Indirect MR arthrography of the shoulder in detection of rotator cuff ruptures

The aim of this study was to compare the efficacy of indirect MR arthrograp hy images obtained following intravenous contrast injection and conventiona l MR imaging in the diagnosis of rotator cuff tears. Twenty-four patients w ith clinically suspected rotator cuff disease were examined. Conventional M R images and post-contrast indirect MR arthrography images were obtained. A ll images were evaluated in a blinded fashion by two musculoskeletal radiol ogist. Results were than analyzed depending on surgical output. The correla tion coefficient (Spearman rank correlation test) and the kappa values for agreement between surgery and imaging techniques were calculated. The corre lation coefficients between indirect MR arthrography and surgery for reader 1 and reader 2 were 0.9137 and 0.9773, respectively. Whereas the agreement between conventional MR imaging and surgery was moderate (kappa = 0.383-0. 571), the agreement between indirect MR arthrography and surgery was excell ent (kappa = 0.873-0.936). We suggest the use of indirect MR arthrography t echnique when conventional MR images are equivocal in diagnosis of rotator cuff disease.