Coracoid Process-A Hub of Shoulder Ligaments

Area of Science:

• Radiology
• Orthopedics
• Anatomy

Background:

• The coracoid process is a complex anatomical structure.
• Its intricate ligamentous attachments can be challenging to delineate.
• Accurate visualization is crucial for diagnosing shoulder pathologies.

Purpose of the Study:

• To identify and evaluate the visibility of key ligaments attached to the coracoid process using 3T MRI.
• To assess interobserver agreement in ligament identification on MRI.
• To determine optimal MRI sequences for visualizing these structures.

Main Methods:

• Retrospective observational study of 120 shoulder MRI scans (3T Siemens).
• Two musculoskeletal radiologists evaluated scans for coracohumeral (CHL), coracoclavicular (CCL), coracoacromial (CAL), and coracoglenoid (CGL) ligaments.
• Analysis of image planes (axial, sagittal) and sequences (T1, PDFS, non-fat-saturated).

Main Results:

• Substantial interobserver agreement (κ=0.65) for CHL identification on sagittal T1 and PDFS sequences.
• CCL and CAL ligaments were consistently identified across sequences, with better confidence on non-fat-saturated sagittal images.
• Substantial agreement (κ=0.702-0.72) for CGL identification, with sagittal images proving superior.

Conclusions:

• 3T MRI is a valuable tool for visualizing coracoid process ligaments.
• Sagittal sequences offer advantages for CGL evaluation.
• Accurate MRI identification of these ligaments aids in managing associated shoulder pathologies.