Young Han Lee MD, Presenter: Nothing to Disclose

Ho-Taek Song MD, Abstract Co-Author: Nothing to Disclose

Yong-Min Huh MD, Abstract Co-Author: Nothing to Disclose

Sung-Joon Kim MD, Abstract Co-Author: Nothing to Disclose

Sung-Jae Kim MD, Abstract Co-Author: Nothing to Disclose

Jin-Suck Suh MD, Abstract Co-Author: Nothing to Disclose

The purpose of our study was to validate virtual MR arthroscopy reconstructed from fat suppressed 3D GRE sequence MR arthrography in discriminating various labral lesions over the 3D GRE MR arthrographic images.

The study group comprised 28 patients (22 man, 6 women; mean age 25) with an episode of recurrent shoulder dislocation who had been referred for MR arthrography of the shoulder and then underwent arthroscopy. Arthrographic procedure was performed with a 22 gauge angiocath introducer needle placing within the glenohumeral joint under fluoroscopic guidance. 15-20 ml of a gadolinium/saline solution were injected. MR examination were performed with a 1.5-T imager. For each patient we acquired fat suppressed T1-weighted 3D fast field echo (3D-FFE) sequence. Virtual arthroscopic image was made from postprocessing works with three-dimensional reconstruction software (VoxelPlus; Mevisys, Daejeon, Korea) in a separate workstation. Virtual MR arthroscopic images and 3D GRE MR arthrographic images were reviewed, focused on the anterior inferior labral lesion, Bankart, ALPSA, and Perthes lesion respectively. Each lesion scored grade 1 to 5 according to the lesion conspicuousness. Golden standard of the diagnosis was arthroscopic finding.

Total number of lesions on arthroscopy are; Bankart lesion 17, ALPSA 18, Perthes lesion 4 and combined lesion of Bankart lesion and ALPSA 8, ALPSA and Perthes lesion 4. Sensitivity of the Bankark and ALPSA lesion was 100% at the virtual arthroscopy and 82.4%, 94.4% at the 3D GRE MR arthrographic image respectively. Bankart lesion was more accurately discriminated at the virtual arthroscopy than 3D GRE MR arthrographic images with statistical significance (p<0.05).

Virtual MR shoulder arthroscopy made of fat suppressed 3D GRE MR arthrography could be a robust and feasible method for assessing labral pathology in recurrent shoulder dislocation, specifically for investigating Barkart lesion. Thus, it could be very beneficial in diagnostic accuracy as well as proper preoperative surgical planning.

Lee, Y, Song, H, Huh, Y, Kim, S, Kim, S, Suh, J, Validity of Virtual MR Arthroscopy Made of Fat Suppressed 3D GRE Direct MR Shoulder Arthrography in Determining the Labral Lesion of the Shoulder.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4413020.html