Comparison of a Fast 5-Minute Shoulder MRI Protocol With a Standard Shoulder MRI Protocol: A Multiinstitutional Multireader Study.

Abstract

The purpose of this study was to compare the diagnostic performance of a 5-minute shoulder MRI protocol consisting of multiplanar 2D fast spin-echo (FSE) sequences with parallel imaging to that of a standard shoulder MRI protocol. A retrospective review of 151 3-T MRI examinations of shoulders of 147 patients (mean age, 46.95 years) and 50 1.5-T MRI examinations of shoulders of 50 patients (mean age, 53.74 years) with four fast and five standard sequences from two academic centers between January 2014 and April 2015 was performed by three musculoskeletal radiologists. Interchangeability of fast and standard MRI was tested by comparing interprotocol (fast vs standard) interreader agreement with standard MRI interreader agreement. Interreader agreement was also compared using kappa statistics. The frequency of major findings was compared using an adjusted McNemar test. Sensitivity and specificity of MRI were measured for 51 patients who underwent surgery. Interprotocol reader agreement was essentially equal to reader agreement on standard MRI (mean difference ≤ 1%; 95% CI, -3.8% to 3.9%; 61-96% across structures). Interprotocol kappa values (0.373-0.645) were similar to standard MRI kappa values (0.320-0.726). Frequencies of major findings on fast and standard MRI were similar (0.7-19.6% across structures; p ≥ 0.08). Sensitivities of fast MRI for tendon and labral tears (33-92%) were equivalent or higher than those of standard MRI with similar specificities (77-98%). Fast 5-minute shoulder MRI with multiplanar 2D FSE sequences using parallel imaging is interchangeable, with similar interreader agreement and accuracy, with standard shoulder MRI for evaluating shoulder injuries.