Freehand direct arthrography of the shoulder using near real-time guidance in an open 1.0-T MRI scanner
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Updated: May 7, 2026
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Christian Wybranski1, Ilya Adamchic2, Friedrich-Wilhelm Röhl3
1Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany. Christian.Wybranski@uk-koeln.de.
Objective:
To assess the technical success and duration of magnetic resonance imaging (MRI)-guided freehand direct shoulder arthrography (FDSA) with near real-time imaging implemented in a routine shoulder MRI examination on an open 1.0-T MRI scanner, and to assess the learning curve of residents new to this technique.
Methods:
An experienced MRI interventionalist (the expert) performed 125 MRI-guided FDSA procedures, and 75 patients were treated by one of three residents without previous experience in MRI-guided FDSA. Technical success rate and duration of MRI-guided FDSA of the expert and the residents were compared. The residents' learning curves were assessed. The occurrence of extra-articular deposition and leakage of contrast media from the puncture site and the subsequent impairment of image interpretation were retrospectively analyzed.
Results:
Overall technical success was 97.5 %. The expert needed overall fewer puncture needle readjustments and was faster at puncture needle positioning (p < 0.01). The learning curve of the residents, however, was steep. They leveled with the performance of the expert after ≈ 15 interventions. With a minimal amount of training all steps of MRI-guided FDSA can be performed in ≤10 min.
Conclusion:
Magnetic resonance-guided FDSA in an open 1.0-T MRI scanner can be performed with high technical success in a reasonably short amount of time. Only a short learning curve is necessary to achieve expert level.
