Fast magnetic resonance arthrography of the labrum

Research question: Short volumetric interpolated breath hold exam (VIBE) 3D gradient echo sequences are comparable to T1 spin echo (SE) sequences for evaluating the shoulder labrum using arthroscopy as a gold standard. Methods: 24 patients with suspected labral tears had magnetic resonance (MR) arthrography of the shoulder using 1.5T MR scanner. Coronal oblique 3D VIBE FS sequences were performed and reconstructed in axial and sagittal oblique planes and compared with standard T1 SE sequences. Presence and location of labral tear and rotator cuff tears were noted. Findings were correlated with surgery where available. Time to obtain T1 SE sequences versus 3D VIBE acquisition was recorded. Results: Of 24 patients, 54% had arthroscopy. Sensitivity and positive predictive value (PPV) of both T1 SE and VIBE sequences for labral tears was 92%. 100% agreement for diagnosis of labral tear by readers between both sequences was noted. Specific labral tear location was accurate in 75% for both sequences. The mean time to obtain T1 SE sequences was 13.5 mins and 7.5 minutes for 3D VIBE sequences. Conclusion: Fast MR arthrography using 3D VIBE sequences shows excellent concordance with standard T1-FS sequence for diagnosis of labral tears. With shorter acquisition time and high diagnostic sensitivity 3D VIBE sequences maybe used as an alternative to standard sequences. Level of evidence: Level III retrospective diagnostic study.