American Journal of Roentgenology, Vol 169, 1453-1457, Copyright © 1997 by American Roentgen Ray Society

ARTICLES

MR arthrography of the shoulder: rethinking traditional imaging procedures to meet the technical requirements of MR imaging guidance

CA Petersilge, JS Lewin, JL Duerk and SF Hatem
Department of Radiology, University Hospitals of Cleveland, OH 44106, USA.

OBJECTIVE: The purpose of this study was to determine the feasibility of and the appropriate technique for performance of MR imaging-guided arthrography of the shoulder. SUBJECTS AND METHODS: Thirty-eight MR imaging-guided glenohumeral joint punctures were performed using an open C-arm scanner with a vertically oriented magnetic field, adapted for interventional procedures. Two different approaches to the shoulder were used: a modification of the traditional anterior approach (seven procedures), and an anterosuperior approach (31 procedures) mimicking the anterior arthroscopy portal. The average procedure duration was determined. A retrospective review of needle mediolateral and anterioposterior position was determined for the anterosuperior approaches. RESULTS: Average procedure duration was 21 min for the anterior approach and 12 min for the anterosuperior approach. Subjectively, needle conspicuity was minimal with the anterior approach, contributing to prolonged imaging times. Needle visualization was much improved with the anterosuperior approach. Nine of the 31 anterosuperior procedures involved inadvertent injection of the subacromial or subdeltoid bursa. At the time of retrospective review, the needle was too laterally or too anteriorly positioned in six of these nine patients. CONCLUSION: With consideration of the technical demands of MR imaging guidance for interventional procedures, MR imaging-guided arthrography of the shoulder is feasible. The traditional radiologic approach to the shoulder must be modified to provide adequate visualization of the needle. The anterosuperior approach meets this needs.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				H. Depelteau, N. J. Bureau, E. Cardinal, B. Aubin, and P. Brassard Arthrography of the Shoulder: A Simple Fluoroscopically Guided Approach for Targeting the Rotator Cuff Interval Am. J. Roentgenol., February 1, 2004; 182(2): 329 - 332. [Abstract] [Full Text] [PDF]

				K. D. Farmer and P. M. Hughes MR Arthrography of the Shoulder: Fluoroscopically Guided Technique Using a Posterior Approach Am. J. Roentgenol., February 1, 2002; 178(2): 433 - 434. [Full Text] [PDF]

				C. A. Petersilge Chronic Adult Hip Pain: MR Arthrography of the Hip RadioGraphics, October 1, 2000; 20(90001): 43S - 52. [Abstract] [Full Text]

				J. S. Lewin, E. M. Merkle, J. L. Duerk, and R. W. Tarr Low-Flow Vascular Malformations in the Head and Neck: Safety and Feasibility of MR Imaging–guided Percutaneous Sclerotherapy—Preliminary Experience with 14 Procedures in Three Patients Radiology, May 1, 1999; 211(2): 566 - 570. [Abstract] [Full Text]

				J. W. Genant, J. E. Vandevenne, A. G. Bergman, C. F. Beaulieu, S. T. Kee, A. M. Norbash, and P. Lang Interventional Musculoskeletal Procedures Performed by Using MR Imaging Guidance with a Vertically Open MR Unit: Assessment of Techniques and Applicability Radiology, April 1, 2002; 223(1): 127 - 136. [Abstract] [Full Text] [PDF]