スポーツ障害肩の外転外旋位MRアルトログラム斜位横断像の有用性

概要

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The purpose of this study was to determine the utility of MR arthrography (MRA) in abduction and external rotation (ABER) position for a painful shoulder in overhead athletes. We studied 28 cases (26 male cases and 2 femal cases) ranging in age from 16 to 31 years old (average, 21.5 years old). Standard MRA (S-MRA) and ABER MRA with an oblique axial image were performed in all cases. In S-MRA with or without the ABER position, we evaluated the glenoid labral detachment, the articular-side partial rotator cuff tear, internal impingement. Arthroscopic correlation was obtained in all patients. Tears of the glenoid labrum were identified with a sensitivity of 96.3% with S-MRA, with a sensitivity of 66.7% with ABER MRA. In articular-side partial rotator cuff tear, S-MRA had a sensitivity of 58.8% and a specificity of 90.9%, ABER MRA had a sensitivity of 76.5% and a specificity of 90.9%. Using both the S-MRA and ABER MRA, the sensitivity was increased to 88.2% but the specificity was equal to the one alone. Internal impingement was identified with a sensitivity of 83.3% and a specificity of 100% with ABER MRA alone. The ABER MRA was useful in detection and characterization of articular-side partial rotator cuff tear and in diagnosis of internal impingement.