The Usefulness of Multidetector CT Arthrography in the Diagnosis of Shoulder Pathology: Comparison with MR Arthrography and Arthroscopic Findings in the Same Patient |
Dong Soo Kim, Kyoung Jin Park, Yong Min Kim, Eui Sung Choi, Hyun Chul Shon, Byung Ki Cho, Ji Kang Park, Seok Won Kim |
Department of Orthopedic Surgery, Chungbuk National University Cheongju, Korea. oslion@chungbuk.ac.kr |
견관절 병변의 진단에서 다중 검출 전산화 단층촬영을 이용한 관절조영술의 유용성 - 동일 환자에서 시행한 자기공명 관절조영술 및 관절경 소견과의 비교 - |
김동수·박경진·김용민·최의성·손현철·조병기·박지강·김석원 |
충북대학교 의과대학 정형외과학교실 |
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Abstract |
PURPOSE The purpose of the study is to evaluate the usefulness of CT arthrography (CTA) by conducting a comparative study of CTA and MR arthrography (MRA) with the arthroscopic findings in the same patients.
MATERIALS AND METHODS: Forty nine patients who suffered from shoulder disease underwent MRA and CTA concurrently. The sensitivity and specificity of CTA was evaluated, as compared to MRA, in the case of four types of shoulder pathological lesions. The accuracy of CTA was evaluated by analyzing the arthroscopic findings of thirty four patients. RESULTS Compared to MRA, CTA showed a sensitivity of 90% and a specificity of 100% for diagnosing supraspinatus tendon (SST) full thickness tear, and CTA showed a sensitivity of 100% and a specificity of 97.5% for making the diagnosis of superior labrum anterior to posterior (SLAP) lesion. For diagnosing partial articular side supraspinatus avulsion (PASTA) lesion, some studies have shown the usefulness of CTA with a sensitivity of 71.4% and a specificity of 97.7%. However, for diagnosing SST bursal side partial tear, the sensitivity of CTA was as low as 10%. CTA has been shown to be relatively accurate when the diagnoses were verified with the arthroscopic findings; diagnosing SST full thickness tear and SLAP lesion with CTA has shown an accuracy of 100% and87.5% respectively, and CTA showed 71.4% diagnostic accuracy for PASTA lesion. CONCLUSION CTA was a useful tool and it was equivalent to MRA for the assessment of SST full thickness tear, SLAP lesion and PASTA lesion, but not bursal side partial tear. Thus, it may be used preferably to diagnose shoulder pathology and for follow up as an inexpensive tool after operation. |
Key Words:
Shoulder; CT arthrography; MR arthrography; Arthroscopy |
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