Archives of Orthopaedic and Trauma Surgery

, Volume 138, Issue 5, pp 699–709 | Cite as

Diagnosis of glenoid labral tears using 3-tesla MRI vs. 3-tesla MRA: a systematic review and meta-analysis

  • Adil Ajuied
  • Ciaran P. McGarvey
  • Ziad Harb
  • Christian C. Smith
  • Russell P. Houghton
  • Steven A. Corbett
Arthroscopy and Sports Medicine
First Online:
Received:
  • 17 Downloads

Abstract

Background

Various protocols exist for magnetic resonance arthrogram (MRA) of the shoulder, including 3D isotropic scanning and positioning in neutral (2D neutral MRA), or abduction-external-rotation (ABER).

Hypothesis

MRA does not improve diagnostic accuracy for labral tears when compared to magnetic resonance imaging (MRI) performed using 3-Tesla (3T) magnets.

Method

Systematic review of the Cochrane, MEDLINE, and PubMed databases according to PRISMA guidelines. Included studies compared 3T MRI or 3T MRA (index tests) to arthroscopic findings (reference test). Methodological appraisal performed using QUADAS-2. Pooled sensitivity and specificity were calculated.

Results

Ten studies including 929 patients were included. Index test bias and applicability were a concern in the majority of studies. The use of arthroscopy as the reference test raised concern of verification bias in all studies. For anterior labral lesions, 3T MRI was less sensitive (0.83 vs. 0.87 p = 0.083) than 3T 2D neutral MRA. Compared to 3T 2D neutral MRA, both 3T 3D Isotropic MRA and 3T ABER MRA significantly improved sensitivity (0.87 vs. 0.95 vs. 0.94). For SLAP lesions, 3T 2D neutral MRA was of similar sensitivity to 3T MRI (0.84 vs. 0.83, p = 0.575), but less specific (0.99 vs. 0.92 p < 0.0001). For posterior labral lesions, 3T 2D neutral MRA had greater sensitivity than 3T 3D Isotropic MRA and 3T MRI (0.90 vs. 0.83 vs. 0.83).

Conclusions

At 3-T, MRA improved sensitivity for diagnosis of anterior and posterior labral lesions, but reduced specificity in diagnosis of SLAP tears. 3T MRA with ABER positioning further improved sensitivity in diagnosis of anterior labral tears.

Level of evidence

IV.

Keywords

3-Tesla MRI MRA Labrum Accuracy Diagnosis 
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Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Adil Ajuied
    • 1
    • 3
  • Ciaran P. McGarvey
    • 1
  • Ziad Harb
    • 1
  • Christian C. Smith
    • 1
  • Russell P. Houghton
    • 2
  • Steven A. Corbett
    • 1
    • 3
  1. 1.Department of Trauma and OrthopaedicsGuy’s and St Thomas’ Hospital NHS Foundation TrustLondonUK
  2. 2.Department of RadiologyGuy’s and St Thomas’ Hospital NHS Foundation TrustLondonUK
  3. 3.Fortius ClinicLondonUK

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