Wallny T, Sommer T, Steuer K, Vahlensieck M, Wagner U A, Schmitz A, Schmitt O
Orthopädische Universitätsklinik, Bonn.
Unfallchirurg. 1998 Aug;101(8):613-8. doi: 10.1007/s001130050314.
Clinical and radiological evaluation of labral tears remains challenging. It has been shown that intravenous administration of contrast agents produces an MR arthrographic effect without the need for intraarticular injection. This is the first study evaluating this new technique of indirect MR arthrography in diagnosis of glenoid labrum tears.
28 patients with clinically suspected labral injuries were prospectively investigated (1.5 Tesla, flexible surface coil). A native MR exam of the shoulder (transverse and oblique-coronar orientation, T1-weighted spin-, proton density- and T2*-weighted gradient echo sequences) and indirect MR arthrography (transverse and oblique-coronar orientation, fat-suppressed T1-weighted spin-echo sequences, intravenous injection of gadopentetate dimeglumine [0.1 mmol/kg], followed by 10-15 min of joint movement) were performed. Results were confirmed by arthroscopy and/or open surgery. Additionally sensitivity evaluation of clinical tests for investigation of labral tears were performed.
Indirect MR-Arthrography improved delineation of the glenoid labrum and hyaline cartilage significantly (p < 0.05). Sensitivity and specificity of indirect MR arthrography in diagnosis of labral injuries were 90% and 89% respectively, compared to 79% and 67% of the native MR exam. The reliability of the checked clinical tests is not sufficient enough to determine labral lesions (predictive value between 50 and 70%).
Indirect MR-arthrography is a promising non-invasive technique in the evaluation of the glenoid labrum.
盂唇撕裂的临床和影像学评估仍然具有挑战性。已表明静脉注射造影剂可产生磁共振关节造影效果，而无需关节内注射。这是第一项评估这种间接磁共振关节造影新技术在诊断盂唇撕裂中的研究。
对28例临床怀疑有盂唇损伤的患者进行前瞻性研究（1.5特斯拉，柔性表面线圈）。进行肩部的常规磁共振检查（横断位和斜冠状位，T1加权自旋回波、质子密度加权和T2*加权梯度回波序列）以及间接磁共振关节造影（横断位和斜冠状位，脂肪抑制T1加权自旋回波序列，静脉注射钆喷酸葡胺[0.1 mmol/kg]，随后进行10 - 15分钟的关节活动）。结果通过关节镜检查和/或开放手术得到证实。此外，还对用于盂唇撕裂检查的临床测试进行了敏感性评估。
间接磁共振关节造影显著改善了盂唇和透明软骨的显示（p < 0.05）。间接磁共振关节造影诊断盂唇损伤的敏感性和特异性分别为90%和89%，而常规磁共振检查的敏感性和特异性分别为79%和67%。所检查的临床测试的可靠性不足以确定盂唇病变（预测值在50%至70%之间）。
间接磁共振关节造影是一种有前景的用于评估盂唇的非侵入性技术。
