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MRI v.s. Arthrogram 

Comparing different types of MRI Scans for diagnosing ligament tear

Ligament tear around the shoulder joints is one of the more common sports injuries. The diagnosis of a ligament tear starts with accurate history-taking and clinical assessment. This is then supplemented with radiological imaging, such as Magnetic Resonance Imaging (MRI).

Magnetic Resonance Arthrography, in short MRA, is a sensitive diagnostic tool for ligamentous tears. This involves injection of MR contrast into the affected joint, followed immediately by imaging using 1.5 Tesla MRI. The injection of contrast into the affected joint may be tedious, painful and time-consuming, but this is essential as 1.5 Tesla MRI does not provide enough resolution to give an accurate assessment of ligamentous tear.

Using the 3.0 Tesla MRI is different. It has a higher resolution, thus enabling the assessment of ligamentous tears even without the injection of intra-articular contrast.

By eliminating the intra-articular injection of contrast the patient is being diagnosed without having to suffer any pain. It is also time-saving, as there is no need for patients to first visit the fluoroscopy room, for the contrast medium to be administered, before proceeding to the MRI. It thus shortens waiting time for patients to have the procedure done.

Doing away with the need for intra-articular contrast injection also means cost-savings for the patient.

In CGH, the accuracy of diagnosis, depending on the types of ligament tear, for the two procedures is charted as:

  • 3.0 Tesla MRI: 75% - 87%
  • 1.5 Tesla MRI with contrast: 80% – 100%
In view of the comparable accuracy and the advantages enjoyed by patients who underwent imaging by the 3.0 Tesla MRI, we are of the opinion that the 3.0 Tesla MRI is preferable to the 1.5 Tesla MRI with intra-articular contrast for patients with shoulder joint ligament tear.

(Source: Department of Radiology & Medical Information Management, CGH)

References

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