Direct magnetic resonance arthrography, indirect magnetic resonance arthrography, and computed tomography arthrography for rotator cuff lesions and superior labral anterior and posterior tears: State of the art

Abstract

Continual improvements in diagnostic modalities used for shoulder imaging have led to better resolution, sensitivity, and specificity. There is no consensus about whether conventional MRI, direct MR arthrography, indirect MR arthrography, or CT arthrography is the best method. Many publications from very diverse origins propose different criteria for selecting the technique to apply in different patients. However, the application of rigid protocols that do not include all the imaging options does not help patients. Moreover, this approach also restricts radiologists’ creativity, especially in countries in which resources are more limited. It is important to ensure the rational use of the techniques depending on the patient and the place, considering the patient's age, associated diseases, surgical possibilities, complications, and available equipment. This article reviews the state of the art in imaging rotator cuff and superior labral anterior and posterior lesions, considering the indications, advantages, and advantages of the different techniques in different cases.