Onofrio Antonio Catalano MD, Presenter: Nothing to Disclose

Riccardo Manfredi MD, Abstract Co-Author: Nothing to Disclose

Angelo Vanzulli MD, Abstract Co-Author: Nothing to Disclose

Ernesto Tomei MD, Abstract Co-Author: Nothing to Disclose

Alfonso Bencivenga, Abstract Co-Author: Nothing to Disclose

Donald L. Resnick MD, Abstract Co-Author: Nothing to Disclose

To compare sensitivity and specificity of MR and arthroMR of the shoulder, following intrarticular gadolium solution injection, in partial articular side tear of the infraspinatus and or supraspinatus muscle tendon, not associated with full thickness tendon tears

More than 350 patients have undergone shoulder magnetic resonance imaging (MRI)both before and after intrarticular gadoliniun solution injection. Precontrast examination consisted of axial, oblique coronal and oblique sagittal fast spin echo (FSE) T2 weighetd fat saturated sequences, and sagittal oblique FSE T1 weighted sequence. The post contrast examination consisted of triplanar T1 weighted FSE fat saturated sequences. 238 pazients have underogone arthroscopy and results were available for comparison. 47 of them had arthroscopic diagnosis of partial articular side tear of infraspinatus and or supraspinatus muscle tendon not associated with full thickness tendon tears. MRI diagnostic criteria to diagnose partial articula side tears before contrast were:1)intratendinous high signal intensity (SI) areas on T2 weighted sequences 2)lack of involvement of the bursal side of the tendons by the high SI area.MRI diagnostic criteria after intrarticular contrast medium injection were:1) intratendineous contrast medium extension 2) lack of flow of the contrast medium into the subacromial bursa. Arthroscopy , performed within 2 months from the MRI scans, was our gold standard.

MRI before contrast medium correctly diagnosed 34 out of 47 patients, sensitivity was 72%. specificity was 85% because of 29 false positive patients. MRI after intra articular contrast medium administration correclty diagnosed 43 out of 47 patients, with a sensitivity of 91% . Specificity was 96% because of 8 false negative results.

MRI of the shoulder, performed after intrarticular contrast medium injection, has a higher specificity and sensitivity then MRI without contrast medium.

we think that all patients with a suspected partial tear of the supraspinatus and or infraspinatus muscle tendon should undergo MRI of the shoulder after intra-articular contrast medium injection.

Catalano, O, Manfredi, R, Vanzulli, A, Tomei, E, Bencivenga, A, Resnick, D, Comparison between MR and ArthroMR of the Shoulder in Isolated Partial Articular Side Tear of the Sopraspinatus and or Infraspinatus Muscle Tendons, Correlation with Arthroscopy.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4440506.html