Skip to main content
SpringerLink
Log in

Diagnostic performance of shoulder magnetic resonance arthrography for labral tears having surgery as reference: comparison of high-resolution isotropic 3D sequence (THRIVE) with standard protocol

  • MAGNETIC RESONANCE IMAGING
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

To compare the diagnostic performance of T1 high-resolution isotropic volume excitation (THRIVE) sequence with that of a standard protocol for direct shoulder magnetic resonance arthrography (MRA) for the diagnosis of superior labral anterior-to-posterior (SLAP) and Bankart lesions, using arthroscopy findings as a reference standard.

Materials and methods

We retrospectively studied 84 patients who underwent direct shoulder 3T MRA using THRIVE and two-dimensional three-plane proton-density fat-suppressed (2D-PD-FS) sequences. One reviewer evaluated the contrast-to-noise ratio (CNR) as a quantitative image quality. Other two reviewers independently evaluated the subjective image noise, image sharpness, and radiologic diagnosis as qualitative image quality. Arthroscopic surgical findings were considered the reference standard. Wilcoxon rank sum, Chi-square/Fisher’s exact, and DeLong’s tests, as well as intraclass correlation coefficients (ICCs) were used to evaluate differences between THRIVE and 2D-PD-FS images.

Results

THRIVE images had significantly higher CNR (p < 0.001), and subjective ratings of image noise (p = 0.009) and sharpness (p = 0.039) than 2D-PD-FS images (p < 0.001). THRIVE images had similar (p ≥ 0.18) diagnostic performance (sensitivity, 93.0–97.2%; specificity, 95.8–100%; accuracy, 95.2–97.6%) for the diagnosis of SLAP and Bankart lesions with excellent agreement (ICC = 0.898–0.942) when compared to 2D-PD-FS images (sensitivity, 86.1–91.7%; specificity, 93.8–95.8%; accuracy, 90.5–92.9%; agreement, ICC = 0.782–0.858). The scan time was reduced by 69% for THRIVE sequence compared to 2D-PD-FS sequence (2 min 40 s vs. 8 min 40 s).

Conclusion

The THRIVE sequence may be helpful in the diagnosis of SLAP and Bankart lesions, and may be routinely used during direct shoulder 3T MRA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Sebro R, Oliveira A, Palmer WE (2014) MR arthrography of the shoulder: technical update and clinical applications. Semin Musculoskelet Radiol 18:352–364

    Article  PubMed  Google Scholar 

  2. Sconfienza LM, Albano D, Messina C, Silvestri E, Tagliafico AS (2018) How, when, why in magnetic resonance arthrography: an international survey by the European Society of Musculoskeletal Radiology (ESSR). Eur Radiol. https://doi.org/10.1007/s00330-017-5208-y [Epub ahead of print]

    Article  PubMed  Google Scholar 

  3. Ng AW, Hung EH, Griffith JF, Tong CS (2013) Cho CC (2013) comparison of ultrasound versus fluoroscopic guided rotator cuff interval approach for MR arthrography. Clin Imaging 37:548–5534

    Article  PubMed  Google Scholar 

  4. Lee YH, Choi YR, Kim S, Song HT, Suh JS (2013) Intrinsic ligament and triangular fibrocartilage complex (TFCC) tears of the wrist: comparison of isovolumetric 3D-THRIVE sequence MR arthrography and conventional MR image at 3 T. Magn Reson Imaging 31:221–226

    Article  PubMed  Google Scholar 

  5. Hussain SM (2008) UNMC advances 3.0T abdominal imaging. Field Strength Issue 35:8–13

    Google Scholar 

  6. Wieslander SB, Rappeport ED, Lausten GS, Thomsen HS (1998) Multiplanar reconstruction in MR imaging of the knee. Comparison with standard sagittal and coronal images. Acta Radiol 39:116–119

    PubMed  CAS  Google Scholar 

  7. Kijowski R, Davis KW, Woods MA et al (2009) Knee joint: comprehensive assessment with 3D isotropic resolution fast spin-echo MR imaging—diagnostic performance compared with that of conventional MR imaging at 3.0 T. Radiology 252:486–495

    Article  PubMed  Google Scholar 

  8. Jung JY, Jee WH, Park MY, Lee SY, Kim JM (2012) Meniscal tear configurations: categorization with 3D isotropic turbo spin-echo MRI compared with conventional MRI at 3 T. Am J Roentgenol 198:W173–W180

    Article  Google Scholar 

  9. Wagner SC, Schweitzer ME, Weishaupt D (2001) Temporal behavior of intraarticular gadolinium. J Comput Assist Tomogr 25:661–670

    Article  PubMed  CAS  Google Scholar 

  10. Kopka L, Funke M, Fischer U, Keating D, Oestmann J, Grabbe E (1994) MR arthrography of the shoulder with gadopentetate dimeglumine: influence of concentration, iodinated contrast material, and time on signal intensity. Am J Roentgenol 163:621–623

    Article  CAS  Google Scholar 

  11. Snyder SJ, Karzel RP, Del Pizzo W, Ferkel RD, Friedman MJ (1990) SLAP lesions of the shoulder. Arthroscopy 6:274–279

    Article  PubMed  CAS  Google Scholar 

  12. Woertler K, Waldt S (2006) MR imaging in sports-related glenohumeral instability. Eur Radiol 16:2622–2636

    Article  PubMed  PubMed Central  Google Scholar 

  13. DeLong ER, DeLong DM, Clarke-Pearson DL (1988) Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 44:837–845

    Article  PubMed  CAS  Google Scholar 

  14. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174

    Article  PubMed  CAS  Google Scholar 

  15. Kim MS, Park CS, Lee EJ et al (2010) Magnetic resonance colonography: comparison between T1 high resolution isotropic volume excitation (THRIVE) and balanced fast field echo (bFFE) using an air enema or water gadolinium enema. Clin Radiol 65:319–324

    Article  PubMed  CAS  Google Scholar 

  16. Foti G, Avanzi P, Mantovani W et al (2017) MR arthrography of the shoulder: evaluation of isotropic 3D intermediate-weighted FSE and hybrid GRE T1-weighted sequences. Radiol Med 122:353–360

    Article  PubMed  Google Scholar 

  17. Jung JY, Jee WH, Park MY, Lee SY, Kim YS (2013) SLAP tears: diagnosis using 3-T shoulder MR arthrography with the 3D isotropic turbo spin-echo space sequence versus conventional 2D sequences. Eur Radiol 23:487–495

    Article  PubMed  Google Scholar 

  18. Jung JY, Yoon YC, Choi SH, Kwon JW, Yoo J, Choe BK (2009) Three-dimensional isotropic shoulder MR arthrography: comparison with two-dimensional MR arthrography for the diagnosis of labral lesions at 3.0 T. Radiology 250:498–505

    Article  PubMed  Google Scholar 

  19. Lee JH, Yoon YC, Jee S, Kwon JW, Cha JG, Yoo JC (2014) Comparison of three-dimensional isotropic and two-dimensional conventional indirect MR arthrography for the diagnosis of rotator cuff tears. Korean J Radiol 15:771–780

    Article  PubMed  PubMed Central  Google Scholar 

  20. Lee YH, Kim AH, Suh JS (2014) Magnetic resonance visualization of surgical classification of rotator cuff tear: comparison with three-dimensional shoulder magnetic resonance arthrography at 3.0 T. Clin Imaging 38:858–863

    Article  PubMed  Google Scholar 

  21. Oh DK, Yoon YC, Kwon JW et al (2009) Comparison of indirect isotropic MR arthrography and conventional MR arthrography of labral lesions and rotator cuff tears: a prospective study. Am J Roentgenol 192:473–479

    Article  Google Scholar 

  22. Park HJ, Lee SY, Rho MH, Kwon HJ, Kim MS, Chung EC (2015) The usefulness of the three-dimensional enhanced T1 high-resolution isotropic volume excitation MR in the evaluation of shoulder pathology: comparison with two-dimensional enhanced T1 fat saturation MR. Br J Radiol 88:20140830

    Article  PubMed  PubMed Central  Google Scholar 

  23. Park SY, Lee IS, Park SK, Cheon SJ, Ahn JM, Song JW (2014) Comparison of three-dimensional isotropic and conventional MR arthrography with respect to the diagnosis of rotator cuff and labral lesions: focus on isotropic fat-suppressed proton density and VIBE sequences. Clin Radiol 69:e173–e182

    Article  PubMed  CAS  Google Scholar 

  24. Jung JY, Jee WH, Park MY, Lee SY, Kim YS (2012) Supraspinatus tendon tears at 3.0 T shoulder MR arthrography: diagnosis with 3D isotropic turbo spin-echo SPACE sequence versus 2D conventional sequences. Skeletal Radiol 41:1401–1410

    Article  PubMed  Google Scholar 

  25. Park HJ, Lee SY, Kim MS et al (2015) Evaluation of shoulder pathology: three-dimensional enhanced T1 high-resolution isotropic volume excitation MR vs two-dimensional fast spin echo T2 fat saturation MR. Br J Radiol 88:20140147

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  26. Dietrich TJ, Zanetti M, Saupe N, Pfirrmann CW, Fucentese SF, Hodler J (2010) Articular cartilage and labral lesions of the glenohumeral joint: diagnostic performance of 3D water-excitation true FISP MR arthrography. Skeletal Radiol 39:473–480

    Article  PubMed  Google Scholar 

  27. Magee T (2007) Can isotropic fast gradient echo imaging be substituted for conventional T1 weighted sequences in shoulder MR arthrography at 3 Tesla? J Magn Reson Imaging 26:118–122

    Article  PubMed  Google Scholar 

  28. Lee MJ, Motamedi K, Chow K, Seeger LL (2008) Gradient-recalled echo sequences in direct shoulder MR arthrography for evaluating the labrum. Skeletal Radiol 37:19–25

    Article  PubMed  Google Scholar 

  29. Gottsegen CJ, Merkle AN, Bencardino JT, Gyftopoulos S (2017) Advanced MRI techniques of the shoulder joint: current applications in clinical practice. Am J Roentgenol 209:544–551

    Article  Google Scholar 

  30. Rastogi AK, Davis KW, Ross A, Rosas HG (2016) Fundamentals of joint injection. Am J Roentgenol 207:484–494

    Article  Google Scholar 

  31. Fox MG, Petrey WB, Alford B, Huynh BH, Patrie JT, Anderson MW (2012) Shoulder MR arthrography: intraarticular anesthetic reduces periprocedural pain and major motion artifacts but does not decrease imaging time. Radiology 262:576–583

    Article  PubMed  Google Scholar 

  32. Lee SH, Lee YH, Song HT, Suh JS (2017) Rapid acquisition of magnetic resonance imaging of the shoulder using three-dimensional fast spin echo sequence with compressed sensing. Magn Reson Imaging 42:152–157

    Article  PubMed  Google Scholar 

  33. Lustig M, Donoho D, Pauly JM (2007) Sparse MRI: the application of compressed sensing for rapid MR imaging. Magn Reson Med 58:1182–1195

    Article  PubMed  Google Scholar 

  34. Ugas MA, Huynh BH, Fox MG, Patrie JT, Gaskin CM (2014) MR arthrography: impact of steroids, local anesthetics, and iodinated contrast material on gadolinium signal intensity in phantoms at 1.5 and 3.0 T. Radiology 272:475–483

    Article  PubMed  Google Scholar 

  35. Messina C, Banfi G, Aliprandi A (2016) Ultrasound guidance to perform intra-articular injection of gadolinium-based contrast material for magnetic resonance arthrography as an alternative to fluoroscopy: the time is now. Eur Radiol 26:1221–1225

    Article  PubMed  Google Scholar 

  36. Silvestri E, Barile A, Albano D et al (2017) Interventional therapeutic procedures in the musculoskeletal system: an Italian Survey by the Italian College of Musculoskeletal Radiology. Radiol Med. https://doi.org/10.1007/s11547-017-0842-7

    Article  PubMed  Google Scholar 

  37. Messina C, Banfi G, Orlandi D et al (2016) Ultrasound-guided interventional procedures around the shoulder. Br J Radiol 89:20150372

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul, 01757, Republic of Korea

    Sun Hwa Lee

  2. Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea

    Seong Jong Yun

  3. Department of Radiology, Gangnam Severance Hospital, College of Medicine, Yonsei University, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea

    Youngno Yoon

Authors
  1. Sun Hwa Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Seong Jong Yun
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Youngno Yoon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Seong Jong Yun.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. In addition, as this was a retrospective study we state that for this type of study formal consent is not required.

Ethical standards

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

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, S.H., Yun, S.J. & Yoon, Y. Diagnostic performance of shoulder magnetic resonance arthrography for labral tears having surgery as reference: comparison of high-resolution isotropic 3D sequence (THRIVE) with standard protocol. Radiol med 123, 620–630 (2018). https://doi.org/10.1007/s11547-018-0879-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11547-018-0879-2

Keywords

Search

Navigation