The Diagnostic Valuation Of MRI And MR Arthrography In The Rotator Cuff Injuries

Objective: Conduct MR Arthrography for the first time in our hospital. Analyze the characteristics of the MRI and MRar performance ,and evaluate the diagnostic valuation of MRI and MRar in the rotator cuff injuries.Methods: Since July 2006 to December 2007, 106 cases of shoulder pain that suspected rotator cuff injury patients received MRI examination, 55 cases subsequently accepted MRar examination, which, 20 patients received arthroscopic diagnosis and treatment.Reference to clinical features , arthroscopic diagnosic results as the gold standard for diagnosis. Has not been invited arthroscopic examination has extensive experience in two MRI diagnostic doctors conducting separate analysis, diagnosis. diagnostic inconsistencies resolved through consultations, and reached the final diagnostic results. Comparison the diagnostic valuation of MRI and MRar in the rotator cuff injuries.Result: 20 patients Arthroscopic diagnosed, full-thickness rotator cuff tear 5 cases, MRI accurately diagnosed 3 cases, MRar accurately diagnosed 5 cases; partial-thickness rotator cuff tear 12 cases, accurately diagnosed of 7 cases of MRI, MRar accurately diagnosed 12 cases; rotator cuff degeneration 3 cases, 1 case of MRI accurately diagnosed, MRar accurately diagnosed 3 cases; labrum injury with rotator cuff injury 6 cases, MRI accurately diagnosed 3 cases, MR accurately diagnosed 6 cases.Based on the above study, all cases accepted MRI and MRar, the results of the analysis are as follows checks:1 Full-thickness rotator cuff tear in 11 cases: conventional MRI accurately diagnosed 7 cases ,of the other 4 cases diagnosed as partial-thickness tear. Among them, 5 cases of the Arthroscopic confirmed,6 cases were diagnosed by the MRar (The tendon runs through the whole of contrast material, at the same time, extravasation of contrast material into the subacromial bursa).2 Partial-thickness rotator cuff tear of the 36 cases: conventional MRI accurately diagnosed 20 cases,of the other 16 cases, 6 cases for the diagnosis of full-thickness tear, 10 cases diagnosed as rotator cuff degeneration. 12 cases confirmed by Arthroscopic, 24 cases were diagnosed by MRar (Articular surface rotator cuff side irregular contrast, the accumulation of abnormal or contrast material extending into the articular surface of the supraspinatus,but not throughout the whole of the tendon, subacromial bursa without contrast material filling).3 Rotator cuff degeneration 8 cases: conventional MRI accurately diagnosed 4 cases, of the other 4 cases diagnosed as partial-thickness tear. After Arthroscopic 3 cases confirmed,5 cases diagnosed by the MRar (Articular surface rotator cuff side contrast material smooth, continuous, subacromial bursa without contrast material filling).4 Rotator cuff injury with labrum injury: a total of 16 cases, conventional MRI accurately diagnosed 8 cases, 6 cases of suspected labrum injury, 2 cases misdiagnosed as normal labrum. Arthroscopic 6 cases confirmed, 10 cases were diagnosed by MRar (Labrum irregular shape, line in the foreseeable contrast material filling).5 Supraspinatus tendon calcification in 3 cases: 3 cases of the X-ray examination obtain accurately diagnosed. 1 case conventional MRI can not be accurately diagnosed. 2 cases conventional MRI and MRar also failed to provide an accurately diagnosis.Conclusion: 1 Full-thickness rotator cuff tear, conventional MRI is more accurate diagnostic methods, and the MRar is a more accurate method.2 Partial-thickness rotator cuff tear ,conventional MRI is not a high diagnostic methods, MRar is a reliable method.3 Rotator cuff degeneration, MRI is not a highly diagnostic method, while MRar is a reliable methods.4 Acute Bankart lesion, MRI is a higher diagnostic method, chronic lesion, diagnostic accuracy is not high, and MRar for both acute and chronic Bankart lesion has a higher diagnostic accuracy.5 Hill-Sachs lesion, MRI can be very good, and often accompanies with Bankart lesion, MRar is a useful supplement to the diagnosis. 6 SLAP lesion, not high diagnostic accuracy of MRI, MRar higher diagnostic accuracy.7 Rotator cuff calcification, ordinary X-ray examination can be very good, MRI and MRar not sensitive to the tendon calcification, and it do not need to conduct MRI and MRar pections.