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Diagnostic Performance of MR Arthrography in the Assessment of Superior Labral Anteroposterior Lesions of the Shoulder

Simone Waldt1, Andreas Burkart2, Peter Lange1, Andreas B. Imhoff2, Ernst J. Rummeny1 and Klaus Woertler1

1 Department of Radiology, Technische Universität München, Klinikum rechts der Isar, Ismaninger Strasse 22, Munich, D-81675 Germany.
2 Department of Sports Orthopedics, Technische Universität München, Conollystrasse 32, Munich, D-80809 Germany.



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  		Fig. 1. —Superior labral anteroposterior type I lesion correctly interpreted in 23-year-old male athlete with overhead sports activity (basketball). Coronal oblique T1-weighted MR arthrogram shows irregularities of superior glenoid labrum (arrowhead).

 


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  		Fig. 2. —Superior labral anteroposterior type II lesion correctly interpreted on MR arthrography in 26-year-old man. Coronal oblique T1-weighted MR arthrogram shows lateral and superior extension of contrast media (arrowhead) into superior labrum and biceps tendon.

 


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  		Fig. 3. —False-negative diagnosis in 29-year-old-man. Coronal oblique T1-weighted MR arthrogram shows regular, medial extension of contrast media (arrowhead) between superior labrum and glenoid, interpreted as sublabral recess. At arthroscopy, superior labral anteroposterior type II lesion was diagnosed.

 


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  		Fig. 4. —False-positive diagnosis in 34-year-old man. Coronal oblique T1-weighted MR arthrogram shows lateral and superior contrast media extension (arrowhead) into superior labrum interpreted as superior labral anteroposterior type II lesion. At arthroscopy, labral–bicipital complex was described as unremarkable.

 


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  		Fig. 5A. —Correctly diagnosed superior labral anteroposterior (SLAP) type III lesion in 42-year-old man. Coronal oblique T1-weighted MR arthrogram shows detachment and inferior displacement of triangular superior labrum (arrowhead).

 


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  		Fig. 5B. —Correctly diagnosed superior labral anteroposterior (SLAP) type III lesion in 42-year-old man. Consecutive coronal oblique T1-weighted MR arthrogram confirms preservation of biceps tendon insertion above bucket-handle fragment (arrowhead). Arthroscopy confirmed SLAP type III lesion.

 


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  		Fig. 6A. —Superior labral anteroposterior type IV lesion correctly diagnosed in 31-year-old woman. Coronal oblique T1-weighted MR arthrogram shows detachment of fragment from superior labrum (arrowhead).

 


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  		Fig. 6B. —Superior labral anteroposterior type IV lesion correctly diagnosed in 31-year-old woman. Consecutive coronal oblique T1-weighted MR arthrogram shows extension of tear (arrow) into biceps tendon.

 


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  		Fig. 6C. —Superior labral anteroposterior type IV lesion correctly diagnosed in 31-year-old woman. Consecutive coronal oblique T1-weighted MR arthrogram shows lateral extension of labral tear.

 


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  		Fig. 6D. —Superior labral anteroposterior type IV lesion correctly diagnosed in 31-year-old woman. Axial T1-weighted MR arthrogram shows detached labral fragment completely delineated by contrast media (arrowhead) and interposed between humeral head and glenoid.

 


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  		Fig. 7A. —Superior labral anteroposterior type II lesion with coexisting Bankart lesion correctly interpreted in 27-year-old man with chronic instability of glenohumeral joint. Axial T1-weighted MR arthrogram shows detachment of anteroinferior capsulolabral complex (arrowhead).

 


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  		Fig. 7B. —Superior labral anteroposterior type II lesion with coexisting Bankart lesion correctly interpreted in 27-year-old man with chronic instability of glenohumeral joint. Axial T1-weighted MR arthrogram shows cranial extension of labral tear.

 


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  		Fig. 7C. —Superior labral anteroposterior type II lesion with coexisting Bankart lesion correctly interpreted in 27-year-old man with chronic instability of glenohumeral joint. Coronal oblique T1-weighted MR arthrogram shows lateral extension of labral tear (arrowhead) into labral–bicipital complex.

 

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