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European Radiology

Published in:

01-02-2013 | Musculoskeletal

SLAP tears: diagnosis using 3-T shoulder MR arthrography with the 3D isotropic turbo spin-echo space sequence versus conventional 2D sequences

Authors: Joon-Yong Jung, Won-Hee Jee, Michael Yong Park, So-Yeon Lee, Yang-Soo Kim

Published in: European Radiology | Issue 2/2013

Abstract

Objectives

The aim of this study was to determine the accuracy and reliability of shoulder magnetic resonance (MR) arthrography with three-dimensional (3D) isotropic intermediate-weighted turbo spin-echo (TSE) sampling perfection with application-optimised contrasts using different flip angle evolution (SPACE) in the diagnosis of superior labrum anterior-to-posterior (SLAP) lesions compared with two-dimensional (2D) TSE at 3.0 T.

Methods

MR arthrograms, including 2D TSE and 3D TSE-SPACE, in 87 patients who underwent arthroscopy were retrospectively analysed by two reviewers for the presence and type of SLAP lesions. Sensitivity and specificity were compared using McNemar’s test, and inter-observer agreement was calculated using Cohen’s kappa. Receiver operating characteristic (ROC) curve analyses were performed.

Results

The mean sensitivity, specificity and accuracy were 90%, 85% and 86% for 2D TSE, and 81%, 86% and 85% for 3D TSE-SPACE respectively, with no statistically significant differences. Inter-observer agreements were substantial in 2D TSE (κ = 0.76) and 3D TSE-SPACE (κ = 0.68). The areas under the ROC curves were 0.92 for 2D TSE and 0.90 for 3D TSE-SPACE, which were not significantly different.

Conclusions

MR arthrography with 3D TSE-SPACE showed comparable accuracy and substantial inter-observer agreement for the diagnosis of SLAP lesions

Key Points

• MR arthrography is regarded as the definitive method of shoulder imaging

• Different MR sequences are evolving for SLAP lesions

• 3D TSE-SPACE demonstrated comparable overall accuracy to 2D TSE for SLAP lesions

• But more false-negative interpretations occurred using 3D TSE-SPACE

• Further technical improvement is necessary before 3D TSE-SPACE replaces 2D TSE sequences

Bencardino JT, Beltran J, Rosenberg ZS et al (2000) Superior labrum anterior-posterior lesions: diagnosis with MR arthrography of the shoulder. Radiology 214:267–271PubMed

Jee WH, McCauley TR, Katz LD et al (2001) Superior labral anterior posterior (SLAP) lesions of the glenoid labrum: reliability and accuracy of MR arthrography for diagnosis. Radiology 218:127–132PubMed

Waldt S, Burkart A, Lange P et al (2004) Diagnostic performance of MR arthrography in the assessment of superior labral anteroposterior lesions of the shoulder. AJR Am J Roentgenol 182:1271–1278PubMed

Magee T (2007) Can isotropic fast gradient echo imaging be substituted for conventional T1 weighted sequences in shoulder MR arthrography at 3 Tesla? J Magn Reson Imaging 26:118–122PubMedCrossRef

Lee MJ, Motamedi K, Chow K, Seeger LL (2008) Gradient-recalled echo sequences in direct shoulder MR arthrography for evaluating the labrum. Skeletal Radiol 37:19–25PubMedCrossRef

Dietrich TJ, Zanetti M, Saupe N et al (2010) Articular cartilage and labral lesions of the glenohumeral joint: diagnostic performance of 3D water-excitation true FISP MR arthrography. Skeletal Radiol 39:473–480PubMedCrossRef

Gold GE, Busse RF, Beehler C et al (2007) Isotropic MRI of the knee with 3D fast spin-echo extended echo-train acquisition (XETA): initial experience. AJR Am J Roentgenol 188:1287–1293PubMedCrossRef

Busse RF, Brau AC, Vu A et al (2008) Effects of refocusing flip angle modulation and view ordering in 3D fast spin echo. Magn Reson Med 60:640–649PubMedCrossRef

Notohamiprodjo M, Horng A, Pietschmann MF et al (2009) MRI of the knee at 3 T: first clinical results with an isotropic PDfs-weighted 3D-TSE-sequence. Invest Radiol 44:585–597PubMedCrossRef

10.

Snyder SJ, Karzel RP, Del Pizzo W et al (1990) SLAP lesions of the shoulder. Arthroscopy 6:274–279PubMedCrossRef

11.

Smith DK, Chopp TM, Aufdemorte TB, Witkowski EG, Jones RC (1996) Sublabral recess of the superior glenoid labrum: study of cadavers with conventional nonenhanced MR imaging, MR arthrography, anatomic dissection, and limited histologic examination. Radiology 201:251–256PubMed

12.

Tuite MJ, Cirillo RL, De Smet AA, Orwin JF (2000) Superior labrum anterior-posterior (SLAP) tears: evaluation of three MR signs on T2-weighted images. Radiology 215:841–845PubMed

13.

Holzapfel K, Waldt S, Bruegel M et al (2010) Inter- and intraobserver variability of MR arthrography in the detection and classification of superior labral anterior posterior (SLAP) lesions: evaluation in 78 cases with arthroscopic correlation. Eur Radiol 20:666–673PubMedCrossRef

14.

Tuite MJ, Rutkowski A, Enright T, Kaplan L, Fine JP, Orwin J (2005) Width of high signal and extension posterior to biceps tendon as signs of superior labrum anterior to posterior tears on MRI and MR arthrography. AJR Am J Roentgenol 185:1422–1428PubMedCrossRef

15.

Waldt S, Metz S, Burkart A et al (2006) Variants of the superior labrum and labro-bicipital complex: a comparative study of shoulder specimens using MR arthrography, multi-slice CT arthrography and anatomical dissection. Eur Radiol 16:451–458PubMedCrossRef

16.

Maffet MW, Gartsman GM, Moseley B (1995) Superior labrum-biceps tendon complex lesions of the shoulder. Am J Sports Med 23:93–98PubMedCrossRef

17.

Mohana-Borges AV, Chung CB, Resnick D (2003) Superior labral anteroposterior tear: classification and diagnosis on MRI and MR arthrography. AJR Am J Roentgenol 181:1449–1462PubMed

18.

Handelberg F, Willems S, Shahabpour M, Huskin JP, Kuta J (1998) SLAP lesions: a retrospective multicenter study. Arthroscopy 14:856–862PubMedCrossRef

19.

DeLong ER, DeLong DM, Clarke-Pearson DL (1998) Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 44:837–845CrossRef

20.

Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174PubMedCrossRef

21.

Ristow O, Steinbach L, Sabo G et al (2009) Isotropic 3D fast spin-echo imaging versus standard 2D imaging at 3.0 T of the knee—image quality and diagnostic performance. Eur Radiol 19:1263–1272PubMedCrossRef

22.

Kijowski R, Davis KW, Woods MA et al (2009) Knee joint: comprehensive assessment with 3D isotropic resolution fast spin-echo MR imaging—diagnostic performance compared with that of conventional MR imaging at 3.0 T. Radiology 252:486–495PubMedCrossRef

23.

Jung JY, Yoon YC, Kwon JW, Ahn JH, Choe BK (2009) Diagnosis of internal derangement of the knee at 3.0-T MR imaging: 3D isotropic intermediate-weighted versus 2D sequences. Radiology 253:780–787PubMedCrossRef

24.

Jung JY, Yoon YC, Choi SH et al (2009) Three-dimensional isotropic shoulder MR arthrography: comparison with two-dimensional MR arthrography for the diagnosis of labral lesions at 3.0 T. Radiology 250:498–505PubMedCrossRef

25.

McCauley TR, Pope CF, Jokl P (1992) Normal and abnormal glenoid labrum: assessment with multiplanar gradient-echo MR imaging. Radiology 183:35–37PubMed

26.

Choo HJ, Lee SJ, Kim OH, Seo SS, Kim JH (2012) Comparison of three-dimensional Isotropic T1-weighted fast spin-echo MR arthrography with two-dimensional MR arthrography of the shoulder. Radiology 262:921–931PubMedCrossRef

27.

Stevens KJ, Busse RF, Han E et al (2008) Ankle: isotropic MR imaging with 3D-FSE-cube–initial experience in healthy volunteers. Radiology 249:1026–1033PubMedCrossRef

28.

Busse RF, Hariharan H, Vu A et al (2006) Fast spin echo sequences with very long echo trains: design of variable refocusing flip angle schedules and generation of clinical T2 contrast. Magn Reson Med 55:1030–1037PubMedCrossRef

29.

Gobezie R, Warner JJP (2007) SLAP lesions: what is it…really? Skeletal Radiol 36:379PubMedCrossRef

Title: SLAP tears: diagnosis using 3-T shoulder MR arthrography with the 3D isotropic turbo spin-echo space sequence versus conventional 2D sequences
Authors: Joon-Yong Jung
Won-Hee Jee
Michael Yong Park
So-Yeon Lee
Yang-Soo Kim
Publication date: 01-02-2013
Publisher: Springer-Verlag
Published in: European Radiology / Issue 2/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-012-2599-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

SLAP tears: diagnosis using 3-T shoulder MR arthrography with the 3D isotropic turbo spin-echo space sequence versus conventional 2D sequences

Abstract

Objectives

Methods

Results

Conclusions

Key Points

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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