Three-dimensional MRI of the glenoid labrum

Abstract

The objective of this study was to assess the accuracy of three-dimensional (3D) magnetic resonance imaging (MRI) reformation in the evaluation of tears of the glenoid labrum complex (GLC). Fifty-five shoulders were evaluated by MRI using standard spin-echo sequences. Gradient-refocused-echo axial projections were used to assess the GLC on the two-dimensional (2D) studies. Three-dimensional Fourier transform multiplanar gradient-recalled imaging with a resolution of 0.7 mm was also performed in all patients. Independent analyses of the anterior and posterior labra were performed in a blinded manner for both the 2D and 3D studies by three experienced musculoskeletal radiologists. Observations of the imaging studies were compared with the videoarthroscopic findings. The appearance of the GLC was rated on a scale of 0 to 4 (0-2 = normal, 3, 4 = abnormal or torn). The diagnostic confidence was averaged from the three reader's scores. Anterior labral tears were effectively detected with sensitivities of 89% and 96% and specificities of 96% and 100% (P < 0.0001) for the 2D and 3D studies, respectively. For posterior labral tears, the sensitivity and specificity of the 2D method were 47% and 98%, respectively. The sensitivity and specificity of the 3D volume sequence were 53% and 98%, respectively. The lower sensitivity of both imaging methods for detecting posterior labral tears may be influenced by the smaller number (n = 5) of arthroscopically confirmed cases in our study and reflects the difficulty of visualizing the posteroinferior borders of the GLC with present MRI techniques.

Shoulder Instability: Interobserver and Intraobserver Agreement in the Assessment of Labral Tears

“…16 Arthroscopic surgery is routinely used as a diagnostic tool and has been considered the gold standard for the diagnosis of shoulder lesions in previous studies evaluating the diagnostic ability of different imaging techniques. 5,6,[8][9][10]12,13 However, studies evaluating shoulder arthroscopic surgery as a diagnostic tool have demonstrated variability in intraobserver and interobserver agreement when surgeons are describing and characterizing intra-articular structures. 4,11,14,17 To our knowledge, only 1 study has evaluated this specifically for patients with shoulder instability, and that study only evaluated interobserver variability, 14 while 2 other studies have evaluated patients specifically related to superior labrum anterior posterior (SLAP) lesions.…”

Glenoid Labral Repair in Major League Baseball Pitchers

“…The glenoid labrum is a fi brocartilaginous structure around the glenoid rim that deepens the glenoid fossa, increases glenoid surface area, and serves as an anchoring structure for the glenohumeral ligaments and the long head of the biceps tendon [4,9,12,15,21,23,31] . The exact etiology of labral injury in the overhead athlete remains controversial, although it is increasingly recognized as a cause of shoulder pain in this population, particularly superior labral lesions extending anterior and posterior (SLAP) [30] .…”