Clin Should Elbow.  2022 Sep;25(3):182-187. 10.5397/cise.2021.00598.

Can indirect magnetic resonance arthrography be a good alternative to magnetic resonance imaging in diagnosing glenoid labrum lesions?: a prospective study

Affiliations
  • 1Orthopaedic Research Center, Department of Orthopaedics, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
  • 2Department of Radiology, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran
  • 3General Practitioner, Department of Orthopaedic, Guilan University of Medical Sciences, Rasht, Iran
  • 4Department of Statistics, School of Health, Guilan University of Medical Sciences, Rasht, Iran

Abstract

Background
This study was designed to evaluate and compare the diagnostic value of magnetic resonance imaging (MRI) and indirect magnetic resonance arthrography (I-MRA) imaging with those of arthroscopy and each other.
Methods
This descriptive-analytical study was conducted in 2020. All patients who tested positive for labrum lesions during that year were included in the study. The patients underwent conservative treatment for 6 weeks. In the event of no response to conservative treatment, MRI and I-MRA imaging were conducted, and the patients underwent arthroscopy to determine their ultimate diagnosis and treatment plan. Imaging results were assessed at a 1-week interval by an experienced musculoskeletal radiologist. Image interpretation results and arthroscopy were recorded in the data collection form.
Results
Overall, 35 patients comprised the study. Based on the kappa coefficient, the results indicate that the results of both imaging methods are in agreement with the arthroscopic findings, but the I-MRA consensus rate is higher than that of MRI (0.612±0.157 and 0.749±0.101 vs. 0.449±0.160 and 0.603±0.113). The sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of MRI in detecting labrum tears were 77.77%, 75.00%, 91.30%, 50.00%, and 77.14%, respectively, and those of I-MRA were 88.88%, 75.00%, 92.30%, 66.66%, and 85.71%.
Conclusions
Here, I-MRA showed higher diagnostic value than MRI for labral tears. Therefore, it is recommended that I-MRA be used instead of MRI if there is an indication for potential labrum lesions.

Keyword

Shoulder; Labrum; Indirect magnetic resonance arthrography; MRI; Diagnosis
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