Abstract:
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Purpose: To study the value of MR arthrography for classification of labro-ligamentous injuries in patients with anterior glenohumeral instability in comparison with arthroscopic assessments.
Methods and Materials: MR arthrograms of 89 patients with arthroscopically confirmed labro-ligamentous injuries in patients with acute or chronic anterior glenohumeral instability were randomized with 90 MR arthrograms of patients with an arthroscopically intact labro-ligamentous complex. MR arthrography was performed at a 1.0 Tesla system using triplanar T1w SE sequences and a paracoronal T2w FSE sequence. The images were evaluated by two radiologists with agreement by consensus, and the results were compared with arthroscopic findings.
Results: Arthroscopy revealed 33 Bankart lesions, 11 Perthes lesions, 20 ALPSA lesions, and 2 GLAD lesions. In 23 patients the lesions were not classifiable at arthroscopy, all of which occurred after a history of chronic instability. With arthroscopy as the gold standard labro-ligamentous lesions were detected with a sensitivity of 87% and a specificity of 92%. Bankart lesions were classified correctly in 73% of cases, Perthes lesions in 45% of cases, and ALPSA lesions in 75% of cases. Both GLAD lesions were assessed correctly.
Conclusion: MR arthrography is a highly accurate technique for the detection of labro-ligamentous injuries. Furthermore, it provides accurate information on the type of lesion; however, correct interpretation of Perthes lesions remains difficult. Classification of chronic lesions with scar tissue formation in patients with a long-standing history of instability and multiple dislocations can be impossible even at arthroscopy.
Waldt MD, S,
Performance of MR Arthrography in Classification of Labro-ligamentous Injuries in Patients with Anterior Glenohumeral Instability. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3106582.html
