1
|
Gokce A, Guclu D, Unlu EN, Kazoglu I, Arican M, Ogul H. Comparison of conventional MR arthrography and 3D volumetric MR arthrography in detection of cartilage defects accompanying glenoid labrum pathologies. Skeletal Radiol 2024; 53:1081-1090. [PMID: 38051423 DOI: 10.1007/s00256-023-04536-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVES In this study, we aimed to compare conventional and T1-weighted volumetric magnetic resonance arthrography (MRA) in the diagnosis and grading of glenoid cartilage defects that accompany labral pathologies. MATERIALS AND METHODS A total of 79 patients who were prediagnosed with labrum pathologies based on shoulder magnetic resonance imaging (MRI) had MRA and CTA between December 2021 and May 2022. CTA was regarded as reference standard. CTA images were examined by a radiologist experienced in musculoskeletal radiology, and MRA images were examined by two radiologists independently to determine presence, grade, and localization of any glenoid cartilage defect, if present. Sensitivity, specificity, and accuracy were calculated separately for conventional and T1-weighted volumetric MRA. In addition, at the last stage, two observers examined all MRAs together, and the presence of a cartilage defect was decided by consensus, and the overall sensitivity, specificity, and accuracy were calculated. RESULTS Cartilage defect was detected on CTAs of 48 (60.75%) cases of among 79 patients with labrum pathology. The sensitivity, specificity, and accuracy of conventional MRA for two examiners were 17-19%, 100-100%, and 49-51%, respectively, while those values were 67-65%, 92-97%, and 84-77%, respectively, for T1-weighted volumetric MRA. Inter-examiner agreement was excellent for diagnosis of cartilage defects on all MRAs. The overall sensitivity, specificity, and accuracy for detection of glenoid cartilage lesions by MRA were 69%, 97%, and 80%, respectively. CONCLUSION T1-weighted volumetric MRA seems to demonstrate cartilage defects accompanied with labrum pathologies accurately with high sensitivity, specificity, and excellent inter-examiner agreement.
Collapse
Affiliation(s)
- Ayse Gokce
- Department of Radiology, Aksaray Research and Training Hospital, Aksaray, Turkey.
| | - Derya Guclu
- Department of Radiology, Faculty of Medicine, Duzce University, Duzce, Turkey
| | - Elif Nisa Unlu
- Department of Radiology, Faculty of Medicine, Duzce University, Duzce, Turkey
| | - Ibrahim Kazoglu
- Department of Orthopedics and Traumatology, Faculty of Medicine, Duzce University, Duzce, Turkey
| | - Mehmet Arican
- Department of Orthopedics and Traumatology, Faculty of Medicine, Duzce University, Duzce, Turkey
| | - Hayri Ogul
- Department of Radiology, Faculty of Medicine, Duzce University, Duzce, Turkey
| |
Collapse
|
2
|
Guclu D, Ogul H, Unlu EN, Tuncer K, Kose M, Kantarci M, Eren S. The 2D and 3D MR arthrographic description of aponeurotic expansion of supraspinatus tendon and biceps tendon anomaly in a large patient cohort. Skeletal Radiol 2024; 53:365-374. [PMID: 37522946 DOI: 10.1007/s00256-023-04409-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/21/2023] [Accepted: 07/23/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE To describe the aponeurotic expansion of supraspinatus tendon (AEST) and biceps tendon abnormalities with magnetic resonance (MR) arthrographic examinations and determine their prevalence in patients, we performed a high-resolution 3D direct MR arthrography. MATERIALS AND METHODS This was a retrospective study of 700 shoulder MR arthrograms performed between May 2010 and January 2022. Extension in the coronal plane of an AEST on 3D fat-suppressed T1-weighted volumetric interpolated breath-hold examination (VIBE) MR arthrography was identified. Based on its morphology, the AEST on MR arthrography was divided into four subtypes: absence of tendinous thickness in the bicipital synovial surface or intra-synovial tendon-like structure in the bicipital groove, thin and flat tendinous thickness ≥1 mm of bicipital synovium, oval tendinous structure less than half the size of the adjacent biceps tendon, oval tendinous structure more than half the size of the adjacent biceps tendon, and oval tendinous structure larger than the adjacent biceps tendon. Based on its origin and termination, aponeurotic expansions can be divided into three subtypes: proximal pulley zone, middle humeral neck zone, and distal myotendinous junction zone. Association with the biceps synovium of the AEST was categorized into three types: intra-synovial, extra-synovial, and trans-synovial. RESULTS An AEST in the anterior shoulder joint in 3D VIBE MR arthrography images was identified in 63 (9%) of 700 arthrograms. The most common arthrographic type of AEST was type 1-this was detected in 39 of 63 patients. The most common course type of the AEST was anteriorly midline. The most common distal insertion type was at the tenosynovial sheath of the long head of the biceps tendon (LHBT) in the middle humeral neck zone-this was detected in 31 of 63 patients. There were only 10 MR arthrograms biceps tendon abnormality, including 4 biceps agenesis and 6 split ruptures. CONCLUSION A 2D and high-resolution 3D MR arthrography can demonstrate the anatomical detail around the bicipital groove and facilitate the differentiation between a biceps tendon anomaly and an AEST. On high-resolution 3D MR arthrographic images, the AEST tends to be in the anterior midline and anteromedial portions of the biceps synovium with intra-synovial, extra-synovial, and trans-synovial courses and its three different insertion types.
Collapse
Affiliation(s)
- Derya Guclu
- Department of Radiology, Medical Faculty, Duzce University, 81000, Duzce, Turkey
| | - Hayri Ogul
- Department of Radiology, Medical Faculty, Duzce University, 81000, Duzce, Turkey.
| | - Elif Nisa Unlu
- Department of Radiology, Medical Faculty, Duzce University, 81000, Duzce, Turkey
| | - Kutsi Tuncer
- Department of Orthopedic Surgery, Medical Faculty, Altinbas University, Istanbul, Turkey
| | - Mehmet Kose
- Department of Orthopedic Surgery, Medical Faculty, Altinbas University, Istanbul, Turkey
| | - Mecit Kantarci
- Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Suat Eren
- Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey
| |
Collapse
|
3
|
Detection of the glenoid bare spot by non-arthrographic MR imaging, conventional MR arthrography, and 3D high-resolution T1-weighted VIBE MR arthrography: comparison with CT arthrography. Eur Radiol 2023; 33:3276-3285. [PMID: 36792853 DOI: 10.1007/s00330-023-09443-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 01/09/2023] [Accepted: 01/18/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVES To determine the diagnostic accuracy of non-arthrographic MR imaging, conventional MR arthrography, and 3D T1-weighted volumetric interpolated breath-hold examination (VIBE) MR arthrography sequences as compared with a CT arthrography in the diagnosis of glenoid bare spot. METHODS A retrospective study of 216 patients who underwent non-arthrographic MR imaging, conventional MR arthrography, VIBE MRI arthrography, and CT arthrogram between January 2011 and March 2022 was conducted. The diagnostic accuracy of non-arthrographic MR imaging, direct MR arthrography, and VIBE MRI arthrography in the detection of glenoid bare spot was compared with that of CT arthrography. All studies were reviewed by 2 MSK radiologists. Interobserver agreement for MR imaging and MR arthrographic findings was calculated. RESULTS Sixteen of 216 patients were excluded. Twenty-three of 200 shoulders had glenoid bare spot on CT arthrographic images. The glenoid bare spot was detected in 11 (47.8%) and 7 (30.4%) patients on conventional non-arthrographic MR images and in 18 (78.3%) and 16 (69.6%) patients on conventional MR arthrograms by observers 1 and 2, respectively. Both observers separately described the bare spot in 22 of 23 patients (95.7%) on 3D volumetric MR arthrograms. Interobserver variabilities were fair agreement for conventional non-arthrographic MR imaging (κ = 0.35, p < 0.05), moderate agreement for conventional MR arthrogram (κ = 0.50, p < 0.05), and near-perfect agreement for 3D volumetric MR arthrogram reading (κ = 0.87, p < 0.05). CONCLUSIONS A 3D high-resolution T1-weighted VIBE MR arthrography sequence may yield diagnostic performance that is comparable with that of CT arthrography in the diagnosis of glenoid bare spot. KEY POINTS •Glenoid bare spot should not be misdiagnosed as a transchondral defect of the glenoid surface by radiologists. •A 3D high-resolution T1-weighted VIBE MR arthrography sequence may be used as a high-sensitivity imaging technique in the diagnosis of glenoid bare spot.
Collapse
|
4
|
Kaptan AY, Özer M, Alim E, Perçin A, Ayanoğlu T, Öztürk BY, Kanatli U. The middle glenohumeral ligament: a classification based on arthroscopic evaluation. J Shoulder Elbow Surg 2022; 31:e85-e91. [PMID: 34474136 DOI: 10.1016/j.jse.2021.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 07/11/2021] [Accepted: 07/26/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Although middle glenohumeral ligament (MGHL) variations have been shown in the literature, their clinical effect and relationship with intra-articular pathologies have yet to be revealed, except for the Buford complex. This study was designed to classify MGHL and to reveal its relationship with clinical pathologies. METHODS A total of 843 consecutive shoulder arthroscopies were evaluated retrospectively, and a classification system was proposed for MGHL with regard to its structure and its relation to the anterior labrum. The associations of each MGHL type with superior labrum anterior-posterior (SLAP) lesions, subscapularis tears, and anterior instability were investigated. RESULTS MGHL variations were grouped into 6 types according to the classification. A significant difference in favor of type 6 MGHL (Buford complex) was observed in the distribution of SLAP lesions (P < .001). There was no significant difference between MGHL types and the distribution of anterior instability history (P = .131) and subscapularis tears (P = .324). CONCLUSION SLAP lesions accompany type 6 MGHLs (Buford complex) significantly more frequently than other types. There is also a negative relation between the anterior instability and thicker MGHL variants.
Collapse
Affiliation(s)
- Ahmet Yiğit Kaptan
- Department of Orthopaedics & Traumatology, Harran University School of Medicine, Şanlıurfa, Turkey.
| | - Mustafa Özer
- Department of Orthopaedics & Traumatology, Necmettin Erbakan University School of Medicine, Konya, Turkey
| | - Ece Alim
- Department of Anatomy, Gazi University School of Medicine, Ankara, Turkey
| | - Ali Perçin
- Department of Orthopaedics & Traumatology, Gazi University School of Medicine, Ankara, Turkey
| | - Tacettin Ayanoğlu
- Department of Orthopaedics & Traumatology, Abant İzzet Baysal University School of Medicine, Bolu, Turkey
| | - Burak Yağmur Öztürk
- Department of Orthopaedics & Traumatology, International Knee and Joint Center, Abu Dhabi, United Arab Emirates
| | - Ulunay Kanatli
- Department of Orthopaedics & Traumatology, Gazi University School of Medicine, Ankara, Turkey
| |
Collapse
|
5
|
Krueger VS, Shigley C, Bokshan SL, Owens BD. Humeral Avulsion of the Glenohumeral Ligament: Diagnosis and Management. JBJS Rev 2022; 10:01874474-202202000-00002. [PMID: 35113820 DOI: 10.2106/jbjs.rvw.21.00140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
» The most common type of humeral avulsion of the glenohumeral ligament (HAGL) is a purely ligamentous avulsion involving the anterior inferior glenohumeral ligament (IGHL), but other variants are seen, including posterior lesions and those with an osseous avulsion. » A central lesion between the intact anterior and posterior bands of the IGHL is gaining recognition as a distinct clinical entity. » HAGL lesions are most commonly seen in patients with anterior instability without a Bankart tear or in those with persistent symptoms despite having undergone a Bankart repair. » Magnetic resonance imaging is the most sensitive imaging modality. An arthrogram is helpful with subacute and chronic lesions when the joint is not distended. Arthroscopy is the gold standard for diagnosis. » While some have reported success with nonoperative management, surgical repair with either arthroscopic or open techniques has provided a high rate of successful outcomes; however, the literature is limited to mostly Level-IV and V evidence.
Collapse
Affiliation(s)
- Van S Krueger
- Department of Orthopaedic Surgery, Brown University Warren Alpert Medical School, Providence, Rhode Island
| | | | | | | |
Collapse
|
6
|
Demonstration With Three-Dimensional Volumetric Magnetic Resonance Sequences of Deep Peroneal Nerve Compression on Os Intermetatarseum Syndrome. Am J Phys Med Rehabil 2021; 100:e116-e117. [PMID: 33315610 DOI: 10.1097/phm.0000000000001664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT The os intermetatarseum is a rare accessory bone of the foot. It is commonly asymptomatic, as are other such accessory bones of the foot. Nevertheless, when it becomes symptomatic, it can cause "os intermetatarseum syndrome." Reported here is a case of os intermetatarseum syndrome, which is extremely rarely seen. To the best of the authors' knowledge, there are very few cases of os intermetatarseum syndrome in the literature.
Collapse
|
7
|
Ogul H, Taydas O, Sakci Z, Altinsoy HB, Kantarci M. Posterior shoulder labrocapsular structures in all aspects; 3D volumetric MR arthrography study. Br J Radiol 2021; 94:20201230. [PMID: 33989028 DOI: 10.1259/bjr.20201230] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Pathologies of the posterior labrocapsular structures of the shoulder joint are far less common than anterior labrocapsuloligamentous lesions. Most of these pathologies have been associated with traumatic posterior dislocation. A smaller portion of the lesions include posterior extension of superior labral anteroposterior lesions, posterior superior internal impingement, and damage to the posterior band of the inferior glenohumeral ligament. Labrocapsular anatomic variations of the posterior shoulder joint can mimic labral pathology on conventional MR and occasionally on MR arthrographic images. Knowledge of this variant anatomy is key to interpreting MR images and studying MR arthrography of the posterior labrocapsular structure to avoid misdiagnosis and unnecessary surgical procedures. In this article, we review normal and variant anatomy of the posterior labrocapsular structure of the shoulder joint based on MR arthrography and discuss how to discriminate normal anatomic variants from labrocapsular damage.
Collapse
Affiliation(s)
- Hayri Ogul
- Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey.,Anesthesiology, Clinical Research Office, Ataturk University, Erzurum, Turkey
| | - Onur Taydas
- Department of Radiology, Medical Faculty, Sakarya University, Sakarya, Turkey
| | - Zakir Sakci
- Department of Radiology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | | | - Mecit Kantarci
- Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey.,Department of Radiology, Medical Faculty, Binali Yildirim University, Erzincan, Turkey
| |
Collapse
|
8
|
Pirimoglu B, Ogul H, Polat G, Kantarci M, Levent A. The comparison of direct magnetic resonance arthrography with volumetric interpolated breath-hold examination sequence and multidetector computed tomography arthrography techniques in detection of talar osteochondral lesions. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2019; 53:209-214. [PMID: 30956024 PMCID: PMC6599417 DOI: 10.1016/j.aott.2019.03.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 09/16/2018] [Accepted: 03/17/2019] [Indexed: 11/10/2022]
Abstract
Objective The aim of this study was to compare additive diagnostic values of magnetic resonance (MR) arthrography with volumetric interpolated breath-hold examination (VIBE) sequence and multidetector computed tomography (MDCT) arthrography for diagnosis and grading of talar osteochondral lesions. Methods MDCT arthrography and MR arthrography with three dimensional VIBE sequence were performed in 27 patients. Findings of MR arthrography and MDCT arthrography images were compared with arthroscopic findings. Sensitivity, specificity, and accuracy rates were calculated for both MR arthrography and MDCT arthrography imaging findings. Results For grade I osteochondral lesions; sensitivity, specificity and accuracy rates of MR arthrography were 95%, 73%, 90%, respectively; For grade I osteochondral lesions; sensitivity, specificity and accuracy rates of MDCT arthrography were 96%, 79%, 81%. For grade IV osteochondral lesions; sensitivity, specificity and accuracy rates of MDCT arthrography and MR arthrography were 100%. For grade II lesions, the sensitivity, specificity and accuracy rates of the MR arthrography were 80%, 76%, 77%, respectively; for grade III lesions, the sensitivity, specificity and accuracy rates of the MR arthrography were 78%, 68%, 75%. For grade II osteochondral lesions; the sensitivity, specificity and accuracy rates of the MDCT arthrography were 91%, 81%, 86%; for grade III osteochondral lesions; the sensitivity, specificity and accuracy rates of the MDCT arthrography were 90%, 83%, 89%; For grade II and III osteochondral lesions, MDCT arthrography had higher sensitivity, specificity and accuracy rates than MR arthrography. MDCT arthrography had higher diagnostic performance than MR arthrography for detection of grade II and III lesions (p = 0.041 and p = 0.038, respectively). Conclusion MDCT arthrography appears to be more reliable than MR arthrography with three dimensional VIBE sequence for accurate detection and grading of osteochondral lesions. Level of evidence Level III, Diagnostic Study.
Collapse
|
9
|
Collotte P, Nové-Josserand L. Arthroscopic anatomy of the middle glenohumeral ligament. Surg Radiol Anat 2018; 40:1363-1370. [PMID: 30220000 DOI: 10.1007/s00276-018-2100-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 09/03/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE The middle glenohumeral ligament (MGHL) has seldom been studied and its function is unknown. The aim of this study was to describe its anatomical presentations. METHODS A prospective study was conducted of MGHL anatomy in 107 arthroscopies, with a description of its shape and superior and inferior insertion in the articular surface of the subscapularis tendon. The MGHL was investigated dynamically during internal rotation of the glenohumeral joint. RESULTS Sixty-three percent (68/107) of the MGHLs were found to be leaf-like, and 27% (28/107) cord-like, 5.5% (6/107) vestigial, and 2% (2/107) had several strands. The MGHL was absent for 2% of patients (2/107). The inferior insertion point of the MGHL was lateral, masked by the humeral head, in 34% of cases (36/105), intermediate, in front of the glenohumeral joint line, in 57% of cases (60/105), and medial, in front of the labrum, in 9% of cases (9/105). During internal rotation, 46% (48/105) of the MGHLs were observed to retract medially, the subscapularis tendon moving away from the anterior glenoid rim, while 54% (57/105) remained visible in front of the glenohumeral joint and came into contact with the articular surface of the subscapularis tendon. CONCLUSIONS The MGHL has many anatomical variations.
Collapse
Affiliation(s)
- Philippe Collotte
- Ramsay Générale de Santé, Hôpital Privé Jean Memoz, Centre Orthopédique Santy, 24 avenue Paul Santy, 69008, Lyon, France
| | - Laurent Nové-Josserand
- Ramsay Générale de Santé, Hôpital Privé Jean Memoz, Centre Orthopédique Santy, 24 avenue Paul Santy, 69008, Lyon, France.
| |
Collapse
|
10
|
|
11
|
The Ramp Test: An Arthroscopic Technique for Confirming Intra-articular Subluxation and Instability of the Long Head of the Biceps Tendon Within the Shoulder. Arthrosc Tech 2018; 7:e327-e330. [PMID: 29868399 PMCID: PMC5981836 DOI: 10.1016/j.eats.2017.09.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 09/26/2017] [Indexed: 02/03/2023] Open
Abstract
Shoulder arthroscopy in expert hands is now a tool for diagnosis and treatment. Diagnostic shoulder arthroscopy begins with a systematic review of the shoulder. This review should include the ramp test for confirming normal superior glenohumeral ligament (SGHL) integrity and function. The ramp test uses manipulation of the biceps tendon to achieve this. A negative ramp test finding means that the SGHL is intact and the biceps tendon moves freely down in a V-type pattern. A positive ramp test finding results when the biceps tendon subluxates through a failed SGHL and therefore presents with a U-shaped pattern indicating pathology. Intra-articular biceps tendon instability occurs due to SGHL tearing, which can lead to upper subscapularis rotator cuff partial tears or complete tears either acutely or over time.
Collapse
|
12
|
Ogul H. MR arthrographic demonstration of an unusual multiplication anomaly concerning the glenohumeral ligaments. Surg Radiol Anat 2018; 40:323-326. [DOI: 10.1007/s00276-018-1983-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 01/22/2018] [Indexed: 11/29/2022]
|
13
|
Pirimoglu B, Sade R, Ogul H, Kantarci M, Eren S, Levent A. How Can New Imaging Modalities Help in the Practice of Radiology? Eurasian J Med 2017; 48:213-221. [PMID: 28149149 DOI: 10.5152/eajm.2016.0260] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The purpose of this article was to provide an up-to-date review on the spectrum of new imaging applications in the practice of radiology. New imaging techniques have been developed with the objective of obtaining structural and functional analyses of different body systems. Recently, new imaging modalities have aroused the interest of many researchers who are studying the applicability of these modalities in the evaluation of different organs and diseases. In this review article, we present the efficiency and utilization of current imaging modalities in daily radiological practice.
Collapse
Affiliation(s)
- Berhan Pirimoglu
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Recep Sade
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Hayri Ogul
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Mecit Kantarci
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Suat Eren
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Akın Levent
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
| |
Collapse
|
14
|
Ahlawat S, Morris C, Fayad LM. Three-dimensional volumetric MRI with isotropic resolution: improved speed of acquisition, spatial resolution and assessment of lesion conspicuity in patients with recurrent soft tissue sarcoma. Skeletal Radiol 2016; 45:645-52. [PMID: 26897528 DOI: 10.1007/s00256-016-2348-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 01/31/2016] [Accepted: 02/04/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND To assess the acquisition speed, lesion conspicuity, and inter-observer agreement associated with volumetric T(1)-weighted MR sequences with isotropic resolution for detecting recurrent soft-tissue sarcoma (STS). METHODS Fifteen subjects with histologically proven recurrent STS underwent MRI, including axial and coronal T(1)-weighted spin echo (T(1)-WSE) (5-mm slice thickness) and coronal 3D volumetric T(1)-weighted (fat-suppressed, volume-interpolated, breath-hold examination; repetition time/echo time, 3.7/1.4 ms; flip angle, 9.5°; 1-mm slice thickness) sequences before and after intravenous contrast administration. Subtraction imaging and multiplanar reformations (MPRs) were performed. Acquisition times for T(1)-WSE in two planes and 3D sequences were reported. Two radiologists reviewed images for quality (>50 % artifacts, 25-50 % artifacts, <25 % artifacts, and no substantial artifacts), lesion conspicuity, contrast-to-noise ratio (CNR(muscle)), recurrence size, and recurrence-to-joint distance. Descriptive and intraclass correlation (ICC) statistics are given. RESULTS Mean acquisition times were significantly less for 3D imaging compared with 2-plane T(1)-WSE (183.6 vs 342.6 s; P = 0.012). Image quality was rated as having no substantial artifacts in 13/15 and <25 % artifacts in 2/15. Lesion conspicuity was significantly improved for subtracted versus unsubtracted images (CNR(muscle), 100 ± 138 vs 181 ± 199; P = 0.05). Mean recurrent lesion size was 2.5 cm (range, 0.7-5.7 cm), and measurements on 3D sequences offered excellent interobserver agreement (ICC, 0.98 for lesion size and 0.96 for recurrence-to-joint distance with MPR views). CONCLUSION Three-dimensional volumetric sequences offer faster acquisition times, higher spatial resolution, and MPR capability compared with 2D T(1)-WSE for postcontrast imaging. Subtraction imaging provides higher lesion conspicuity for detecting recurrent STS in skeletal muscle, with excellent interobserver agreement between readers.
Collapse
Affiliation(s)
- Shivani Ahlawat
- The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, MD, 21287, USA.
| | - Carol Morris
- Department of Orthopedic Surgery, The Johns Hopkins Medical Institutions, 601 North Caroline Street, Baltimore, MD, 21287, USA.,Department of Oncology, The Johns Hopkins Medical Institutions, 601 North Caroline Street, Baltimore, MD, 21287, USA
| | - Laura M Fayad
- The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, MD, 21287, USA.,Department of Orthopedic Surgery, The Johns Hopkins Medical Institutions, 601 North Caroline Street, Baltimore, MD, 21287, USA.,Department of Oncology, The Johns Hopkins Medical Institutions, 601 North Caroline Street, Baltimore, MD, 21287, USA
| |
Collapse
|
15
|
Abstract
CLINICAL/METHODICAL ISSUE Shoulder impingement syndrome is a clinically common entity involving trapping of tendons or bursa with typical clinical findings. STANDARD RADIOLOGICAL METHODS Important radiological procedures are ultrasound, magnetic resonance imaging (MRI) and MR arthrography. Projection radiography and computed tomography (CT) are ideal to identify bony changes and CT arthrography also serves as an alternative method in cases of contraindications for MRI. These modalities support the clinically suspected diagnosis of impingement syndrome and may identify its cause in primary diagnosis. In addition, effects of impingement are determined by imaging. Therapy decisions are based on a synopsis of radiological and clinical findings. PERFORMANCE The sensitivity and specificity of these imaging modalities with regard to the diagnostics of a clinically evident impingement syndrome are given in this review article. PRACTICAL RECOMMENDATIONS Orthopedic and trauma surgeons express the suspicion of an impingement syndrome based on patient history and physical examination and radiologists confirm structural changes and damage of intra-articular structures using dedicated imaging techniques.
Collapse
Affiliation(s)
- J K Kloth
- Klinik für diagnostische und interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland,
| | | | | |
Collapse
|