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Published in: European Radiology 10/2014

01-10-2014 | Musculoskeletal

Extra-articular contrast material leaks into locations unrelated to the injection path in shoulder MR arthrography

Authors: Hayri Ogul, Mecit Kantarci, Murat Topal, Leyla Karaca, Kutsi Tuncer, Berhan Pirimoglu, Aylin Okur, Omer Selim Yildirim, Akin Levent

Published in: European Radiology | Issue 10/2014

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Abstract

Objectives

To evaluate the localisation, frequency and amount of extravasation in patients with extra-articular contrast material leak into locations unrelated to the injection path in shoulder magnetic resonance (MR) arthrography and associated shoulder disorders.

Methods

The sites of extravasation were determined on the shoulder MR arthrography of 40 patients. The extravasations were measured on three vertical planes of the MR arthrography. Sufficient joint distension was assessed according to the transverse diameters of the axillary recess on coronal MR images.

Results

Extravasation of the contrast material occurred through the subscapular recess, the synovium of the biceps, and the axillary recess. In four cases, extravasations were observed in more than one anatomic location. The most common site of extravasation was along the subscapularis muscle. Superior labrum anterior-posterior (SLAP) lesions were found to be most frequently associated with extravasations. The amount of extravasation was significantly higher in patients with adhesive capsulitis compared with the patients with a different diagnosis (p = 0.022).

Conclusions

The extravasations adjacent to the axillary recess do not always indicate glenohumeral ligament pathology. Massive subscapular extravasations were most frequently associated with adhesive capsulitis and SLAP lesions, and might be considered in the MR arthrography report.

Key Points

Contrast material extravasation may reduce the diagnostic value of shoulder MR arthrography.
The extravasations may occur into locations unrelated to the injection path.
The extravasations adjacent to axillary recess can be misleading for HAGL lesion.
Massive subscapular extravasations were frequently associated with adhesive capsulitis and SLAP lesions.
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Metadata
Title
Extra-articular contrast material leaks into locations unrelated to the injection path in shoulder MR arthrography
Authors
Hayri Ogul
Mecit Kantarci
Murat Topal
Leyla Karaca
Kutsi Tuncer
Berhan Pirimoglu
Aylin Okur
Omer Selim Yildirim
Akin Levent
Publication date
01-10-2014
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 10/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3270-2

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