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Musculoskeletal Imaging |
1 From the Department of Diagnostic Radiology, Long Island Jewish Medical Center, 270-05 76th Ave, New Hyde Park, NY 11040 (J.T.B.); the Department of Diagnostic Radiology, Maimonides Medical Center, Brooklyn, NY (J.B.); and the Departments of Diagnostic Radiology (Z.S.R., S.S., J.M., J.M.M.) and Orthopedic Surgery (A.R., J.Z., F.C., D.R.), Hospital for Joint Diseases–Orthopedic Institute, New York University Medical Center, NY. From the 1997 RSNA scientific assembly. Received September 29, 1998; revision requested November 4; revision received March 29, 1999; accepted April 26. Address reprint requests to J.T.B. (e-mail: bencardi@lij.edu).
PURPOSE: To determine the accuracy of magnetic resonance (MR) arthrography in the diagnosis of superior labrum anterior-posterior (SLAP) lesions of the shoulder.
MATERIALS AND METHODS: From January 1995 to June 1998, MR arthrography of the shoulder was performed in 159 patients with a history of chronic shoulder pain or instability. Fifty-two patients underwent arthroscopy or open surgery 12 days to 5 months after MR arthrography. Diagnostic criteria for SLAP lesion included marked fraying of the articular aspect of the labrum, biceps anchor avulsion, inferiorly displaced bucket handle fragment, and extension of the tear into the biceps tendon fibers. Surgical findings were correlated with those from MR arthrography.
RESULTS: SLAP injuries were diagnosed at surgery in 19 of the 52 patients (37%). Six of the 19 lesions (32%) were classified as type I, nine (47%) as type II, one (5%) as type III, and three (16%) as type IV. MR arthrography had a sensitivity of 89% (17 of 19 patients), a specificity of 91% (30 of 33 patients), and an accuracy of 90% (47 of 52 patients). The MR arthrographic classification showed correlation with the arthroscopic or surgical classification in 13 of 17 patients (76%) in whom SLAP lesions were diagnosed at MR arthrography.
CONCLUSION: MR arthrography is a useful and accurate technique in the diagnosis of SLAP lesions of the shoulder. MR arthrography provides pertinent preoperative information with regard to the exact location of tears and grade of involvement of the biceps tendon.
Index terms: Shoulder, abnormalities, 41.4819 • Shoulder, injuries, 41.4819 • Shoulder, MR, 41.121411, 41.121415, 41.121416, 41.122
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