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[MR tomography versus CT arthrography in glenohumeral instabilities]
K F Kreitner1, M Runkel, P Grebe
1Klinik mit Poliklinik für Radiologie, Universität Mainz.
Rofo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin
|July 1, 1992
Summary
CT arthrography (CT-A) is more accurate than MRI for diagnosing shoulder instability, especially for capsular lesions. Both imaging methods effectively evaluate the glenoid labrum and humeral head fractures.
Area of Science:
- Orthopedics
- Radiology
- Sports Medicine
Background:
- Shoulder instability is a common clinical problem requiring accurate diagnosis.
- Magnetic Resonance Imaging (MRI) and Computed Tomography Arthrography (CT-A) are used for evaluating shoulder joint pathology.
Purpose of the Study:
- To prospectively compare the diagnostic accuracy of MRI and CT-A in patients with shoulder instability.
- To specifically assess the detection rates of glenoid labrum, capsular lesions, and fractures.
Main Methods:
- Prospective study involving 26 patients with 27 unstable shoulder joints.
- Comparison of diagnostic findings from MRI and CT-A against surgical and/or arthroscopic correlation.
- Evaluation of sensitivity, accuracy, and negative predictive value for specific lesion types.
Main Results:
- Both MRI (94%) and CT-A (96%) demonstrated high accuracy for glenoid labrum evaluation.
- CT-A significantly outperformed MRI in detecting capsular lesions (sensitivity 96% vs. 44%, accuracy 96% vs. 72%).
- Humeral head fracture detection was similar; CT-A showed a trend towards better glenoid rim fracture detection.
Conclusions:
- CT arthrography is diagnostically superior to MRI for unstable shoulders, particularly for identifying capsular lesions.
- CT-A offers greater certainty in diagnosing joint capsule injuries compared to MRI.
- Both modalities are valuable, but CT-A provides more comprehensive information for capsular pathology.