Effectiveness of multidetector computed tomography arthrography for the diagnosis of shoulder pathology: Comparison with magnetic resonance imaging with arthroscopic correlation

Abstract

Hypothesis: This study evaluated the diagnostic efficacy of computed tomography arthrography (CTA) in the assessment of various shoulder pathologies with arthroscopic correlation. We hypothesized that CTA would be cost-effective and effectively comparable with magnetic resonance arthrography (MRA) for assessing labral detachments and full-thickness rotator cuff tears. Materials and methods: A musculoskeletal radiologist interpreted CTAs for 78 patients and MRAs for 70 patients. Each imaging study was evaluated for the presence of bony (Hill-Sachs) or labral (Bankart or superior labrum anteroposterior [SLAP]) lesions, and rotator cuff disorder (full- or partial-thickness tears). All patients subsequently underwent arthroscopic surgery. Detailed arthroscopic findings were reported and compared with CTA and MRA findings. The sensitivity, specificity, K coefficients, and the area under the receiver operating characteristic (AUROC) curve were calculated. Results: The sensitivity, specificity, and agreement were comparable in each imaging study for Bankart. SLAP, and Hill-Sachs lesions, and full-thickness rotator cuff tears, but those of CTA were significantly lower than MRA for partial-thickness cuff tears. The AUROC curve for CTA and MRA were not significantly different for any of the pathologies, except partial-thickness cuff tears. Conclusions: Our data suggest that CTA is a cost-effective, useful method in the preoperative evaluation of labral abnormalities, such as Bankart and SLAP lesions. It may also be useful for the detection of full-thickness rotator cuff tears.