Indirect MR arthrography of the unexercised glenohumeral joint in patientswith rotator cuff tears

RATIONALE AND OBJECTIVES. TO evaluate the diagnostic utility of indirect MR arthrography of the unexercised glenohumeral joint in patients with rotato r cuff tears confirmed by arthroscopy or arthrotomy as the gold standard. METHODS. Twenty-six patients underwent conventional MR imaging and indirect MR arthrography of the stationary glenohumeral joint using a wrap-around s urface coil. Unenhanced T1-weighted spin echo/T2-weighted fast spin echo se quences and T1-weighted gradient echo sequences, adding spectral fat suppre ssion after intravenous administration of contrast medium, were performed i n the oblique coronal and oblique sagittal planes. Images were analyzed by three experienced radiologists in consensus. Levels of diagnostic confidenc e were evaluated using a four-point scale of diagnostic certainty. RESULTS. Performing indirect MR arthrography of the unexercised shoulder le ads to a diagnostically efficient enhancement of joint fluid (120% at 4 min utes and 145% at 8 minutes after intravenous injection of gadodiamide). In terms of soft tissue delineation, characterization of rotator cuff tears wa s significantly improved by using enhanced fat-suppressed T1-weighted gradi ent echo sequences compared with conventional MR imaging. CONCLUSIONS. Indirect MR arthrography without glenohumeral joint exercise i n the diagnosis of rotator cuff tears is feasible and represents a more con venient and less time-consuming alternative to indirect MR arthrography aft er joint exercise.