Magnetic resonance imaging of the glenoid labrum

Abstract

Shoulder complaints are common in the athletic population. Successful treatment is dependent upon the ability to correctly identify the pathologic changes associated with a specific disorder and arrive at an accurate diagnosis. Labral abnormalities are traditionally associated with glenohumeral instability. Isolated labral tears or degenerative changes may also cause shoulder dysfunction. A reliable clinical tool to assess the status of the labrum would be useful for diagnosis and management of shoulder disorders. The magnetic resonance images of 48 shoulders that had subsequent surgical examination of their labra were reviewed with respect to labral appearance. Labra appearing as abnormal were further classified as torn, degenerative, or eroded. Surgical examination was used as the reference standard. Magnetic resonance imaging demonstrated high levels of sensitivity, specificity, positive and negative predictive values, and accuracy for evaluation of the glenoid labrum. Magnetic resonance imaging is a reliable and accurate method for depicting the status of the glenoid labrum. Magnetic resonance imaging appearance of the labrum may assist the clinician in distinguishing the varying forms of shoulder dysfunction and facilitate diagnosis and effective treatment.

Three-dimensional MRI of the glenoid labrum

“…Identification of these findings was generally not significantly different whether 3D or 2D GRE imaging was used. Although they were not objective criteria indicating definite GLC pathology in our study, these findings have proven to be helpful in corroborating the diagnosis of labral injury [11][12][13].…”

“…An advantage of MRI is that the GLC can also be evaluated. The standard MRI survey of the GLC usually employs 2D imaging with axial gradient-echo or T2-weighted sequences [12][13][14][15].…”

“…They also demonstrated a wide range of variability of both morphology and signal characteristics in normal labra. Others such as Gross et al [13] have subclassified signal changes within the labrum as indicating normal, frankly torn, degenerative, or eroded types. Our definitions for evaluating labral tears involved both of these methods of classification to some extent.…”

Shoulder MRI accuracy in the community setting

“…Regarding the glenoid labrum, the sensitivities, specificities, and accuracies noted for MRI studies of surgically confirmed glenoid labral tears has varied widely in the literature (59-88%, 58-100%, 33-87%, respectively). 1,3,4,[7][8][9][10]15,17,18,24,29,31 The addition of contrast in MR evaluation of these injuries has traditionally slightly improved the accuracies in these studies (79-89%). We evaluated sensitivities, specificities, and accuracies for superior, anterior, and posterior labral tears, and found that the accuracies of the radiologists in our community setting were consistent with historical values cited.…”

Sensitivity of Preoperative Magnetic Resonance Imaging and Magnetic Resonance Arthrography in Detection of Panlabral Tears of the Glenohumeral Joint

“…[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Sensitivities and specificities have been reported at greater than 90% in certain studies in detecting unidirectional tears of the glenoid labrum on noncontrast MRI, and even higher values have been reported with MR arthrography. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Little has been written, however, regarding the use and accuracy of MRI in identifying labral tears involving more than 1 location of the glenoid. 1,4 The purpose of this study was to evaluate the sensitivity of preoperative MRI, including both noncontrast MRI and MR arthrography, in detecting combined lesions of the anterior, posterior, and superior glenoid labrum.…”