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European Radiology
Published in: European Radiology 3/2017

01-03-2017 | Musculoskeletal

Diagnostic performance of susceptibility-weighted magnetic resonance imaging for the assessment of sub-coracoacromial spurs causing subacromial impingement syndrome

Authors: Dominik Nörenberg, Marco Armbruster, Yi-Na Bender, Thula Walter, Hans U. Ebersberger, Gerd Diederichs, Bernd Hamm, Ben Ockert, Marcus R. Makowski

Published in: European Radiology | Issue 3/2017

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Abstract

Objectives

To evaluate the potential of susceptibility-weighted-magnetic-resonance-imaging (SWMR) for the detection of sub-coracoacromial spurs in patients with clinically suspected subacromial impingement syndrome (SAIS), compared to standard MR-sequences and radiographs.

Methods

Forty-four patients with suspected SAIS were included. All patients underwent radiography, standard MRI of the shoulder and SWMR. Radiograph-based identification of sub-coracoacromial spurs served as goldstandard. Radiographs identified twenty-three spurs in twenty-three patients. Twenty-one patients without spur formation served as reference group. Detection rate, sensitivity/specificity and interobserver-agreements were calculated. Linear regression was applied to determine the relationship between size measurements on radiographs and MRI.

Results

Detection rates for spurs on standard MRI and SWMR were 47.8 % and 91.3 % compared to radiography (p<0.001). SWMR demonstrated a sensitivity of 97.7 % (CI=0.92-1) and a specificity of 91.3 % (CI=0.788-1) for the identification of spurs. Standard MR-sequences achieved a sensitivity of 47.8 % (CI=0.185-0.775) and a specificity of 80.8 % (CI=0.642-0.978). Size measurements between SWMR and radiography showed a good correlation (R2=0.75;p<0.0001), while overestimating lesion size (5.7±1.2 mm; 4.3±1.3 mm;p<0.0001). Interobserver-agreement for spurs was high on SWMR (R2=0.74;p<0.0001), but low on standard MRI (R2=0.24;p<0.0001).

Conclusions

SWMR allows a reliable detection of sub-coracoacromial spur formation in patients with SAIS and is superior to standard MR-sequences using radiography as goldstandard.

Key Points

• SWMR has the potential to reliably identify sub-coracoacromial spurs without radiation exposure.
• SWMR provides comparable detection rates to conventional radiography for sub-coracoacromial spur formation.
• SWMR yields higher detection rates compared to standard-MR regarding sub-coracoacromial spur formation.
• SWMR can be implemented in routine shoulder MRI protocols.
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Metadata
Title
Diagnostic performance of susceptibility-weighted magnetic resonance imaging for the assessment of sub-coracoacromial spurs causing subacromial impingement syndrome
Authors
Dominik Nörenberg
Marco Armbruster
Yi-Na Bender
Thula Walter
Hans U. Ebersberger
Gerd Diederichs
Bernd Hamm
Ben Ockert
Marcus R. Makowski
Publication date
01-03-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 3/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4441-0

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