Summary
The ability to detect and categorize SLAP (Superior Labrum Anterior to Posterior) lesions of the scapular labrum is of practical importance to the orthopedic surgeon and the radiologist. The aim of this study, performed on cadaveric shoulders, was to determine whether CT arthrography or MR arthrography is able to show normal anatomical variation of the glenoid labrum and detect labral abnormalities. CT arthrography, MR arthrography followed by anatomical dissection were performed on twenty three fresh frozen cadaveric shoulders and analysed by a radiologist and two orthopaedic surgeons. As Gadolinium intra-articular injection is not allowed in France, we used an iodinated contrast media for both MR arthrography and CT arthrography. In this study, the sensitivity of MR arthrography seemed higher than CT arthrography (respectively 4 and 3 labral lesions diagnosed out of five), although no significant statistical conclusions can be made due to the small number of cases. In conclusion, under such specific conditions, MR arthrography seems to be the method of choice for the detection and classification of labral lesions.
Résumé
La possibilité de détecter et de classer les lésions du bourrelet supérieur de la cavité glénoïdale de la scapula (SLAP lesions: Superior Bourrelet Anterior to Posterior) est une nécessité pour le radiologue et l'orthopédiste confrontés à des patients présentant des douleurs de l'épaule. Le but de cette étude réalisée sur des épaules cadavériques, était de déterminer les valeurs respectives de l'arthro-scanner et de l'arthro-IRM dans la détection des variations anatomiques normales et des anomalies pathologiques du bourrelet glénoïdal supérieur. Un arthro-scanner, une arthro-IRM, puis une dissection anatomique ont été réalisées sur 23 épaules fraîches et les résultats de ces examens ont été analysés par un radiologue et deux chirurgiens orthopédistes. L'injection intra-articulaire de gadolinium n'étant actuellement pas autorisée en France, un produit de contraste iodé à été utilisé pour l'arthro-scanner et l'arthro-IRM. Dans cette étude, la sensibilité de l'arthro-IRM semblait meilleure que celle de l'arthro-scanner (respectivement 4 et 3 lésions diagnostiquées sur 5), bien que ce résultat ne soit pas statistiquement significatif compte tenu du petit nombre de cas. En conclusion, dans les conditions spécifiques de notre étude, l'arthro-IRM semble être la méthode de choix pour la détection et la classification des lésions du bourrelet glénoïdal supérieur.
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Bresler, F., Blum, A., Braun, M. et al. Assessment of the superior labrum of the shoulder joint with CT-arthrography and MR-arthrography: correlation with anatomical dissection. Surg Radiol Anat 20, 57–62 (1998). https://doi.org/10.1007/BF01628117
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DOI: https://doi.org/10.1007/BF01628117