To determine how often patients with surgically proven labral tears have labral signal on shoulder MR arthrography (MRA) that is not equal to gadolinium or fluid on T1- and T2-weighted images, respectively.
Materials and methods
Consecutive patients with surgical repair of a SLAP or Bankart labral tear within 95 days of an MRA were included. Using cartilage signal as an internal reference, two musculoskeletal (MSK) radiologists retrospectively categorized labral signal as T1-hyperintense, T1-gadolinium, T2-hyperintense, or T2-fluid. In patients without T1-gadolinium or T2-fluid labral signal, secondary findings such as the orientation, extent, shape, and width of the abnormal signal was recorded. Statistical analyses were performed using Fisher’s test and ANOVA.
Sixty-one labral tears (36 SLAP and 25 Bankart) in 54 patients (mean age, 30.7; F:M 8:46) met the inclusion criteria. In 67% and 76% of SLAP and Bankart labral tears, T1-gadolinium signal was present (p = 0.43). T2-fluid signal was present in 50% and 92% of these same labral tears (p = 0.001). The absence of T1-gadolinium or T2-fluid signal was more common in SLAP tears (33%) compared to Bankart tears (8%) (p = 0.02). In the SLAP cases, at least two secondary findings of a SLAP tear were present in 92% (11/12).
Lack of surfacing T1-gadolinium or T2-fluid labral signal is unusual in Bankart tears but relatively common in SLAP tears. However, a SLAP tear was diagnosed in 92% of these 12 cases when two secondary findings were present.
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Waldt S, Burkart A, Lange P, Imhoff AB, Rummeny EJ, Woertler K. Diagnostic performance of MR arthrography in the assessment of superior labral anteroposterior lesions of the shoulder. Am J Roentgenol. 2004;182(5):1271–8.
Major NM, Browne J, Domzalski T, Cothran RL, Helms CA. Evaluation of the glenoid labrum with 3-T MRI: is intraarticular contrast necessary? Am J Roentgenol. 2011;196(5):1139–44.
Monu JUV, Pope TL, Chabon SJ, Vanarthos WJ. MR diagnosis of superior labral anterior posterior (SLAP) injuries of the glenoid labrum: value of routine imaging without intraarticular injection of contrast material. Am J Roentgenol. 1994;163(6):1425–9.
Chandnani VP, Yeager TD, DeBerardino T, Christensen K, Gagliardi JA, Heitz DR, et al. Glenoid labral tears: prospective evaluation with MR imaging, MR arthrography, and CT arthrography. Am J Roentgenol. 1993;161(6):1229–35.
Magee T, Williams D, Mani N. Shoulder MR arthrography: which patient group benefits most? Am J Roentgenol. 2004;183(4):969–74.
Llopis E, Montesinos P, Guedez MT, Aguilella L, Cerezal L. Normal shoulder MRI and MR arthrography: anatomy and technique. Semin Musculoskelet Radiol. 2015;19(3):212–30.
Legan JM, Burkhard KB, Goff WB, Balsara ZN, Martinez AJ, Burks DD, et al. Tears of the glenoid labrum: MR imaging of 88 arthroscopically confirmed cases. Radiology. 1991;179:241–6.
Bencardino JT, Beltran J, Rosenberg ZS, Rokito A, Schmahmann S, Mota J, et al. Superior labrum anterior–posterior lesions: diagnosis with MR arthrography of the shoulder. Radiology. 2000;214(1):267–71.
Jee WH, McCauley TR, Katz LD, Matheny JM, Ruwe PA, Daigneault JP. Superior labral anterior posterior (SLAP) lesions of the glenoid labrum: reliability and accuracy of MR arthrography for diagnosis. Radiology. 2001;218(1):127–32.
Palmer WE, Brown JH, Rosenthal DI. Labral-ligamentous complex of the shoulder: evaluation with MR arthrography. J Radiol. 1994;190:645–51.
Arirachakaran A, Boonard M, Chaijenkij K, Pituckanotai K, Prommahachai A, Kongtharvonskul J. A systematic review and meta-analysis of diagnostic test of MRA versus MRI for detection superior labrum anterior to posterior lesions type II–VII. Skelet Radiol. 2017;46(2):149–60.
Waldt S, Burkart A, Imhoff AB, Bruegel M, Rummeny EJ, Woertler K. Anterior shoulder instability: accuracy of MR arthrography in the classification of anteroinferior labroligamentous injuries. Radiology. 2005;237(2):578–83.
Magee T, Shapiro M, Rodriguez J, Williams D. MR arthrography of postoperative knee: for which patients is it useful? Radiology. 2003;229(1):159–63.
Applegate R, Flannigan B, Tolin B, Fox J, Del Pizzo WMR. Diagnosis in the knee: contrast material of recurrent value of intraarticular tears. AJR Am J Roentgenol. 1993;161:821–5.
Vives MJ, Homesley D, Ciccotti MG, Schweitzer ME. Evaluation of recurring meniscal tears with gadolinium-enhanced magnetic resonance imaging. A randomized, prospective study. Am J Sport Med. 2003;31(6):868–73.
Magee T. Accuracy of 3-Tesla MR and MR arthrography in diagnosis of meniscal retear in the post-operative knee. Skelet Radiol. 2014;43(8):1057–64.
De Smet AA, Horak DM, Davis KW, Choi JJ. Intensity of signal contacting meniscal surface in recurrent tears on MR arthrography compared with that of contrast material. AJR Am J Roentgenol. 2006;187(6):W565–8.
Hajek PC, Sartoris DJ, Neumann CH, Resnick D. Potential contrast agents for MR arthrography: in vitro evaluation and practical observations. Am J Roentgenol. 1987;149(1):97–104.
Willemsen UF, Brunner U, Scheck R, Pfluger T, Kueffer G, Hahn K. Prospective evaluation of MR arthrography performed with high-volume intraarticular saline enhancement in patients with recurrent anterior dislocations of the shoulder. Am J Roentgenol. 1998;170(January):79–84.
Cooper DE, Arnoczky SP, O’Brien SJ, Warren RF, DiCarlo E, Allen AA. Anatomy, histology, and vascularity of the glenoid labrum. An anatomical study. J Bone Joint Surg Am. 1992;74(1):46–52.
Neviaser TJ. The anterior labroligamentous periosteal sleeve avulsion lesion: a cause of anterior instability of the shoulder. Arthroscopy. 1993;9(1):17–21.
Tuite MJ, Cirillo RL, De Smet AA, Orwin JF. Superior labrum anterior-posterior (SLAP) tears: evaluation of three MR signs on T2-weighted images. Radiology. 2000;215(3):841–5.
Jin W, Ryu KN, Kwon SH, Rhee YG, Yang DM. MR arthrography in the differential diagnosis of type II superior labral anteroposterior lesion and sublabral recess. Am J Roentgenol. 2006;187(4):887–93.
Chang D, Mohana-Borges A, Borso M, Chung CB. SLAP lesions: anatomy, clinical presentation, MR imaging diagnosis and characterization. Eur J Radiol. 2008;68(1):72–87.
Wischer TK, Bredella MA, Genant HK, Stoller DW, Bost FW, Tirman PFJ. Perthes lesion (a variant of the Bankart lesion). Am J Roentgenol. 2002;178(1):233–7.
Wagner SC, Schweitzer ME, Morrison WB, Fenlin JM Jr, Bartolozzi AR. Shoulder instability: accuracy of MR imaging performed after surgery in depicting recurrent injury—initial findings. Radiology. 2002;222(1):196–203.
The data for this project originated from and was provided by the University of Virginia.
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The University of Virginia Institutional Review Board (IRB) gave permission for this study.
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Nacey, N.C., Fox, M.G., Bertozzi, C.J. et al. Incidence of gadolinium or fluid signal within surgically proven glenoid labral tears at MR arthrography. Skeletal Radiol 48, 1185–1191 (2019). https://doi.org/10.1007/s00256-018-3143-x
- MR arthrography