Chandnani V P, Yeager T D, DeBerardino T, Christensen K, Gagliardi J A, Heitz D R, Baird D E, Hansen M F
Department of Radiology, Tripler Army Medical Center, HSHK-DR Honolulu, HI 96859-5000.
AJR Am J Roentgenol. 1993 Dec;161(6):1229-35. doi: 10.2214/ajr.161.6.8249731.
We prospectively compared MR imaging, MR arthrography, and CT arthrography to determine the sensitivity of each technique in detecting glenoid labral tears and in determining whether the labrum is detached or degenerated.
Thirty patients 19-39 years old (mean, 27 years old) who had either signs and symptoms of shoulder instability or shoulder pain of unexplained origin were referred for diagnostic imaging. Each patient underwent MR imaging, followed by MR arthrography after intraarticular injection of 25 ml of a dilute solution of gadopentetate dimeglumine. Twenty-eight of thirty patients underwent CT arthrography after intraarticular injection of air and radiographic contrast material. Each patient also underwent arthroscopy or open surgery.
At surgery, labral tears were found in 28 patients; a detached fragment was found in 26 patients. The labrum was found to be degenerated in 18. A labral tear was detected on MR images in 26 (93%) of 28, on MR arthrograms in 27 (96%) of 28, and on CT arthrograms in 19 (73%) of 26. A detached labral fragment was detected on MR images in 12 (46%) of 26, on MR arthrograms in 25 (96%) of 26, and on CT arthrograms in 13 (52%) of 25. Labral degeneration was detected on MR images in two (11%) of 18, on MR arthrograms in 10 (56%) of 18, and on CT arthrograms in four (24%) of 17. MR arthrography was the best of the three imaging techniques for showing the inferior part of the glenoid labrum and inferior glenohumeral ligament.
MR arthrography and MR imaging both showed labral tears with greater sensitivity than CT arthrography did. MR arthrography was the most sensitive of the three techniques for detecting a detached labral fragment and labral degeneration. Furthermore, MR arthrography afforded the best visualization of the inferior part of the labrum and the inferior glenohumeral ligament. MR imaging and MR arthrography also enabled direct visualization of rotator cuff disease and other unsuspected associated abnormalities.
我们前瞻性地比较了磁共振成像（MR成像）、磁共振关节造影和CT关节造影，以确定每种技术在检测盂唇撕裂以及确定盂唇是否 detached 或退变方面的敏感性。
30名年龄在19至39岁（平均27岁）之间、有肩部不稳定体征和症状或不明原因肩部疼痛的患者被转诊进行诊断性成像检查。每位患者先接受MR成像检查，然后在关节内注射25毫升钆喷酸葡胺稀释溶液后进行磁共振关节造影。30名患者中有28名在关节内注射空气和放射造影剂后接受了CT关节造影。每位患者还接受了关节镜检查或开放手术。
手术中，28名患者发现有盂唇撕裂；26名患者发现有 detached 碎片。发现18名患者的盂唇退变。28名患者中有26名（93%）在MR图像上检测到盂唇撕裂，28名患者中有27名（96%）在磁共振关节造影上检测到，26名患者中有19名（73%）在CT关节造影上检测到。26名患者中有12名（46%）在MR图像上检测到 detached 盂唇碎片，26名患者中有25名（96%）在磁共振关节造影上检测到，25名患者中有13名（52%）在CT关节造影上检测到。18名患者中有2名（11%）在MR图像上检测到盂唇退变，18名患者中有10名（56%）在磁共振关节造影上检测到，17名患者中有4名（24%）在CT关节造影上检测到。磁共振关节造影是三种成像技术中显示盂唇下部和下盂肱韧带的最佳方法。
磁共振关节造影和MR成像检测盂唇撕裂的敏感性均高于CT关节造影。磁共振关节造影是三种技术中检测 detached 盂唇碎片和盂唇退变最敏感的方法。此外，磁共振关节造影对盂唇下部和下盂肱韧带的显示最佳。MR成像和磁共振关节造影还能够直接观察肩袖疾病和其他未被怀疑的相关异常情况。
