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Skeletal Radiology
Published in: Skeletal Radiology 1/2017

01-01-2017 | Scientific Article

Freehand direct arthrography of the shoulder using near real-time guidance in an open 1.0-T MRI scanner

Authors: Christian Wybranski, Ilya Adamchic, Friedrich-Wilhelm Röhl, Jens Ricke, Frank Fischbach, Katharina Fischbach

Published in: Skeletal Radiology | Issue 1/2017

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Abstract

Objective

To assess the technical success and duration of magnetic resonance imaging (MRI)-guided freehand direct shoulder arthrography (FDSA) with near real-time imaging implemented in a routine shoulder MRI examination on an open 1.0-T MRI scanner, and to assess the learning curve of residents new to this technique.

Methods

An experienced MRI interventionalist (the expert) performed 125 MRI-guided FDSA procedures, and 75 patients were treated by one of three residents without previous experience in MRI-guided FDSA. Technical success rate and duration of MRI-guided FDSA of the expert and the residents were compared. The residents’ learning curves were assessed. The occurrence of extra-articular deposition and leakage of contrast media from the puncture site and the subsequent impairment of image interpretation were retrospectively analyzed.

Results

Overall technical success was 97.5 %. The expert needed overall fewer puncture needle readjustments and was faster at puncture needle positioning (p < 0.01). The learning curve of the residents, however, was steep. They leveled with the performance of the expert after ≈ 15 interventions. With a minimal amount of training all steps of MRI-guided FDSA can be performed in ≤10 min.

Conclusion

Magnetic resonance-guided FDSA in an open 1.0-T MRI scanner can be performed with high technical success in a reasonably short amount of time. Only a short learning curve is necessary to achieve expert level.
Appendix
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Metadata
Title
Freehand direct arthrography of the shoulder using near real-time guidance in an open 1.0-T MRI scanner
Authors
Christian Wybranski
Ilya Adamchic
Friedrich-Wilhelm Röhl
Jens Ricke
Frank Fischbach
Katharina Fischbach
Publication date
01-01-2017
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 1/2017
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-016-2507-3

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