Shoulder low field plain MRI with adducted and externally rotated arm (ADER): an easier and more comfortable way to improve diagnosis?

Congress:

ESSR 2016

Poster Number:

P-0135

Type:

Scientific Poster

Keywords:

Image verification, Athletic injuries, Diagnostic procedure, MR, Musculoskeletal joint

Authors:

C. Ottonello¹, V. Tempesta², A. Giardino², L. Lombardi¹, L. Giuliani², P. Giuliani², F. Perona³; ¹Pomezia/IT, ²Rome/IT, ³Lissone/IT

DOI:

10.1594/essr2016/P-0135

DOI-Link:

https://dx.doi.org/10.1594/essr2016/P-0135

Fig. 2: Coronal T2 weighted slices in standard position(SP)and external rotation(ADER)....

Fig. 3: Coronal T2 weighted slices in standard position (SP) and external rotation...

Fig. 4: Coronal T2 weighted slices in standard position (SP) and external rotation...

Fig. 5: Coronal T2 weighted slices in standard position (SP) and external rotation...

Purpose

To evaluate the diagnostic potential of MRI in ADER position in the study of the shoulder, in particular in detection of rotator cuff, rotator cable and glenoid labrum.

Methods and Materials

We studied 18 patients (5 males, 13 females, age 13-67, 40,5±16,1 mean±standard deviation) affected by atraumatic shoulder pain with standard MRI sequences (S-Scan Open Sectorial MRI Unit, Esaote, Genova-Italy), usual “neutral” position (coronal T1-T2-WI, axial T2-WI, sagittal T2-WI fat suppressed)and in ADER position (coronal T2-WI), with 90° flexed forearm.

Results

ADER position showed: in 3/18 (17%) supraspinatus tear not visualized in standard position (SP), in 4/18 (22%) better visualization of normal rotator cable (RC), in 1/18 RC tear not visibile at SP, in 7/18 (39%) SLAP tear not visualized at SP, in 1/18 (5%) higher grade SLAP compared to SP.

Conclusion

Addictional ADER position, with a little increase of examination time, in more comfortable conditions (compared to abduction-extrarotation position and to high field MRI unit) and without contrast agent administration, seems to allow a better evaluation of SLAP tears, a slightly better evaluation of RC and supraspinatus tears. Larger studies are required to confirm these preliminary data.

References

1 Aydıngöz U, Maraş Özdemir Z, Ergen FB Demystifying ABER (ABduction and External Rotation) sequence in shoulder MR arthrography Diagn Interv Radiol. 2014 Nov;20(6):507-10 2 Schreinemachers SA, van der Hulst VP, Jaap Willems W, Bipat S, van der Woude HJ. Is a single direct MR arthrography series in ABER position as accurate in detecting anteroinferior labroligamentous lesions as conventional MR arthography? Skeletal Radiol (2009) 38:675–683 3 Iyengar JJ1, Burnett KR, Nottage WM, Harwin SF. The abduction external rotation (ABER) view for MRI of the shoulder...