Detection of rotator cuff lesions with indirect MR angiography.

Purpose: To determine the value of indirect MR arthrography in lesions of t he rotator cuff, prospectively versus arthroscopy. Methods: 63 patients wit h suspected shoulder pathology were examined: oblique-coronary and axial T( 1)w sequences, axial FLASH-2D sequences, furthermore oblique-coronary T-2- and PD-weighted sequences were taken. After intravenous administration of 0 .1 mmol Gd-DTPA/kilogram body weight and active motion of the shoulder T(1) w sequences were repeated. Signal intensities (SI) inside the tendon were q uantitatively measured by the ROI technique (region-of-interest) and the pe rcentual contrast-enhancement CE was calculated. In 32 patients the results were confirmed by surgical follow-up. Results: The mean SI measured in the supraspinous tendon we-re higher in lesions (degeneration, impingement, pa rtial and total rupture), before as well as after contrast medium, compared to intact findings (p < 0.05). Similarly the percentual CE (p < 0.05) was higher. We detected 9 total ruptures and three impingements (for both sensi tivity before/after Gd-DTPA 100%), furthermore 6 partial ruptures. Of the l atter three were false positive and one false negative, leading to a sensit ivity of 75% and a specificity of 50%. Conclusion: The visualization of rot ator cuff lesions can be optimized with indirect MR arthrography. The detec tion of partial ruptures remains faulty, because the exact demarcation of d egenerative change and partial rupture is still difficult.