ガドリニウム造影剤を用いない肩MR関節造影

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  • Magnetic resonane arthrography without gadolinium injection

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Background: Magnetic resonane arthrography (MRA) is a useful tool for detecting shoulder joint pathology. Gadolinium (gadopentate) provide superior image contrast, but it is not registered for intra-articular use in Japan. The purpose of this study is to investigate the usefulness of MRA without gadolinium.<BR>Methods: Forty shoulders were evaluated including 18 anterior instability and 22 throwing injuries. Mean age was 26.6 years (15-52), 6 female and 34 male. Thirty shoulders were evaluated by MRA using 15 ml of saline with 5 ml of 1 % lidocine (S group) and 10 shoulders using 20ml of diluted gadolinium (concentration 0.25 nmol/ml). Low-field open MRI (0.3T) was used. Three orthopedic surgeons diagnosed Fat-suppressed T1-weighted images (G group) and Fat-suppressed T2-weighted images (S group), individually. Two surgeons were blinded for the clinical information about patients.<BR>Results: Interexaminer agreement between three surgeons was 93 % of Bnakart lesion, 90 % of SLAP, and 53 % of the partial rotator cuff tear in S group. The rate of agreement of the Banakart or SLAP is significantly superior to rotator cuff lesion. Interexaminer agreement was 93 % of the Bnakart lesion, 90 % of the SLAP, and 70 % of partial rotator cuff tear in G group. There was no significant statistical difference between S and G group. There were no difficulties in detecting ALPSA (anterior labroligamentous periosteal sleeve avulsion) or capsular tear.<BR>Conclusion: MRA using saline is a useful clinical tool, especially for shoulder labrum pathology. It is possible to diagnose the shoulder instability by MRA without gadolinium injection.

収録刊行物

  • 肩関節

    肩関節 37 (3), 975-978, 2013

    日本肩関節学会

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