Correlation between MRI and Arthroscopy in Diagnosis of Shoulder Pathology

Bhatnagar, Abhinav; Bhonsle, Sachin; Mehta, Sandeep

doi:10.7860/jcdr/2016/14867.7309

Cited by 24 publications

(26 citation statements)

References 31 publications

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“…Our primary analysis suggests that direct MR arthrography is more accurate than nonenhanced MR imaging for the diagnosis of a SLAP tear, for MR arthrography and 79% for MR imaging. Although we found a similar sensitivity for MR arthrography, we found a substantially lower sensitivity for MR imaging (63% vs 79%), likely secondary to the inclusion of a number of MR imaging studies (8) that were published after the time frame used by Smith et al (ie, after January 1, 2011) (6,8,10,24,30,34,37,38). We suspect the superior sensitivity of direct MR arthrography is attributable to joint distention and imbibition of contrast agent into the edges of nondisplaced tears that would otherwise remain tightly coapted at examinations that were not arthrographic (5).…”

Section: Discussionmentioning

confidence: 49%

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Diagnosis of Superior Labrum Anterior-to-Posterior Tears by Using MR Imaging and MR Arthrography: A Systematic Review and Meta-Analysis

et al. 2017

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Purpose To evaluate the diagnostic accuracies of nonenhanced magnetic resonance (MR) imaging and MR arthrography for diagnosis of superior labrum anterior-to-posterior (SLAP) tears by using a systematic review and meta-analysis. Materials and Methods A comprehensive literature search was performed on the two main concepts of MR imaging (MR imaging, and direct and indirect MR arthrography) and SLAP tears. Inclusion criteria consisted of original studies that assessed the diagnostic accuracy of MR imaging, direct MR arthrography, and/or indirect MR arthrography for the detection of SLAP tears, by using surgical findings as the reference standard. The Quality Assessment of Diagnostic Accuracy Studies 2, or QUADAS-2 Quality Assessment of Diagnostic Accuracy Studies 2 Quality Assessment of Diagnostic Accuracy Studies 2 , tool was used to assess methodologic quality. Meta-analyses were performed that compared MR imaging studies to direct MR arthrography studies and indirect MR arthrography studies, 3-T studies to 1.5-T studies, and low-bias MR imaging studies to low-bias direct MR arthrography studies. Study variation was analyzed by using the Cochran Q test of heterogeneity and the I statistic. Results Thirty-two studies met inclusion and exclusion criteria, including 3524 imaging examinations: 1963 direct MR arthrography examinations (23 studies), 1402 MR examinations (14 studies), and 159 indirect MR arthrography examinations (three studies). Twelve studies had low risk for bias, two had questionable risk, and 18 had high risk. Mean sensitivities of direct MR arthrography, MR imaging, and indirect MR arthrography for SLAP tear diagnosis were 80.4%, 63.0%, and 74.2%, respectively. Mean specificities of direct MR arthrography, MR imaging, and indirect MR arthrography were 90.7%, 87.2%, and 66.5%, respectively. Summary receiver operator characteristic (ROC) curve demonstrated superior accuracy of direct MR arthrography compared with those of MR imaging and indirect MR arthrography. Similar findings were observed in the low-bias subanalysis. Summary ROC curve demonstrated overall superiority of 3-T imaging, with or without intra-articular contrast material compared with 1.5-T imaging, with or without intra-articular contrast material. Significant variance was observed for MR imaging and direct MR arthrography (P < .001) studies for both mean sensitivity and specificity. Conclusion Direct MR arthrography appears to be more accurate than nonenhanced MR imaging for diagnosis of SLAP tears, whereas 3-T MR imaging with or without intra-articular contrast material appears to improve diagnostic accuracy compared with 1.5-T MR imaging with or without intra-articular contrast material. RSNA, 2017 Online supplemental material is available for this article.

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Section: Discussionmentioning

confidence: 49%

“…For sensitivity, the percentage of total variation across the studies in the MR imaging and direct MR arthrography cohorts because of real heterogeneity (I 2 ) measured 94.4 and 67, respectively. reader was not reported in one study (37).…”

Section: Meta-analysismentioning

confidence: 87%

Diagnosis of Superior Labrum Anterior-to-Posterior Tears by Using MR Imaging and MR Arthrography: A Systematic Review and Meta-Analysis

et al. 2017

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“…1). When comparing MRI results to arthroscopy for diagnosis of shoulder pathologies, Bhatnagar et al found MRI to be least reliable (kappa 0.7) in the diagnosis of SLAP lesions compared to its ability to diagnose other intra-articular pathologies such as osteochondral lesions, rotator cuff tears, and Bankart lesions [31]. Taylor et al described the inability of MRI to completely evaluate the proximal LHBT.…”

Section: Imaging Studiesmentioning

confidence: 99%

Diagnosis and Treatment of Injuries to the Biceps and Superior Labral Complex in Overhead Athletes

Calcei

Boddapati

Altchek

et al. 2018

Curr Rev Musculoskelet Med

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A focused patient history, numerous physical examination maneuvers, and appropriate advanced imaging studies must be utilized to reach an accurate diagnosis. Nonoperative management, even in overhead athletes, has demonstrated relatively good outcomes, while operative outcomes have yielded mixed results. The surgeon must take into account a number of variables when choosing the appropriate surgical procedure: labral repair versus biceps tenodesis. Rehabilitation, either as nonoperative management or as a postoperative protocol, should focus on restoring glenohumeral and scapulothoracic strength, endurance, and full, pain-free range of motion, while correcting any deficiencies in balance or rhythm throughout the overhead motion. Despite the operative treatment challenges that SLAP tears present, with new techniques and proper patient selection, overhead athletes with injuries to the biceps and superior labrum complex can return to sport at a high level.

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“…4 La IRM parece ser el estudio ideal para evaluar la patología del MR, específicamente la ruptura del tendón músculo supraespinoso, ya que ha demostrado tener una sensibilidad (90-95%) y especificidad (85-90%) alta, con una adecuada relación costo-efectividad, no emite radiación y no es invasivo. 5,6,7 Provee información sobre la extensión, el tamaño, la retracción y la configuración de la ruptura del tendón e identifica si la ruptura es parcial o completa. 4,8 A pesar de lo anterior, en ocasiones nos encontramos con rupturas que pasaron inadvertidas en la imagen o bien se sobrediagnostica la ruptura del tendón del músculo supraespinoso, ambas situaciones producen una alteración del plan quirúrgico.…”

Section: Introductionunclassified

Rupturas del tendón del supraespinoso: correlación entre RMN y hallazgos quirúrgicos

Valero-González¹,

Mejía-Terrazas²,

Encalada-Díaz³

et al. 2020

Acta Ortopédica Mexicana

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En la ruptura del manguito de los rotadores, el tendón del supraespinoso ocupa el primer lugar en frecuencia. La resonancia magnética es el estudio de elección para el diagnóstico y planificación preoperatoria. El objetivo de este estudio fue evaluar la concordancia entre los hallazgos observados con la IRM y los hallazgos transoperatorios en pacientes con ruptura del tendón del supraespinoso. Material y métodos: Se realizó un análisis retrospectivo de Enero de 2014 a Enero de 2020. Se incluyeron pacientes mayores de 18 años, con IRM y reporte de ruptura del tendón del supraespinoso. Se realizó un análisis de χ 2 para la sensibilidad, especificidad, valores predictivos y certeza diagnóstica utilizando los hallazgos quirúrgicos como referencia. Se utilizó el índice de Kappa para mostrar la concordancia entre IRM y hallazgos transoperatorios. Resultados: Un total de 79 pacientes se incluyeron en el estudio, 45 masculinos y 34 femeninos. La edad promedio fue de 52.14 años. La IRM diagnosticó correctamente 60.76% de las rupturas del supraespinoso, mostró una sensibilidad de 74% y especificidad de 96% para rupturas completas. Para rupturas parciales mostró una sensibilidad de 96% y una especificidad de 33%. El índice de Kappa mostró una concordancia de 0.90 para rupturas totales y de 0.53 para rupturas parciales. Conclusiones: La resonancia magnéti-ABSTRACT. Introduction: In rotator cuff rupture, the supraspinatus tendon ranks first in frequency. MRI is the study of choice for preoperative diagnosis and planning. The objective of this study was to assess the concordance between findings observed with MRI and transoperative in patients with supraspinatus tendon rupture. Material and methods: A retrospective analysis was conducted from January 2014 to January 2020. Including patients over the age of 18, with MRI and supraspinatus tendon rupture report. A χ 2 analysis was performed for sensitivity, specificity, predictive values and diagnostic certainty using surgical findings as a reference. The kappa index was used to show the concordance between MRI and transoperative findings. Results: A total of 79 patients were included in the study, 45 male and 34 female. The average age was 52.14 years. MRI correctly diagnosed 60.76% of supraspinatus ruptures, showing 74% sensitivity and 96% specificity for complete ruptures. For partial ruptures I show a sensitivity of 96%, a specificity of 33%. The kappa index showed a match of 0.90 for total ruptures and 0.53 for partial. Conclusions: MRI demonstrated good sensitivity and specificity for diagnosing complete ruptures, with good match to surgical findings. MRI proved to be a non-

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Correlation between MRI and Arthroscopy in Diagnosis of Shoulder Pathology

Cited by 24 publications

References 31 publications

Diagnosis of Superior Labrum Anterior-to-Posterior Tears by Using MR Imaging and MR Arthrography: A Systematic Review and Meta-Analysis

Diagnosis of Superior Labrum Anterior-to-Posterior Tears by Using MR Imaging and MR Arthrography: A Systematic Review and Meta-Analysis

Diagnosis and Treatment of Injuries to the Biceps and Superior Labral Complex in Overhead Athletes

Rupturas del tendón del supraespinoso: correlación entre RMN y hallazgos quirúrgicos

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