- Technique:
- protocols: fat suppressed T2 wt images and proton density weighted images
- older protocol:
T1 &
T2 coronal oblique spin-echo sequences with use of 14 cm field of view and a four-millimeter slice thickness;
- Discussion:
- it is the most important view for identification of a lesion of
rotator cuff, as
supraspinatus and
infraspinatus are seen in continuity w/ their insertion on greater tuberosity;
- axis is parallel to supraspinatus muscle and tendon;
- infraspinatus is seen on posterior images and is more obliquely oriented;
- it shows relationship between supraspinatus & acromion (& AC joint);
- sagittal oblique plane, allows optimum visualization of supraspinatus outlet and of the shape of the acromion;
- coracoclavicular, coracohumeral, & CA ligaments can sometimes be seen;
- Anterior Coronal Oblique Images:
- supraspinatus tendon may curves anteriorly, which may cause averaging of images w/ rotator interval which may cause an increased signal
and false impression of rotator cuff tear;
- Case Example: (55 year old female with large rotator cuff tear which lead to anterior instability);
Abnormal findings on magnetic resonance images of asymptomatic shoulders.
J.S. Sher MD, J.W. Uribe MD, A. Posada MD, B.J. Murphy MD, and M.B. Zlatkin MD.
JBJS. Vol 77-A. No 1. Jan 1995.
Magnetic resonance imaging of the shoulder. Sensitivity, specificity, and predictive value.
Magnetic resonance imaging of the shoulder.
Zlatkin MB, Dalinka MK, Kressel HY. Magn Reson Q 1989;5:3-22.
Shoulder instability: evaluation with MR imaging.
Seeger LL, Gold RH, Bassett LW. Radiology 1988;168:695-7.
The use of MRI about the shoulder.
J Beltran.
J. Shoulder Elbow Surg. Vol 1. 1992. p 321.
Evaluation of the painful shoulder. A prospective comparison of magnetic resonance imaging, computerized tomographic arthrography, ultrasonography, and operative findings.
