• Title/Summary/Keyword: Magnetic Resonance Arthrography

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Direct MR Arthrography of the Hip: Diagnosis and Pitfalls of Acetabular Labral Lesions (고관절 직접 자기공명관절조영술: 비구순 병변의 진단 및 함정)

  • Eun Sol Lim; Yong Kyun Kim;Hye Mi Park;Seung Jin Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1140-1162
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    • 2021
  • Tearing of the acetabular labrum is a common cause of chronic hip pain. MR arthrography (MRA) of the hip is the imaging procedure of choice for the evaluation of acetabular labrum. Familiarity with the various imaging findings of MRA of the hip allows recognition of normal variants and differentiation from true pathologic conditions. This article comprehensively reviews the technical aspects and interpretation of MRA of the hip. The appearances of normal and abnormal labra in MRA are discussed. Potential pitfalls in labral tear interpretation, such as sulci around the hip, normal variants of the labrum and plicae, and osseocartilaginous and soft tissue lesions identified on MRA of the hip are also described.

The usefulness of the contrast agent high in gadolinium for the magnetic resonance shoulder arthrography (자기공명 견관절조영검사 시 고함유량 가돌리늄 조영제의 유용성)

  • Na, Sa-Ra;Kim, Yoon-Shin;Choi, Kwan-Woo;Lee, Ho-Beom;Son, Soon-Yong;Min, Jung-Whan;Lee, Joo-Ah;Ma, Sang-Chull;Lee, Jong-Seok;Yoo, Beong-Gyu
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.4
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    • pp.2199-2206
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    • 2014
  • This research, used an contrast agent, which weighs about 1mmol/mL, of twice as much amount of gadolinum, per unit, for the test of magnetic-resonance shoulder arthrography. the reasearch which was carried out from January, of the year 2012 to August of the year 2013. consisted, of target of 41, patients including 20 ones, of whom an original, contrast agent of amount of 0.5mmol/mL, 21, ones of whom, a new, of amount of 1mmol/mL was used on, were the test target, in order to figure out the differences, according to the amount of gadolinum, according to the test results, the SNR of the contrast agent, of amount of 1mmol/mL, which is of high amount of gadolinum, was noticeably higher than the one of amount of 0.5mmol/mL(the percentage of joint space 38.01%, the supraspinous muscle 8.40%, head of humerus 12.78%). and CNR of the contrast agent, of amount of 1mmol/mL, which is of high amount of gadolinum, was higher than the one of amount of 0.5mmol/mL(the percentage of joint space and supraspinous muscle 48.96%, the one of joint space and head of humerus 42.00%). In conclusion, one of the methods of increasing the reducing effect of T1, is to use contrast agent of amount of 1mmol/mL, in order to increase the reducing effect of T1, acquire the visual of high testing quality.

The usefulness of the contrast agent high in gadolinium for the contrast-enhanced magnetic resonance hip arthrography (고관절의 자기공명관절조영검사 시 가돌리늄 함유량이 높은 조영제의 유용성)

  • Choi, Kwan-Woo;Kim, Yoon-Shin;Son, Soon-Yong;Lee, Ho-Beom;Na, Sa-Ra;Min, Jung-Whan;Yoo, Beong-Gyu;Lee, Jong-Seok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.11
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    • pp.5682-5688
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    • 2013
  • The purpose of this study is to maximize diagnositc usefulness with increasing signal to noise ratio(SNR) and contrast to noise ratio(CNR) by using a 1mmol/mL gadolinium contrast agent. From January 2012 to June 2013 fourty-seven patients were underwent the MRI scanning to investigate the contrast difference in gadolinium content. Twenty of the patients were injencted the commercial contrast agent containing 0.5mmol/mL gadolinium and the rest of them were injected the new contrast agent containing 1mmol/mL gadolinium called gadobutrol. We measured and evaluated each SNR and CNR of the hip joint space, iliopsoas muscle and femoral head. As a result, using the 1mmol/mL gadolinium contrast agent had the higher SNR results than using the 0.5mmol/mL agent(27% in the hip joint, 30.01% in the femoral head). Also CNR using the 1mmol/mL gadolinium agent was proved to be higher than that of using 0.5mmol/mL agent(28.31% in the ilopsoas muscle and 26.74% in the femoral head). Therefore, the contrast agent containing more gadolinium like 1mmol/mL used in this study is more effective to shorten T1 relaxation time, so it increases the signal intensity and CNR and furthermore maximizes diagnostic value. This study reports the usefulness of the 1mmol/mL contrast agent in the contrast-enhanced magnetic resonance hip arthrography for the first. Therefore, it can be considered to have an meaningful academic value as showing the method for increasing the diagnostic usefulness by using the 1mmol/mL contrast agent.

A long head of the biceps tendon confluent with the intraarticular rotator cuff: arthroscopic and MR arthrographic fndings

  • Kim, Kyung-Cheon;Rhee, Kwang-Jin;Shin, Hyun-Dae;Byun, Ki-Yong
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2008.03a
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    • pp.162-162
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    • 2008
  • Many anomalous origins of the long head of the biceps tendon (LHBT) have been reported. However, developmental anomalies of the LHBT are rarely encountered in daily practice. We report a patient with an anomalous LHBT that was adherent to and confluent with the rotator cuff throughout its intra-articular course and present the clinical, magnetic resonance arthrography, and arthroscopic findings.

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Arthroscopic Treatment for Calcific Tendinitis of Origin of Long Head of Triceps

  • Kim, Woo;Song, Byung Wook;Rhie, Tae-Yon;Kwon, Jieun
    • Clinics in Shoulder and Elbow
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    • v.19 no.4
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    • pp.245-248
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    • 2016
  • A 55-year-old female experienced acute left shoulder pain without specific trauma. Radiography showed calcific deposits in the inferior part of the glenoid fossa. Magnetic resonance arthrography showed calcific deposits in the origin of the long head of triceps brachii muscle. Conservative treatment failed to resolve the symptoms; therefore, arthroscopic surgery was performed. The patient experienced immediate and dramatic pain relief, and normal shoulder motion was demonstrated 1 year after surgery. In conclusion, although rare, calcific tendinitis of the triceps brachii muscle, which causes shoulder pain, should be included in the differential diagnosis of acute shoulder pain. Arthroscopic surgery is a treatment option for chronic cases and those resistant to conservative treatment.

Ankle Impingement Syndrome (족관절 충돌 증후군)

  • Choi, Gi-Won;Choi, Woo-Jin;Lee, Jin-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.1
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    • pp.19-25
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    • 2012
  • The ankle impingement syndrome is an established cause of ankle dysfunction. In most cases with suspected ankle impingement, the diagnosis can be possible on the basis of mechanism of injury involved and the clinical examination. An appropriate imaging study should be selected where clinical doubt about the exact diagnosis exists. Radiography plays an important role in the initial assessment of these conditions, especially in anterior and posterior impingement. Magnetic resonance arthrography seems to be the most accurate means of assessing the capsular abnormalities present in anterolateral and anteromedial impingement and for confirmation of possible concomitant injury. Surgical treatment can be considered for the patients who did not respond to conservative treatment for more than 6 months, and has a low complication rate and a high level of success.

Pathology of the Rotator Cuff in Adhesive Capsulitis Patients (견관절 유착성 관절 낭염 환자에 동반된 회전근 개 병변)

  • Yoo, Jae-Chul;Ahn, Jin-Hwan;Kim, Jae-Hoon;Chang, Moon-Jong;Seo, Hee-Soo;Sul, Eun-Jin
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.1
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    • pp.24-31
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    • 2007
  • Purpose: To evaluate any combined rotator cuff pathologies in adhesive capsulitis patients with magnetic resonance arthrography (MRA) or ultrasonography (USG), and to see any differences in findings between MRA and USG. Materials and Methods: From June to December 2005, 80 consecutive patients with adhesive capsulitis were prospectively evaluated with either MRA or USG. Two groups were randomly assigned for examination. Evaluation were focused on any combined rotator cuff pathologies especially supraspinatus tendon. Results: Small (less than 1 cm) full-thickness SSP tendon tear were seen in 6 patients (MRA 4, USG 2, 8%) and partial-thickness SSP tendon tears in 21 (MRA 12, USG 9, 26%). In addition, supraspinatus tendinopathy were seen in 15 patients (MRA 7, USG 8, 19%). Overall, various SSP pathologies were reported in 42 patients (53%) of the study objects (MRA 23, 68% and USG 19, 41%). Subscapularis tendon partial tears were reported in 9 patients (MRA 6, USG 3, 11%). There were no statistical differences of the findings between MRA and USG in detecting rotator cuff pathologies (p>0.5). Conclusion: Nearly one half of the adhesive capsulitis patients showed various supraspinatus tendon pathology in MRA or USG. Although MRA group showed slight higher percentage of associated rotator cuff pathology than USG group (without statistical significance), this could be attributed to better resolution capacity of MRA than USG.

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Diagnostic efficacy of specialized MRI & clinical results of arthroscopic treatment in ankle soft tissue impingement syndrome (족근 관절 연부조직 충돌 증후군에서 MRI의 진단적 의의 및 관절경적 치료 결과)

  • Lee, Jin-Woo;Moon, Eun-Su;Kim, Sung-Jae;Hahn, Soo-Bong;Kang, Eung-Shick
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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    • pp.208-217
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    • 2003
  • Introduction: Soft-tissue impingement syndrome is now increasingly recognized as a significant cause of the chronic ankle pain. As a method to detect soft-tissue ankle impingement, a characteristic history and physical examination, routine MR imaging, and direct MR arthrography were used. The efficacy of routine MR imaging has been controversial for usefulness because of low sensitivity and specificity. Direct MR artrhography was recommaned for diagnosis because of the highest sensitivity, specificity and accuracy, but it requires an invasive procedure. The purpose of this study is to investigate the diagnostic accuracy of Fat suppressed, contrast enhanced, three-dimensional fast gradient recalled acquisition in the steady state with rediofrequency spoiling magnetic resonance imaging(CE 3D-FSPGR MRI) and to evaluate the clinical outcome of the arthroscopic treatment in assessing soft-tissue impingement associated with trauma of the ankle. Materials and Methods: We reviewed 38 patients who had arthroscopic evaluations and preoperative magnetic resonance imaging studies(3D-FSPGR MRI) for post-traumatic chronic ankle pain between January 2000 and August 2002. Among them, 24 patients had osteochondral lesion, lateral instability, loose body, malunion of lateral malleoli, and peroneal tendon dislocation. The patient group consisted of 23 men and 15 women with the average age of 34 years(16-81 years). The mean time interval from the initial trauma to the operation was 15.5 months(3 to 40 months), The mean follow-up duration of the assessment was 15.6months(12-48 months). MRI was simultaneously reviewed by two radiologists blinded to the clinical diagnosis. The sensitivity, specificity and accuracy of MRI was obtained from radiologic and arthroscopic finding. Arthroscopic debridement and additional operation for associated disease were performed. We used a standard protocol to evaluate patients before the operation and at follow-up which includes American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score. Results: For the assessment of the synovitis and soft tissue impingement, fat suppressed CE 3D-FSPGR MR imaging had the sensitivity of 91.9%, the specificity of 84.4 and the accuracy of 87.5%. AOFAS Ankle-Hindfoot Score of preoperative state was 69.2, and the mean score of the last follow-up was 89.1. These were assessed as having 50% excellent(90-100) and 50% good(75-89). The presence of other associated disease didn't show the statistically significant difference(>0.05). Conclusion: Fat suppressed CE 3D-FSPGR MR imaging is useful method comparable to MR arthrography for diagnosis of synovitis or soft-tissue impingement, and arthroscopic debridement results in good clinical outcome.

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A CLINICAL AND RADIOLOGICAL STUDY ON THE INTERNAL DERANGEMET OF TMJ (악관절 내장증의 임상 및 방사선학적 연구)

  • Han Won-Jeong;Kim Eun-Kyung
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.22 no.2
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    • pp.351-364
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    • 1992
  • Internal derangement of the temporomandibular joint can be defined an abnormal relationships of the meniscus relative to the mandibular condyle, articuar fossa and eminence. This may cause variable mandibular dysfunctions and pain. For diagnosis, arthrography, computed tomography and magnetic resonance imaging are used. In this study, the author reviewed 98 TMJs of 88 patients who were diagnosed as internal derangement througth inferior joint space arthrography at the department of Oral & Maxillofacial Radiology, Dental Hospita, Dankook university through 1986 to 1992. 98 TMJs consisting of 30 disc displcement with reduction, 48 disc displcement without reduction and 20 perforation were studied about clinical and radiological findings. The results were as follows: 1. Internal derangement was found most frequently in the 2nd 3rd decades and the average age of perforation was higher than that of disc displcement with higher than that of disc displcement with reduction. The sexual predilection was 2 times hiher in females. 2. The most frequent chief complaints were TMJ sound in disc displcement with reduction, pain and limitation of mouth opening in disc displcement without reduction and pain in perforation. The duration of the chief complaints was longer in disc displcement with reduction with than in preforation and disc displcement without reduction. 3. Reciprocal click was the most frequently TMJ sound in disc displcement with reduction. History of joint sound in disc displcement without reduction an crepitus in perforation was the most frequent one. 4. The average maximum opening was 45.4㎜ in disc displcement with reduction, 31.4㎜ in disc displcement without reduction and 33.8㎜ in perforation. 5. In the centric occlusion, posterior condylar position was the most frequent in disc displcement with reduction. posterior and concentric condylar position was frequent in disc displcement without reduction, concentric and anterior condylar position in perforation. At 1 inch opening, the same position to articular eminence was most frequently found in disc displcement with reduction, posterior position in disc disp1cement without reduction, posterior and nterior position in perforation was frequently found. 6. Bony changes, especially sclerosis and flattening, was most frequently found in perforation.

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Peri-anchor cyst formation after arthroscopic bankart repair: comparison between biocomposite suture anchor and all-suture anchor

  • Jin, Seokhwan;Chun, Yong-Min
    • Clinics in Shoulder and Elbow
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    • v.23 no.4
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    • pp.178-182
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    • 2020
  • Background: The purpose of this study is to investigate clinical outcomes and radiological findings of cyst formation in the glenoid around suture anchors after arthroscopic Bankart repair with either biocomposite suture anchor or all-suture anchor in traumatic anterior shoulder instability. We hypothesized that there would be no significant difference in clinical and radiological outcomes between the two suture materials. Methods: This retrospective study reviewed 162 patients (69 in group A, biocomposite anchor; 93 in group B, all-suture anchor) who underwent arthroscopic Bankart repair of traumatic recurrent anterior shoulder instability with less than 20% glenoid defect on preoperative en-face view three-dimensional computed tomography. Patient assignment was not randomized. Results: At final follow-up, the mean subjective shoulder value, Rowe score, and University of California, Los Angeles shoulder score improved significantly in both groups. However, there were no significant differences in functional shoulder scores and recurrence rate (6%, 4/69 in group A; 5%, 5/93 in group B) between the two groups. On follow-up magnetic resonance arthrography/computed tomography arthrography, the incidence of peri-anchor cyst formation was 5.7% (4/69) in group A and 3.2% (3/93) in group B, which was not a significant difference. Conclusions: Considering the low incidence of peri-anchor cyst formation in the glenoid after Bankart repair with one of two anchor systems and the lack of association with recurrence instability, biocomposite and all-suture anchors in Bankart repair yield satisfactory outcomes with no significant difference.