The ability to detect and categorize SLAP (Superior Labrum Anterior to Posterior) lesions of the scapular labrum is of practical importance to the orthopedic surgeon and the radiologist. The aim of this study, performed on cadaveric shoulders, was to determine whether CT arthrography or MR arthrography is able to show normal anatomical variation of the glenoid labrum and detect labral abnormalities. CT arthrography, MR arthrography followed by anatomical dissection were performed on twenty three fresh frozen cadaveric shoulders and analysed by a radiologist and two orthopaedic surgeons. As Gadolinium intra-articular injection is not allowed in France, we used an iodinated contrast media for both MR arthrography and CT arthrography. In this study, the sensitivity of MR arthrography seemed higher than CT arthrography (respectively 4 and 3 labral lesions diagnosed out of five), although no significant statistical conclusions can be made due to the small number of cases. In conclusion, under such specific conditions, MR arthrography seems to be the method of choice for the detection and classification of labral lesions.

The overall quality of delayed images was significantly better with iodixanol than with iohexol.

Direct coronal oblique views of the shoulder were obtained with arthrographic computed tomography (CT) in 35 shoulders with surgical correlation. There were 18 complete cuff tears, four partial ones, two type 3 superior labral, anterior, and posterior (SLAP) lesions, and one type 4 SLAP lesion. The coronal sections were obtained after double-contrast shoulder arthrography and axial CT sections had already been obtained. The patient was seated directly on the slope of the gantry, and the shoulder to be studied was positioned in the center of the gantry. The maximal time needed for this procedure was 5 minutes. Rotator cuff tears were detected with a sensitivity of 95% and a specificity of 100%. The size of the tears as determined on the coronal sections was strongly correlated with surgical measurement (r = .939). All SLAP lesions were detected. The authors' experience shows that obtaining coronal oblique sections is an effective way to improve arthrographic CT.

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Association des géographes de l'Est