The Utility of MR Imaging of the Shoulder Joint: Comparison of the MR Imaging between Conventional MR Imagingand Arthrographic MR Imaging

Choi, Dong Sik; Ryu, Kyung Nam; Kim, Ihn Sub; Rhee, Yong Girl

Abstract

PURPOSE: To evaluate the diagnostic value of MRI of the shoulder.
MATERIALS AND METHODS
Between January andJune 1997, shoulder MRI and arthroscopy were performed in a total of 48 patients with shoulder pain (n=30) orshoulder instability (n=18). Forty-five were males and three were females; their ages ranged from 16 to 67 (mean32.5) years. The period between shoulder MRI and arthroscopy was between one and 390 (mean, 42.2) days. Twenty-sixpatents underwent MR arthrography (AMR), and 22 conventional MRI(CMR). Each image was analyzed for rotator cuffinjury, glenoid labral injury, SLAP lesion, and biceps tendon injury.
RESULTS
On arthroscopy, one disease wasfound in 34 patients, two were found in six, three diseases were found in seven, and one patient had fourdiseases. Arthroscopic diagnosis was as follows: rotator cuff injury, 29 ; SLAP lesion, 12 ; glenoid labralinjury, 10 ; biceps tendon injury, 4 ; subacromial bursitis, 2 ; chronic synovitis, 1 ; adhesive capsulitis, 1 ;superior glenohumeral ligament injury, 1 ; normal, 1. For rotator cuff injury, the sensitivity of MRI was 65.5%and specificity was 93.0% (AMR : 66.7%, 95.8%, CMR : 65.2%, 86.4%). For SLAP lesion, sensitivity was 58.3% andspecificity was 97.2% (AMR : 66.7%, 100%, CMR : 50%, 93.8%) ; for glenoid labral injury, sensitivity was 80.0% andspecificity was 89.5% (AMR : 85.7%, 84.2%, CMR : 66.7%, 94.7%), and for biceps tendon injury, the false negativerate was 100%.
CONCLUSION
In cases involving glenoid labral injury, the diagnostic accuracy of shoulder MRI wasrelatively high ; in rotator cuff injury and SLAP lesion, however, diagnosis was limited, and in biceps tendoninjury was difficult. We suggest, however, that MR arthrography has certain diagnostic advantages overconventional MRI.