A Clinical Audit to investigate delay times between injection of contrast and MR arthrogram in a Teaching Hospital Radiology Department

Congress:

ESSR 2017

Poster Number:

P-0197

Type:

Scientific Poster

Keywords:

Quality assurance, Athletic injuries, Audit and standards, Arthrography, MR, Fluoroscopy, Musculoskeletal joint, Contrast agents

Authors:

L. Nelson¹, J. Harris²; ¹Salford/UK, ²Manchester/UK

DOI:

10.1594/essr2017/P-0197

DOI-Link:

https://dx.doi.org/10.1594/essr2017/P-0197

Fig. 2: Delay times for all patients

Fig. 3: Delay times for patients in arthrogram room A

Fig. 6: Delay times by joint

Table 1: Table showing all patient categories and delay times

Fig. 7: Delayed case by 2 hours 34 minutes, axial T1 weighted fat suppressed view

Purpose

What is Magnetic Resonance Arthrography? Magnetic resonance imaging alone is non-invasive, without ionising radiation, has good soft tissue contrast and has the ability to image in multiple planes, making it superior to CT for evaluation of joint pathology. Direct MR arthrography (MRA) is a widely used technique for imaging the shoulder and hip, amongst other joints. In the imaging of the shoulder, it is especially useful for imaging in the case of rotator cuff pathology, shoulder instability and posterior superior glenoid impingement. Although it is...

Methods and Materials

All patients (n= 202) who had undergone a shoulder or hip MR arthrogram at Salford Royal Hospital in 2016 were included. 10 had undergone 2 separate studies, 6 were removed from analysis due to incomplete procedure or time recording errors on the scanner. 207 arthrograms were included. Patients' ages ranged from 16 years to 66 years, with the average age being 34.1 years. There were 117 males and 79 females. There were 126 studies of theshoulder and 74 of the hip. Joint arthrogram was carried...

Results

Time delay between arthrogram contrast injection and MR ranged between 13 minutes and 2 hours 34 minutes, with the averagedelay being 53 minutes. Data was split into 15 minute ranges (Figure 1). Over half of patients (58%) experienced a delay between 31 and 60 minutes. Overall 45% patient of patients met the 45 minute maximum delay target. The numbers are shownin Figure 2. There were 4studies where the report of the MR suggested that delay time between injection and MR had degraded the images. All...

Conclusion

Overall,MRI was performed within 45 minutes following arthrogram injection in only 45% of the time, however very few studies were delayed by more than 90 minutes. In our experience moderate delay time of up to 90 minutes for either joint did not appear to impact on image quality, bar for around 4 scans. All of these studies were of the shoulder and no hip studies were delayed by more than 90 minutes. Figure 7 is a case with accepabledelay and shows an axial T1 weighted...

References

1. Chandnani VP, Yeager TD, DeBerardino T, Christensen K, Gagliardi JA, Heitz DR, et al. Glenoid labral tears: prospective evaluation with MRI imaging, MR arthrography, and CT arthrography. AJR Am J Roentgenol. 1993 Dec;161(6):1229–35. 2. Recht MP, Kramer J, Petersilge CA, Yu J, Pathria M, Trudell D, et al. Distribution of normal and abnormal fluid collections in the glenohumeral joint: implications for MR arthrography. J Magn Reson Imaging. 1994 Apr;4(2):173–7. 3. Leunig M, Werlen S, Ungersbock A, Ito K, Ganz R. Evaluation of the acetabular...

Personal Information

Dr Lilli S Nelson, Foundation Year 2 Doctor (Intern), Salford Royal Foundation Trust, Eccles, Salford, M6 8HD,UK. Dr Jonathan N Harris, Consultant MSK Radiologist, Salford Royal Foundation Trust, Eccles, Salford, M6 8HD,UK.