Palmer W E, Brown J H, Rosenthal D I
Department of Bone and Joint Radiology, Massachusetts General Hospital, Boston 02114.
Radiology. 1993 Sep;188(3):683-7. doi: 10.1148/radiology.188.3.8351333.
Thirty-seven shoulders with rotator cuff diagnoses proved at arthrography, arthroscopy, or open surgery were examined prospectively with magnetic resonance (MR) arthrography. T1-weighted MR images were obtained with and without fat suppression after intraarticular injection of gadopentetate dimeglumine. Without fat suppression, overall accuracy was 84%. False-positive full-thickness tears were diagnosed in three patients who were proved to have partial tears. False-negative normal tendons were diagnosed in two patients who had partial tears. The corresponding sensitivity and specificity were 90% and 75%, respectively. With the aid of fat-suppressed imaging, full-thickness and partial cuff tears were identified with 100% sensitivity and specificity. Fat-suppressed images also showed intratendinous contrast material imbibition in three torn cuffs with frayed, friable tendon margins. Fat suppression in MR arthrography is valuable in the differentiation of partial from full-thickness cuff tears and in the detection of small partial tears of the inferior tendon surface.
对37例经关节造影、关节镜检查或开放手术证实患有肩袖损伤的肩部进行了磁共振（MR）关节造影前瞻性检查。在关节内注射钆喷酸葡胺后，分别在有和没有脂肪抑制的情况下获取T1加权MR图像。在没有脂肪抑制的情况下，总体准确率为84%。3例被诊断为全层撕裂的患者经证实为部分撕裂，存在假阳性。2例有部分撕裂的患者被诊断为肌腱正常，存在假阴性。相应的敏感性和特异性分别为90%和75%。借助脂肪抑制成像，全层和部分肩袖撕裂的识别敏感性和特异性均为100%。脂肪抑制图像还显示，在3例肌腱边缘磨损、易碎的撕裂肩袖中存在肌腱内造影剂吸收。MR关节造影中的脂肪抑制对于区分部分和全层肩袖撕裂以及检测肌腱下表面的小部分撕裂很有价值。
