• 대한견주관절학회:학술대회논문집
• /
• 대한견주관절학회 2008년도 제16차 학술대회
• /
• pp.14-14
• /
• 2008

• Clinics in Shoulder and Elbow
• /
• 제9권1호
• /
• pp.73-82
• /
• 2006

Purpose: The purpose of the present study was to evaluate the diagnostic efficacy of CT arthrography (CTA) in the assessment of various shoulder pathologies, compared with MR arthrography (MRA) and MRI with arthroscopic correlation. Materials and Methods: CTA in 84 patients, MRA in 70 patients, and MRI in 27 patients were obtained. A radiologist interpreted each image for 5 pathologies: Bankart, SLAP, Hill-Sachs lesion, full-thickness, and partial-thickness rotator cuff tear. Detailed arthroscopic reports were compared with CTA, MRA, and MRI. The sensitivity, specificity, predictive values, and accuracy were calculated. The agreement between each diagnostic modality and arthroscopy was calculated. Diagnostic efficacy was assessed by the areas under the receiver operating characteristic (ROC) curves. Results: The diagnostic values of all three imaging groups were comparable to each other for Bankart, SLAP, Hills-Sachs, and full-thickness cuff tear lesions, but those of CTA were lower than MRI and MRA for partial-thickness cuff tears. The areas under the ROC curves for CTA, MRA, and MRI were not significantly different for all pathologies, except for partial-thickness cuff tears. Conclusion: CTA was equally competent to MRA or MRI in demonstrating Bankart, Hill-Sachs lesions, SLAP, and full thickness rotator cuff tears but not as efficient in diagnosing partial thickness rotator cuff tears.

• 대한견주관절학회:학술대회논문집
• /
• 대한견주관절학회 2006년도 제14차 학술대회
• /
• pp.81-81
• /
• 2006

• Korean Journal of Radiology
• /
• 제2권4호
• /
• pp.216-221
• /
• 2001

Objective: To compare, in terms of their demonstration of tears of the anterior glenoid labrum, oblique axial MR arthrography obtained with the patient's shoulder in the abduction and external rotation (ABER) position, with conventional axial MR arthrography obtained with the patient's arm in the neutral position. Materials and Methods: MR arthrography of the shoulder, including additional oblique axial sequences with the patient in the ABER position, was performed in 30 patients with a clinical history of recurrent anterior shoulder dislocation. The degree of anterior glenoid labral tear or defect was evaluated in both the conventional axial and the ABER position by two radiologists. Decisions were reached by consensus, and a three-point scale was used: grade 1=normal; grade 2=probable tear, diagnosed when subtle increased signal intensity in the labrum was apparent; grade 3=definite tear/defect, when a contrast material-filled gap between the labrum and the glenoid rim or deficient labrum was present. The scores for each imaging sequence were averaged and to compare conventional axial and ABER position scans, Student's t test was performed. Results: In 21 (70%) of 30 patients, the same degree of anterior instability was revealed by both imaging sequences. Eight (27%) had a lower grade in the axial position than in the ABER position, while one (3%) had a higher grade in the axial position. Three whose axial scan was grade 1 showed only equivocal evidence of tearing, but their ABER-position scan, in which a contrast material-filled gap between the labrum and the glenoid rim was present, was grade 3. The average grade was 2.5 (SD=0.73) for axial scans and 2.8 (SD=0.46) for the ABER position. The difference between axial and ABER-position scans was statistically significant (p<0.05). Conclusion: MR arthrography with the patient's shoulder in the ABER position is more efficient than conventional axial scanning in revealing the degree of tear or defect of the anterior glenoid labrum. When equivocal features are seen at conventional axial MR arthrography, oblique axial imaging in the ABER position is helpful.

• 대한견주관절학회:학술대회논문집
• /
• 대한견주관절학회 2006년도 제14차 학술대회
• /
• pp.1-1
• /
• 2006

• 대한견주관절학회:학술대회논문집
• /
• 대한견주관절학회 2008년도 제16차 학술대회
• /
• pp.6-6
• /
• 2008

• Clinics in Shoulder and Elbow
• /
• 제18권4호
• /
• pp.211-216
• /
• 2015

Background: Few studies have investigated magnetic resonance (MR) characteristics of traumatic posterosuperior rotator cuff tears involving the supraspinatus and infraspinatus. We hypothesized that traumatic rotator cuff tears may have MR characteristics distinguishable from those of non-traumatic tears. Methods: Preoperative MR arthrography and intraoperative tear size measurements were compared in 302 patients who underwent MR arthrography and subsequent arthroscopic rotator cuff repairs for traumatic (group T, 61 patients) or non-traumatic (group NT, 241 patients) tears. The inclusion criteria for both groups were posterosuperior full-thickness rotator cuff tear and age between 40 and 60 years. For group T, traumas were limited to accidental falls or slips, or sports injuries, motor vehicle accidents; injuries were associated with acute onset of pain followed by functional shoulder impairment; and time between injury and magnetic resonance imaging (MRI) was 6 weeks or less. Results: In group T, 72.1% of shoulders (44 patients) had tendon tears with blunt edges while 27.9% of shoulders (17 patients) had tears with tapering edges. In contrast, 21.2% of patients in group NT (51 patients) had blunt-edge tears, while 78.8% (190 patients) of tears had tapering edges. These results were statistically significant (p<0.001) and estimated odds ratio was 9.6. The size of tear did not vary significantly between groups. Conclusions: We found no exclusive MR characteristic to define traumatic tears. However, oblique coronal MRI of traumatic tears showed a significant tendency for abrupt and rough torn tendon edges and relatively consistent tendon thicknesses (without lateral tapering) compared to non-traumatic cuff tears.

• Korean Journal of Radiology
• /
• 제20권6호
• /
• pp.931-938
• /
• 2019

Objective: To compare inferior capsular redundancy by using magnetic resonance arthrography (MRA) images in patients with multidirectional instability (MDI) of the shoulder and control subjects without instability and thereby develop a screening method to identify the presence of shoulder MDI. Materials and Methods: The MRA images of patients with MDI of the shoulder (n = 65, 57 men, 8 women; mean age, 24.5 years; age range, 18-42 years) treated over an eight-year period were retrospectively reviewed; a control group (n = 65, 57 men, 8 women; mean age, 27.4 years; age range, 18-45 years) without instability was also selected. The inferior capsular redundancy was measured using a new method we named the glenocapsular (GC) ratio method. MRA images of both groups were randomly mixed together, and two orthopedic surgeon reviewers measured the cross-sectional areas (CSAs) and sagittal capsule-head ratios on oblique sagittal images, as well as the axial capsule-head ratios on axial images and GC ratios on oblique coronal images. Results: The CSAs and GC ratios were significantly higher in patients than in controls (both, p < 0.001); however, the sagittal capsule-head ratios and axial capsule-head ratios were not significantly different (p = 0.317, p = 0.053, respectively). In addition, GC ratios determined the presence of MDI more sensitively and specifically than did CSAs. A GC ratio of > 1.42 was found to be most suggestive of MDI of the shoulder, owing to its high sensitivity (92.3%) and specificity (89.2%). Conclusion: GC ratio can be easily measured and used to accurately screen for MDI of the shoulder.

• Clinics in Shoulder and Elbow
• /
• 제12권2호
• /
• pp.115-125
• /
• 2009

목적: 본 연구의 목적은 동일한 환자에게서 시행한 전산화단층촬영 관절조영술 (CT arthrography, CTA)와 자기공명 관절조영술 (MR arthrography, MRA) 및 관절경 소견을 비교하여 견관절의 다양한 병변을 진단함에 있어 CTA의 유용성을 알아보고자 함이다. 대상 및 방법: 견관절의 질환이 의심되는 49명의 환자에게 MRA와 CTA를 동시에 시행하고, 각각의 영상을 통하여 극상근 전층 파열, 상부 관절와순 전후방 병변 (SLAP 병변), 극상근 관절측 부분층 파열 (PASTA 병변), 극상근 점액낭편 부분층 파열의 총 4개의 병변을 진단하고 MRA와 비교하여 CTA의 민감도 (sensitivity), 특이도 (specificity), 양성예측도 (positive predictive value), 음성예측도 (negative predictive value)를 평가하였다. 또한, 49명의 환자 중 수술을 시행한 34명의 관절경 수술 소견을 분석하여 CTA의 정확도를 평가하였다. 결과: CTA는 MRA와 비교할 때 극상근 전층 파열 및 SLAP 병변에서 민감도가 각각 90%, 100%, 특이도는 100%, 97.5%로 거의 대등한 진단적 유용성이 있었으며, PASTA 병변에서는 민감도 71.4%, 특이도 97.7%로 일부에서 유용성을 보였으나, 극상근 점액낭편 부분파열의 진단에는 민감도가 10%로 취약하였다. 또한 CTA에서 진단된 병변은 수술 소견과 비교할 때 극상근 전층 파열 100%, SLAP 병변 87.5%, PASTA 병변 71.4%로 높은 정확도를 보였다. 결론: CTA는 MRA와 비교할 때, 4개의 견관절 병변 중, 점액낭편 부분 파열을 제외하고 극상근 전층 파열, SLAP 병변, PASTA 병변을 평가함에 있어서 MRA와 거의 대등한 유용성을 보였다. 따라서, 보다 경제적인 검사로서 견관절 병변 진단 및 수술 후 추시 등에 유용하게 사용될 수 있을 것으로 생각된다.

• 대한견주관절학회:학술대회논문집
• /
• 대한견주관절학회 2006년도 제14차 학술대회
• /
• pp.16-17
• /
• 2006