Accuracy of magnetic resonance imaging to diagnose superior labrum anterior-posterior tears

Verfasser / Beitragende:
[Kent Sheridan, Christopher Kreulen, Sunny Kim, Walter Mak, Kirk Lewis, Richard Marder]
Ort, Verlag, Jahr:
2015
Enthalten in:
Knee Surgery, Sports Traumatology, Arthroscopy, 23/9(2015-09-01), 2645-2650
Format:
Artikel (online)
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024 7 0 |a 10.1007/s00167-014-3109-z  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00167-014-3109-z 
245 0 0 |a Accuracy of magnetic resonance imaging to diagnose superior labrum anterior-posterior tears  |h [Elektronische Daten]  |c [Kent Sheridan, Christopher Kreulen, Sunny Kim, Walter Mak, Kirk Lewis, Richard Marder] 
520 3 |a Purpose: The purpose of this study was to evaluate the accuracy of magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA) in diagnosing superior labral anterior-posterior (SLAP) lesions. We hypothesized that the accuracy of MRI and MRA was lower than previously reported. Methods: Between 2006 and 2008, 444 patients who had both shoulder arthroscopy and an MRI (non-contrast or MR arthrography)for shoulder pain at our institution prior to surgery were identified and included in the study. The radiologic diagnosis and surgical evaluation were compared to determine the accuracy of diagnosing a SLAP lesion by MRI. Using arthroscopy as the standard, sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were calculated for all MRIs, as well as separately for the non-intra-articular contrast MRI group and the MR arthrography group. Results: Of the 444 patientshaving an MRI and arthroscopy for shoulder pain, 121 had a SLAP diagnosis by MRI and 44 had a SLAP diagnosis by arthroscopy. Overall, MRI had an accuracy of 76%, a PPV of 24%, and a NPV of 95%. Sensitivity was 66%, and specificity was 77%. MR arthrography had an accuracy of 69%, sensitivity of 80%, and a PPV of 29%. Non-contrast MRI had an accuracy of 85%, sensitivity of 36%, and a PPV of 13%. Conclusions: In our retrospective study of 444 patients, sensitivity, specificity, and accuracy were all lower than previously reported in the literature for diagnosing SLAP lesions. Our data indicated that while MRI could exclude a SLAP lesion (NPV=95%), MRI alone was not an accurate clinical tool. MR arthrography had a large number of false-positive readings in this study. We concluded that even with intra-articular contrast, MRI had limitations in the ability to diagnose surgically proven SLAP lesions. Level of evidence: Diagnostic study, Level II. 
540 |a Springer-Verlag Berlin Heidelberg, 2014 
690 7 |a Superior labrum anterior-posterior tear  |2 nationallicence 
690 7 |a Sensitivity  |2 nationallicence 
690 7 |a Specificity  |2 nationallicence 
690 7 |a Accuracy  |2 nationallicence 
690 7 |a Magnetic resonance imaging  |2 nationallicence 
700 1 |a Sheridan  |D Kent  |u Department of Orthopaedic Surgery, Davis Medical Center, University of California, 4860 Y Street, Suite 3800, 95817, Sacramento, CA, USA  |4 aut 
700 1 |a Kreulen  |D Christopher  |u Sutter Medical Foundation Sacramento, 11795 Education Street, #110, 95603, Auburn, CA, USA  |4 aut 
700 1 |a Kim  |D Sunny  |u Department of Public Health Sciences, University of California, Davis, One Shields Avenue, Med Sci 1-C, 95616, Davis, CA, USA  |4 aut 
700 1 |a Mak  |D Walter  |u Department of Medical Imaging, St Michael's Hospital, University of Toronto, 30 Bond Street, M5B 1W8, Toronto, ON, Canada  |4 aut 
700 1 |a Lewis  |D Kirk  |u Idaho Sports Medicine Institute, 1188 University Dr., 83706, Boise, ID, USA  |4 aut 
700 1 |a Marder  |D Richard  |u Department of Orthopaedic Surgery, Davis Medical Center, University of California, 4860 Y Street, Suite 3800, 95817, Sacramento, CA, USA  |4 aut 
773 0 |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/9(2015-09-01), 2645-2650  |x 0942-2056  |q 23:9<2645  |1 2015  |2 23  |o 167 
856 4 0 |u https://doi.org/10.1007/s00167-014-3109-z  |q text/html  |z Onlinezugriff via DOI 
898 |a BK010053  |b XK010053  |c XK010000 
900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00167-014-3109-z  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Sheridan  |D Kent  |u Department of Orthopaedic Surgery, Davis Medical Center, University of California, 4860 Y Street, Suite 3800, 95817, Sacramento, CA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Kreulen  |D Christopher  |u Sutter Medical Foundation Sacramento, 11795 Education Street, #110, 95603, Auburn, CA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Kim  |D Sunny  |u Department of Public Health Sciences, University of California, Davis, One Shields Avenue, Med Sci 1-C, 95616, Davis, CA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Mak  |D Walter  |u Department of Medical Imaging, St Michael's Hospital, University of Toronto, 30 Bond Street, M5B 1W8, Toronto, ON, Canada  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Lewis  |D Kirk  |u Idaho Sports Medicine Institute, 1188 University Dr., 83706, Boise, ID, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Marder  |D Richard  |u Department of Orthopaedic Surgery, Davis Medical Center, University of California, 4860 Y Street, Suite 3800, 95817, Sacramento, CA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/9(2015-09-01), 2645-2650  |x 0942-2056  |q 23:9<2645  |1 2015  |2 23  |o 167