UPMC Freddie Fu Center for Sports Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
UPMC Freddie Fu Center for Sports Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A..
Arthroscopy. 2024 Sep;40(9):2363-2369. doi: 10.1016/j.arthro.2024.02.020. Epub 2024 Feb 23.
To determine the comparative accuracy and precision of routine magnetic resonance imaging (MRI) versus magnetic resonance (MR) arthrogram in measuring labral tear size as a function of time from a shoulder dislocation.
We retrospectively evaluated consecutive patients who underwent primary arthroscopic stabilization between 2012 and 2021 in a single academic center. All patients completed a preoperative MRI or MR arthrogram of the shoulder within 60 days of injury and subsequently underwent arthroscopic repair within 6 months of imaging. Intraoperative labral tear size and location were used as standards for comparison. Three musculoskeletal radiologists independently interpreted tear extent using a clock-face convention. Accuracy and precision of MR labral tear measurements were defined based on location and size of the tear, respectively. Accuracy and precision were compared between MRI and MR arthrogram as a function of time from dislocation.
In total, 32 MRIs and 65 MR arthrograms (total n = 97) were assessed. Multivariate analysis demonstrated that intraoperative tear size, early imaging, and arthrogram status were associated with increased MR accuracy and precision (P < .05). Ordering surgeons preferred arthrogram for delayed imaging (P = .018). For routine MRI, error in accuracy increased by 3.4° per day and error in precision increased by 2.3° per day (P < .001) from time of injury. MR arthrogram, however, was not temporally influenced. Significant loss of accuracy and precision of MRI compared with MR arthrogram occurred at 2 weeks after an acute shoulder dislocation.
Compared with MR arthrogram, conventional MRI demonstrates time-dependent loss of accuracy and precision in determining shoulder labral tear extent after dislocation, with statistical divergence occurring at 2 weeks.
Level II, retrospective radiographic diagnostic study.
确定常规磁共振成像（MRI）与磁共振（MR）关节造影术在测量肩脱位后时间依赖性肩盂唇撕裂大小方面的准确性和精密度。
我们回顾性评估了 2012 年至 2021 年在一家学术中心接受初次关节镜下稳定术的连续患者。所有患者在受伤后 60 天内完成了术前肩部 MRI 或 MR 关节造影术，随后在成像后 6 个月内进行了关节镜下修复。术中盂唇撕裂的大小和位置被用作比较的标准。3 名肌肉骨骼放射科医生独立使用时钟面惯例解读撕裂程度。根据撕裂的位置和大小分别定义了 MR 盂唇撕裂测量的准确性和精密度。比较了 MRI 和 MR 关节造影术在肩脱位后时间的准确性和精密度。
共评估了 32 个 MRI 和 65 个 MR 关节造影术（共 97 个）。多变量分析表明，术中撕裂大小、早期成像和关节造影状态与增加的 MR 准确性和精密度相关（P<.05）。手术医生更倾向于对延迟成像进行关节造影（P=0.018）。对于常规 MRI，准确性误差每天增加 3.4°，精度误差每天增加 2.3°（P<.001），从受伤时间开始。然而，MR 关节造影术不受时间影响。与 MR 关节造影术相比，常规 MRI 在急性肩脱位后 2 周时显示出准确性和精密度的显著损失。
与 MR 关节造影术相比，常规 MRI 在确定肩盂唇撕裂程度方面具有时间依赖性的准确性和精密度损失，统计差异发生在 2 周后。
二级，回顾性放射学诊断研究。
