Tiegs-Heiden Christin A, Rhodes Nicholas G, Collins Mark S, Fender Quintin A, Howe Benjamin M
Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.
Skeletal Radiol. 2018 Nov;47(11):1475-1481. doi: 10.1007/s00256-018-2947-z. Epub 2018 May 13.
The purpose of this study is to describe the MR arthrogram appearance of the postoperative glenoid labrum and to describe the features consistent with recurrent tear.
We identified 30 patients who had undergone glenoid labral repair, had a subsequent MR arthrogram of his or her shoulder, and went on to repeat shoulder arthroscopy. Each MR arthrogram was reviewed blindly, and the glenoid labrum was described as normal, irregular, or torn. Additional findings recorded included the presence or absence of a paralabral cyst and suture anchors in the glenoid. The operative report was also reviewed for each patient to determine the status of the labrum at arthroscopy.
Following consensus review, 18/30 MRIs were felt to demonstrate recurrent glenoid labral tear, 11/30 showed an irregular labrum, and 1/30 was called normal. The radiology impression regarding the presence or absence of a recurrent glenoid labral tear agreed with the operative report in 24/30 (80%) cases, and was discrepant in six. This equals 83.3% sensitivity and 81.8% specificity of MR arthrogram in the diagnosis of recurrent labral tear in this study. A paralabral cyst was present in 3/30 (10%) cases, all three of which were torn.
MR arthrogram findings of signal equal to gadolinium or fluid within or underlying the glenoid labrum and markedly diminutive or absent labrum were the most useful features to diagnose recurrent tear. Some signal underlying the labrum, which is confined to the anterosuperior quadrant, may be normal. The secondary finding of a paralabral cyst was also highly sensitive for recurrent tear.
本研究旨在描述术后盂唇的磁共振关节造影表现，并描述与复发性撕裂相符的特征。
我们确定了30例接受盂唇修复术的患者，这些患者随后进行了肩部磁共振关节造影，并继续接受了重复肩关节镜检查。对每例磁共振关节造影进行盲法评估，将盂唇描述为正常、不规则或撕裂。记录的其他发现包括盂唇旁囊肿的有无以及盂骨中的缝合锚钉。还对每位患者的手术报告进行了回顾，以确定关节镜检查时盂唇的状态。
经过共识评估，30例磁共振成像中有18例被认为显示复发性盂唇撕裂，11例显示盂唇不规则，1例被称为正常。关于复发性盂唇撕裂有无的放射学印象与手术报告在24/30（80%）的病例中一致，6例存在差异。在本研究中，磁共振关节造影诊断复发性盂唇撕裂的敏感性为83.3%，特异性为81.8%。30例中有3例（10%）存在盂唇旁囊肿，所有3例均为撕裂。
磁共振关节造影显示盂唇内或其下方信号等于钆或液体以及盂唇明显变小或缺失是诊断复发性撕裂最有用的特征。盂唇下方局限于前上象限的一些信号可能是正常的。盂唇旁囊肿这一次要发现对复发性撕裂也具有高度敏感性。
