肩前方不安定症の術前検査で三次元CT検査を省略できるか−関節窩骨形態評価におけるMRIと三次元CTとの比較検討−

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Evaluation of the glenoid for traumatic anterior shoulder instability is essential and imaging studies by scapula 3DCT and shoulder MRI have become standardized. However, carcinogenic risks from CT radiation have been reported and avoidance would be preferred. We valued the glenoid in bony Bankart lesion (BBL) by MRI and confronted with the findings by 3DCT.Thirty-four cases that underwent surgery for traumatic anterior shoulder instability from January 2008 to July 2009 were examined. An orthopaedic surgeon and a radiologist who were blinded to each other assessed the findings by MRI and 3DCT, using the 3DCT as the golden standard.18 and 13 cases were diagnosed as BBL by CT and MRI, respectively. The sensitivity of BBL in MRI was 72.2% and the specificity was 100%. The measurements of the glenoid deficit did not show any significance between MRI and CT. The group in which the bony deficit could not be recognized by MRI (MRNB) showed lower measurements by CT than the group which was possible (MRBB). The deficit area did not exceed 16% in MRNB. All MRBB cases were crescentic by CT and were read as bone erosion by MRI.BBLs of more than moderate size were able to be noticed by MRI and bone erosion suggested slender BBLs. The figure provided by MRI was relatively reliable. The result of a preceding MRI could indicate the need for a further CT retrenching excessive radiation exposures and medical cost. 3DCT of the shoulder could be omitted from pre-operative evaluation for anterior shoulder instability.

肩前方不安定症の術前検査で三次元CT検査を省略できるか−関節窩骨形態評価におけるMRIと三次元CTとの比較検討−

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