 个前盂唇撕裂中的 5 个（敏感性 100%，特异性 100%）。
尽管我们的初步研究的效力较小，但结果表明关节内对比剂有助于诊断肩关节盂唇撕裂，特别是前盂唇撕裂。我们的初步结果表明，与常规 MRI 相比，即使在 3T 下，MR 关节造影术也可提高肩关节盂唇撕裂的诊断价值。
