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Musculoskeletal Imaging |
1 From the Departments of Diagnostic Radiology (W.H.J., T.R.M., L.D.K.) and Orthopedic Surgery (L.D.K., J.M.M., P.A.R., J.P.D.), Yale University School of Medicine, 333 Cedar St, Rm MRC 147, New Haven, CT 06520. Received February 23, 2000; revision requested April 8; revision received May 17; accepted June 28. Address correspondence to T.R.M. (e-mail: mccauley@biomed.med.yale.edu).
PURPOSE: To determine the reliability and accuracy of magnetic resonance (MR) arthrography for the diagnosis of superior labral anterior posterior (SLAP) tears.
MATERIALS AND METHODS: The MR arthrograms in 80 patients who underwent arthroscopy and MR arthrography during a 54-month period were retrospectively reviewed. MR arthrograms were independently scored by three observers for the presence and type of SLAP lesion. Type I SLAP lesions were regarded as negative as they most often are not clinically relevant. Interobserver agreement for detection of SLAP lesions was calculated by using 
coefficients. The differences in areas under the receiver operating characteristic (ROC) curves were assessed with a univariate z score test.
RESULTS: At arthroscopy, there were 25 SLAP tears: type II (n = 22), type III (n = 2), and type IV (n = 1). Sensitivity, specificity, and accuracy of each reader were 92%, 84%, and 86%; 92%, 82%, and 85%; and 84%, 69%, and 74%, respectively. Interobserver agreement for SLAP tears was substantial ( = 0.77) to moderate ( = 0.52, = 0.44). The areas under the ROC curves for each reader were 0.94, 0.93, and 0.83, which were not significantly different.
CONCLUSION: MR arthrography of the shoulder is reliable and accurate for detection of SLAP tears.
Index terms: Magnetic resonance (MR), arthrography, 414.121415, 414.12143 • Shoulder, arthrography, 414.121415, 414.12143 • Shoulder, injuries, 414.4819 • Shoulder, MR, 414.121415, 414.12143
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