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Analysis of Low-Field MRI Scanners for Evaluation of Shoulder Pathology Based on Arthroscopy.

Lee CS, Davis SM, McGroder C, Kouk S, Sung RM, Stetson WB, Powell SE - Orthop J Sports Med (2014)

Bottom Line: Many studies have compared the diagnostic capabilities of low-field magnetic resonance imaging (MRI) scanners to high-field MRI scanners; however, few have evaluated the low-field MRI diagnoses compared with intraoperative findings.For anterior labral lesions, the values were 86%, 99%, 86%, and 99%, and for superior labral anterior-posterior (SLAP) lesions, the values were 20%, 100%, 100%, and 79%, respectively.Low-field MRI is an accurate tool for evaluation of partial- and full-thickness rotator cuff tears; however, it is not effective in diagnosing SLAP lesions.

View Article: PubMed Central - PubMed

Affiliation: Stetson Powell Orthopaedics and Sports Medicine, Burbank, California, USA.

ABSTRACT

Background: Many studies have compared the diagnostic capabilities of low-field magnetic resonance imaging (MRI) scanners to high-field MRI scanners; however, few have evaluated the low-field MRI diagnoses compared with intraoperative findings.

Purpose: To determine the accuracy and sensitivity of low-field MRI scanners in diagnosing lesions of the rotator cuff and glenoid labrum.

Study design: Cohort study (diagnosis); Level of evidence, 3.

Methods: Over a 2-year period, MRI examinations without intra-articular contrast were performed on 79 patients for shoulder pathologies using an in-office 0.2-T extremity scanner. The MRI examinations were read by board-certified, musculoskeletal fellowship-trained radiologists. All patients underwent shoulder arthroscopy performed by a single sports fellowship-trained orthopaedic surgeon within a mean time of 56 days (range, 8-188 days) after the MRI examination. The mean patient age was 54 years (range, 18-81 years). Operative notes from the shoulder arthroscopies were then retrospectively reviewed by a single blinded observer, and the intraoperative findings were compared with the MRI reports.

Results: For partial-thickness rotator cuff tears, the sensitivity, specificity, positive predictive value, and negative predictive value were 85%, 89%, 79%, and 92%, respectively. For full-thickness rotator cuff tears, the respective values were 97%, 100%, 100%, and 98%. For anterior labral lesions, the values were 86%, 99%, 86%, and 99%, and for superior labral anterior-posterior (SLAP) lesions, the values were 20%, 100%, 100%, and 79%, respectively.

Conclusion: Low-field MRI is an accurate tool for evaluation of partial- and full-thickness rotator cuff tears; however, it is not effective in diagnosing SLAP lesions. More information is needed to properly assess its ability to diagnose anterior and posterior labral lesions.

No MeSH data available.


Related in: MedlinePlus

Magnetic resonance imaging and arthroscopic findings of a right shoulder full-thickness tear of the supraspinatus tendon with retraction. (A) Proton density–weighted oblique coronal view using an E-scan Opera Esaote 0.2-T scanner. (B) Standard posterior viewing portal with 30° arthroscope evaluating the rotator cuff following arthroscopic debridement.
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fig2-2325967114540407: Magnetic resonance imaging and arthroscopic findings of a right shoulder full-thickness tear of the supraspinatus tendon with retraction. (A) Proton density–weighted oblique coronal view using an E-scan Opera Esaote 0.2-T scanner. (B) Standard posterior viewing portal with 30° arthroscope evaluating the rotator cuff following arthroscopic debridement.

Mentions: The results suggest that low-field MRIs are an excellent indicator of full-thickness rotator cuff tears (Figure 2), as there was only 1 false negative diagnosed as a partial-thickness tear. This is an important finding because distinguishing between partial- and full-thickness tears can affect the treatment plan of a patient. While identification of partial-thickness tears was less reliable, it was still sufficient enough to aid in the clinical management. Five of the 6 false positives were found to be normal at the time of surgery, and 3 of the 4 false negatives were read as either reactive changes due to calcific tendinitis or tendinosis and tendinopathy. Even using high-field MRIs, it is not uncommon to have difficulty distinguishing low-grade partial-thickness tears from tendinosis and tendinopathy and high-grade tears from full-thickness tears.2,32 All these patients trialed conservative management prior to surgical intervention.


Analysis of Low-Field MRI Scanners for Evaluation of Shoulder Pathology Based on Arthroscopy.

Lee CS, Davis SM, McGroder C, Kouk S, Sung RM, Stetson WB, Powell SE - Orthop J Sports Med (2014)

Magnetic resonance imaging and arthroscopic findings of a right shoulder full-thickness tear of the supraspinatus tendon with retraction. (A) Proton density–weighted oblique coronal view using an E-scan Opera Esaote 0.2-T scanner. (B) Standard posterior viewing portal with 30° arthroscope evaluating the rotator cuff following arthroscopic debridement.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4588525&req=5

fig2-2325967114540407: Magnetic resonance imaging and arthroscopic findings of a right shoulder full-thickness tear of the supraspinatus tendon with retraction. (A) Proton density–weighted oblique coronal view using an E-scan Opera Esaote 0.2-T scanner. (B) Standard posterior viewing portal with 30° arthroscope evaluating the rotator cuff following arthroscopic debridement.
Mentions: The results suggest that low-field MRIs are an excellent indicator of full-thickness rotator cuff tears (Figure 2), as there was only 1 false negative diagnosed as a partial-thickness tear. This is an important finding because distinguishing between partial- and full-thickness tears can affect the treatment plan of a patient. While identification of partial-thickness tears was less reliable, it was still sufficient enough to aid in the clinical management. Five of the 6 false positives were found to be normal at the time of surgery, and 3 of the 4 false negatives were read as either reactive changes due to calcific tendinitis or tendinosis and tendinopathy. Even using high-field MRIs, it is not uncommon to have difficulty distinguishing low-grade partial-thickness tears from tendinosis and tendinopathy and high-grade tears from full-thickness tears.2,32 All these patients trialed conservative management prior to surgical intervention.

Bottom Line: Many studies have compared the diagnostic capabilities of low-field magnetic resonance imaging (MRI) scanners to high-field MRI scanners; however, few have evaluated the low-field MRI diagnoses compared with intraoperative findings.For anterior labral lesions, the values were 86%, 99%, 86%, and 99%, and for superior labral anterior-posterior (SLAP) lesions, the values were 20%, 100%, 100%, and 79%, respectively.Low-field MRI is an accurate tool for evaluation of partial- and full-thickness rotator cuff tears; however, it is not effective in diagnosing SLAP lesions.

View Article: PubMed Central - PubMed

Affiliation: Stetson Powell Orthopaedics and Sports Medicine, Burbank, California, USA.

ABSTRACT

Background: Many studies have compared the diagnostic capabilities of low-field magnetic resonance imaging (MRI) scanners to high-field MRI scanners; however, few have evaluated the low-field MRI diagnoses compared with intraoperative findings.

Purpose: To determine the accuracy and sensitivity of low-field MRI scanners in diagnosing lesions of the rotator cuff and glenoid labrum.

Study design: Cohort study (diagnosis); Level of evidence, 3.

Methods: Over a 2-year period, MRI examinations without intra-articular contrast were performed on 79 patients for shoulder pathologies using an in-office 0.2-T extremity scanner. The MRI examinations were read by board-certified, musculoskeletal fellowship-trained radiologists. All patients underwent shoulder arthroscopy performed by a single sports fellowship-trained orthopaedic surgeon within a mean time of 56 days (range, 8-188 days) after the MRI examination. The mean patient age was 54 years (range, 18-81 years). Operative notes from the shoulder arthroscopies were then retrospectively reviewed by a single blinded observer, and the intraoperative findings were compared with the MRI reports.

Results: For partial-thickness rotator cuff tears, the sensitivity, specificity, positive predictive value, and negative predictive value were 85%, 89%, 79%, and 92%, respectively. For full-thickness rotator cuff tears, the respective values were 97%, 100%, 100%, and 98%. For anterior labral lesions, the values were 86%, 99%, 86%, and 99%, and for superior labral anterior-posterior (SLAP) lesions, the values were 20%, 100%, 100%, and 79%, respectively.

Conclusion: Low-field MRI is an accurate tool for evaluation of partial- and full-thickness rotator cuff tears; however, it is not effective in diagnosing SLAP lesions. More information is needed to properly assess its ability to diagnose anterior and posterior labral lesions.

No MeSH data available.


Related in: MedlinePlus