TY - JOUR
T1 - Anterior shoulder instability
T2 - Accuracy of MR arthrography in the classification of anteroinferior labroligamentous injuries
AU - Waldt, Simone
AU - Burkart, Andreas
AU - Imhoff, Andreas B.
AU - Bruegel, Melanie
AU - Rummeny, Ernst J.
AU - Woertler, Klaus
PY - 2005/11
Y1 - 2005/11
N2 - PURPOSE: To retrospectively evaluate the accuracy of magnetic resonance (MR) arthrography in the classification of anteroinferior labroligamentous injuries by using arthroscopy as the reference standard. MATERIALS AND METHODS: Ethical committee approval and informed consent were obtained. MR arthrograms obtained in 205 patients, including a study group of 104 patients (74 male and 30 female; mean age, 28.2 years) with arthroscopically proved labroligamentous injuries and a control group of 101 patients (65 male and 36 female; mean age, 31.4 years) with intact labroligamentous complex, were reviewed in random order. MR arthrograms were analyzed for the presence and type (Bankart, anterior labral periosteal sleeve avulsion [ALPSA], Perthes, glenolabral articular disruption [GLAD], or nonclassifiable lesion) of labroligamentous injuries by two radiologists in consensus. Results were compared with arthroscopic findings. Sensitivity, specificity, accuracy, and corresponding 95% confidence intervals for the detection and classification of anteroinferior labroligamentous lesions with MR arthrography were calculated. RESULTS: At arthroscopy, 104 anteroinferior labroligamentous lesions were diagnosed, including 44 Bankart lesions, 22 ALPSA lesions, 12 Perthes lesions, and three GLAD lesions. Twenty-three labral lesions were nonclassifiable at arthroscopy, all of which occurred after a history of chronic instability. Nineteen (83%) of these 23 lesions were also nonclassifiable at MR arthrography. With arthroscopy used as the reference standard, labroligamentous lesions were detected and correctly classified at MR arthrography with sensitivities of 88% and 77%, specificities of 91% and 91%, and accuracies of 89% and 84%, respectively. Bankart, ALPSA, and Perthes lesions were correctly classified in 80%, 77%, and 50% of cases, respectively. The three GLAD lesions were all correctly assessed. CONCLUSION: MR arthrography is accurate in enabling classification of acute and chronic anteroinferior labroligamentous injuries, although correct interpretation of Perthes lesions remains difficult.
AB - PURPOSE: To retrospectively evaluate the accuracy of magnetic resonance (MR) arthrography in the classification of anteroinferior labroligamentous injuries by using arthroscopy as the reference standard. MATERIALS AND METHODS: Ethical committee approval and informed consent were obtained. MR arthrograms obtained in 205 patients, including a study group of 104 patients (74 male and 30 female; mean age, 28.2 years) with arthroscopically proved labroligamentous injuries and a control group of 101 patients (65 male and 36 female; mean age, 31.4 years) with intact labroligamentous complex, were reviewed in random order. MR arthrograms were analyzed for the presence and type (Bankart, anterior labral periosteal sleeve avulsion [ALPSA], Perthes, glenolabral articular disruption [GLAD], or nonclassifiable lesion) of labroligamentous injuries by two radiologists in consensus. Results were compared with arthroscopic findings. Sensitivity, specificity, accuracy, and corresponding 95% confidence intervals for the detection and classification of anteroinferior labroligamentous lesions with MR arthrography were calculated. RESULTS: At arthroscopy, 104 anteroinferior labroligamentous lesions were diagnosed, including 44 Bankart lesions, 22 ALPSA lesions, 12 Perthes lesions, and three GLAD lesions. Twenty-three labral lesions were nonclassifiable at arthroscopy, all of which occurred after a history of chronic instability. Nineteen (83%) of these 23 lesions were also nonclassifiable at MR arthrography. With arthroscopy used as the reference standard, labroligamentous lesions were detected and correctly classified at MR arthrography with sensitivities of 88% and 77%, specificities of 91% and 91%, and accuracies of 89% and 84%, respectively. Bankart, ALPSA, and Perthes lesions were correctly classified in 80%, 77%, and 50% of cases, respectively. The three GLAD lesions were all correctly assessed. CONCLUSION: MR arthrography is accurate in enabling classification of acute and chronic anteroinferior labroligamentous injuries, although correct interpretation of Perthes lesions remains difficult.
UR - http://www.scopus.com/inward/record.url?scp=27144458413&partnerID=8YFLogxK
U2 - 10.1148/radiol.2372041429
DO - 10.1148/radiol.2372041429
M3 - Article
C2 - 16244267
AN - SCOPUS:27144458413
SN - 0033-8419
VL - 237
SP - 578
EP - 583
JO - Radiology
JF - Radiology
IS - 2
ER -