Prospective evaluation of MR arthrography performed with high-volume intraarticular saline enhancement in patients with recurrent anterior dislocations of the shoulder

AJR. American Journal of Roentgenology
U F WillemsenK Hahn

Abstract

The purpose of this study was to evaluate the accuracy of high-volume saline-enhanced MR arthrography in assessing the labrum, the ligaments, and the bony components of the glenohumeral joint. Forty-four patients with recurrent anterior dislocations of the shoulder underwent MR arthrography after intraarticular injection of 15-40 ml of saline solution. Two-dimensional fast low-angle shot and T1-weighted spin-echo sequences were prospectively evaluated by two observers. Anterior (Bankart) lesions, superior labral lesions extending from anterior to posterior, and Hill-Sachs lesions were diagnosed. Glenohumeral ligaments (GHLs) were identified and classified using a standard system. MR imaging results were compared with those of arthroscopy (n = 32) or open surgery (n = 12), either of which was the gold standard. Bankart lesions and superior labral lesions extending from anterior to posterior were revealed with a sensitivity of 93% and 89%, respectively, and a specificity of 80% and 89%, respectively. Diagnostic accuracy was 89% for both types of lesions. All six patients with bony Bankart lesions had high fat-marrow signal intensity within the fragment on T1-weighted MR images. For GHLs, MR imaging results and arthroscopy correla...Continue Reading

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