反復性肩関節前方脱臼におけるＣＴ関節造影とＭＲ関節造影との比較

Abstract

Imaging of the Bankart lesion for the patients with reccurent dislocation of the shoulder is useful for making the pre-operative planning. We compared CT arthrography (CTA) with MR arthrography (MRA), and investigated the usefulness of CTA and MRA for the diagnosis.6 patients (6 shoulders) with reccurent anterior dislocation of the shoulder were evaluated with CTA and MRA. There were 5 males and one female, their age ranged from 17 to 40 years (average age 28 years at the time of operation). CT was taken after injecting 20ml of air in the joint space. MRA was done with itraarticular injection of 20ml of Gd-DTPA and T1 images were taken in transverse and oblique sagittal plane. All of them underwent arthroscopy follwed by modified Bristow's operation. The findings of both MRA and CTA were verified with the arthroscopic and operative findings.Absence of labrum in one case and displacement of the labrum in three cases could be seen in both CTA and MRA. In two cases there was only tear without any displcement, both these cases could be diagnosed by MRA, however, CTA missed one case. On the other hand, considering two osseous Bankart lesions, MRA could not detect one case, whereas CTA could diagnose the both. In four cases there was detachment of the anterior capsule, which could be seen in both CTA and MRA. However, MRA has an upper hand in detecting the anterior inferior glenohumeral ligament.