RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin · 1999
[A prospective study on the detection of lesions of the labrum glenoidale by indirect MR arthrography of the shoulder].
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Mäurer J, Rudolph J, Lorenz M, Hidajat N, Schröder R, Südkamp N P, Felix R
Аннотация
PURPOSE: Aim of this prospective study was the evaluation of signal-alterations of anatomic shoulder structures before and after intravenous application of Gd-DTPA. Furthermore the tested clinical value of indirect MR-arthrography in detecting labrum lesions was tested.
MATERIAL AND METHODS: 52 patients with suspected shoulder injury were examined on a 1.5 T system: Sequences were T1-weighted axial and oblique-coronary, additionally oblique-coronary T2-weighted, PD-weighted- and axial FLASH-2D-Sequences. After intravenous injection of contrast medium T1-weighted sequences were repeated. Signal-intensities (SI) of anatomic structures were measured by ROI-technique, the percentual contrast-enhancement (CE) and alterations in SNR (signal-noise-ratio) and CNR (contrast-noise-ratio) were calculated. Labrum tears were graded by three observers, their results could be confirmed by arthroscopy or open surgery in 24 patients.
RESULTS: Contrast-enhancement was shown in all structures, most remarkable in the joint cavity. In pathologic findings of the labrum the SI and CE were significantly higher compared to intact strictures (p < 0.05). Sensitivity and specificity in the detection of labrum tears were 70% and 71.4% without contrast media, respectively 100% and 71.4% with indirect arthrography.
CONCLUSIONS: The indirect arthrography improves the signal parameters of the structures. The detection of labrum lesions is improved, but still remains difficult.
MATERIAL AND METHODS: 52 patients with suspected shoulder injury were examined on a 1.5 T system: Sequences were T1-weighted axial and oblique-coronary, additionally oblique-coronary T2-weighted, PD-weighted- and axial FLASH-2D-Sequences. After intravenous injection of contrast medium T1-weighted sequences were repeated. Signal-intensities (SI) of anatomic structures were measured by ROI-technique, the percentual contrast-enhancement (CE) and alterations in SNR (signal-noise-ratio) and CNR (contrast-noise-ratio) were calculated. Labrum tears were graded by three observers, their results could be confirmed by arthroscopy or open surgery in 24 patients.
RESULTS: Contrast-enhancement was shown in all structures, most remarkable in the joint cavity. In pathologic findings of the labrum the SI and CE were significantly higher compared to intact strictures (p < 0.05). Sensitivity and specificity in the detection of labrum tears were 70% and 71.4% without contrast media, respectively 100% and 71.4% with indirect arthrography.
CONCLUSIONS: The indirect arthrography improves the signal parameters of the structures. The detection of labrum lesions is improved, but still remains difficult.