Posterosuperior suture granuloma impingement after arthroscopic SLAP repair using suture anchors: a case report

Arthroscopic refixation of the glenoid labrum has become a standard treatment of type II SLAP lesions although postoperative results are not uniformly good due to factors which are yet unclear. We present the case of an active overhead athlete with an intraarticular posterosuperior impingement syndrome arising from a suture granuloma formation complicating the postoperative course after arthroscopic SLAP repair. The symptoms resolved completely following revision arthroscopy during which the granuloma and the permanent sutures were removed. Implant related complications should be considered when patients present with recurrent pain after arthroscopic SLAP repair using suture anchors, in particular during overhead activity.     

Sports activity after arthroscopic superior labral repair using suture anchors in overhead-throwing athletes

PURPOSE: To evaluate the results of arthroscopic repair of type II superior labral anterior posterior lesions of the shoulder in overhead athletes. HYPOTHESIS: Such repair is useful for overhead athletes in terms of postoperative sports activity. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: The study group was composed of 40 patients with a mean age of 24 years (range, 15-38 years); mean follow-up was 41 months (range, 24-58 months). They were divided into an overuse (n=22) and a trauma group (n=18). The authors used 2 suture anchors loaded with a nonabsorbable suture at the 11-o'clock and 1-o'clock positions through the anterosuperior and lateral trans-rotator cuff portal. A modified Rowe score and postoperative athletic activities were evaluated. RESULTS: After arthroscopic repair, mean modified Rowe scores improved from 27.5 to 92.1 points (P<.0001). Rated on this scale, the results were excellent in 30 (75%), good in 6 (15%), and fair in 4 (10%) athletes; there were no poor results. Satisfactory outcomes were achieved in 36 (90%) of these patients; 30 (75%) experienced a return to the preinjury level. The complete return rate of baseball players in the overuse group was lower than that of other overhead athletes in the trauma group. CONCLUSION: Arthroscopic superior labral repair is a safe and reliable procedure in overhead athletes.     

Arthroscopic repair of isolated type II superior labrum anterior–posterior lesion

The effectiveness of arthroscopic repair of type II superior labrum anterior-posterior lesion (SLAP) was unclear as previous studies examined this treatment with patients of combined types of SLAP lesions. To address this research gap, we evaluated the clinical and functional outcomes of arthroscopic repair for 16 patients (mean=24.2, SD=6.5) with clinical evidence of isolated type II SLAP lesion. After having arthroscopic stabilizations with Bioknotless suture anchors (Mitek), the patients were offered post-operative rehabilitation programs (e.g., physiotherapy) for 6 months. The symptoms of SLAP lesion and the functions of the shoulder were assessed pre-operatively and 28-month post-operatively by O'Brien test, Speed test, Yergason test, and University of California at Los Angeles rating for pain and function of the shoulder. Wilcoxon Signed Ranks test and McNemar test were employed to analyze the difference between assessment in pre-operation and post-operation phases. The result showed that patients' shoulder functions improved (UCLA Shoulder Score), and symptoms of SLAP lesion reduced (O'Brien test, Speed test, and Yergason test) significantly (P<0.05). Time for returning to play with pre-injury level was in average 9.4 months (range 4-24), and no complication or recurrence was detected. We concluded that arthroscopic repair is an effective operation of type II SLAP lesion with good clinical and functional outcomes; however, athletes with high demand of overhead throwing activities are likely to take longer duration of rehabilitation to attain full recovery.     

Shoulder MR arthrography: which patient group benefits most?

OBJECTIVE: We sought to compare the diagnostic accuracy of conventional MRI versus MR arthrography of the shoulder in the assessment of high-performance athletes (professional baseball players) and to compare our findings in these patients with the conventional MRI and MR arthrographic findings in an age-matched control group of nonprofessional athletes. MATERIALS AND METHODS: Conventional MRI and MR arthrographic examinations of the shoulder in 20 consecutive professional baseball players with shoulder pain were reviewed retrospectively by two musculoskeletal radiologists in consensus. These interpretations were compared with retrospective consensus interpretations of conventional MRI and MR arthrographic examinations of the shoulder obtained in a control group of 50 consecutive nonprofessional athletes with shoulder pain. MR images were assessed for full- or partial-thickness supraspinatus tendon tears, superior labral anteroposterior (SLAP) tears, and anterior or posterior labral tears. RESULTS: In the 20 consecutive professional athlete patients, two full-thickness and six partial-thickness undersurface supraspinatus tendon tears were seen on MR arthrography but not seen on conventional MRI as well as six SLAP tears, two anterior labral tears, and one posterior labral tear. Three patients had both SLAP tears and full- or partial-thickness supraspinatus tendon tears. Of 14 patients with findings on MR arthrography that were not seen on MRI, 11 had arthroscopic correlation. In all 11, arthroscopic findings confirmed findings on MR arthrography. In the group of 50 nonprofessional athlete patients, five had additional findings on MR arthrography not seen on conventional MRI: two anterior labral tears, two partial-thickness supraspinatus tendon tears, and two SLAP tears. One patient had both a partial-thickness supraspinatus tendon tear and a SLAP tear seen on MR arthrography. The five patients with additional findings on MR arthrography had arthroscopy. In all five, arthroscopic findings confirmed the findings on MR arthrography. CONCLUSION: MR arthrography is considerably more sensitive for detection of partial-thickness supraspinatus tears and labral tears than conventional MRI. MR arthrography showed injuries in addition to those seen on conventional MRI in 14 of 20 patients in the high-performance athlete group. These results suggest high-performance athletes may be a subgroup of patients for whom MR arthrography yields considerably more diagnostic information than conventional MRI.     

Diagnostic performance of MR arthrography in the assessment of superior labral anteroposterior lesions of the shoulder

OBJECTIVE: The purpose of this study was to evaluate the diagnostic performance of MR arthrography in the assessment of superior labral anteroposterior (SLAP) lesions of the shoulder with emphasis on the classification of SLAP lesions. MATERIALS AND METHODS: Two hundred sixty-five MR arthrograms including 68 MR arthrograms of patients with arthroscopically proven SLAP lesions of the shoulder and 197 MR arthrograms of patients with an intact superior labrum and biceps anchor were retrospectively reviewed in random order. MR arthrography was performed using triplanar T1-weighted spin-echo sequences and a coronal oblique T2-weighted fast spin-echo sequence. MR arthrograms were evaluated by two radiologists with agreement by consensus, and the results were compared with arthroscopic findings. RESULTS: Of 68 SLAP lesions, seven (10%) were arthroscopically classified as type I, 41 (60%) as type II (including 20 type II lesions with coexisting Bankart lesions [29%]), 14 (21%) as type III, and six (9%) as type IV. Compared with arthroscopy as the gold standard, MR arthrography showed a sensitivity of 82% and a specificity of 98% for the overall detection of SLAP lesions. MR arthrographic grading and arthroscopic grading were concurrent in 45 (66%) of 68 arthroscopic diagnoses. Of the surgically confirmed SLAP lesions, involvement of the biceps insertion and SLAP type II lesions with coexisting Bankart lesions were assessed correctly in 75% and 95% of cases, respectively. CONCLUSION: MR arthrography is a highly effective method for the detection of SLAP lesions, but this technique is limited in the classification of different types of SLAP lesions. However, for preoperative planning MR arthrography provides accurate information about the stability of the biceps insertion and the presence of associated anteroinferior labral injuries.     

Rehabilitation after surgical management of the thrower's shoulder

The overhead throwing motion is a complex and coordinated movement pattern involving the lower extremities, the trunk, and the upper extremity. Because of these tremendous demands on the shoulder, various shoulder injuries may occur. Two of the more common injuries to throwers are shoulder instability and superior labrum anterior-posterior lesions. Although nonoperative treatment is frequently successful in treating these conditions, surgical management may be necessary for the athlete to return to their sport. The purpose of this article is to review the first 3 phases of rehabilitation after arthroscopic capsular stabilization and superior labrum anterior-posterior debridement or repair. The fourth phase, return to throwing, will be covered in the final section.     

SLAP lesions: anatomy, clinical presentation, MR imaging diagnosis and characterization

Superior labral anterior posterior (SLAP) tears are an abnormality of the superior labrum usually centered on the attachment of the long head of the biceps tendon. Tears are commonly caused by repetitive overhead motion or fall on an outstretched arm. SLAP lesions can lead to shoulder pain and instability. Clinical diagnosis is difficult thus imaging plays a key diagnostic role. The normal anatomic variability of the capsulolabral complex can make SLAP lesions a diagnostic challenge. Concurrent shoulder injuries are often present including rotator cuff tears, cystic changes or marrow edema in the humeral head, capsular laxity, Hill-Sachs or Bankart lesion. The relevant anatomy, capsulolabral anatomic variants, primary and secondary findings of SLAP tears including MR arthrography findings, types of SLAP lesions and a practical approach to labral lesions are reviewed.     

An arthroscopic and electromyographic study of painful shoulders in elite gymnasts

Shoulder problems are common in overhead sports like baseball, basketball and volleyball. Although gymnastics also includes overhead activities, there are few reports about shoulder problems in this sports activity. During the time period 1992–1995 we treated five young competitive gymnasts for shoulder pain. Arthroscopy revealed that they were all suffering from SLAP lesions or other labral pathology, although they had never dislocated their shoulders. These injuries have not been described earlier in connection with gymnastics. In a survey of 13 gymnasts in an elite club, we found that six (46%) complained about shoulder pain. Since four of these athletes explained that their shoulder pain started acutely during ring exercises in suspension while one suffered a slower onset with pain also during parallel bar exercises, we undertook an electromyographic study of the shoulder musculature of three normal elite gymnasts during exercises on the parallel bars and rings. We found that during the ring exercises in suspension there was a critical phase during which the muscle activity around the shoulder was very low, leading to great articular stresses. This might explain the occurrence of labral lesions like the SLAP lesions in this type of athlete. If shoulder pain in elite gymnasts does not respond to rest and physical therapy over 2–3 months, a shoulder arthroscopy should be considered.     

Outcome of the isolated SLAP lesions and analysis of the results according to the injury mechanisms

Superior labral anterior posterior (SLAP) lesions of the shoulder arise from various causes and have some controversies in their treatment. The purpose of this study is to evaluate the outcomes of arthroscopic SLAP repair and the relationship between injury mechanisms and outcomes. We evaluated the clinical results of 24 patients (mean 33 months follow-up) who had an arthroscopic isolated SLAP (type II: 21, type III: 1, type IV: 2 patients) repair with suture anchors. These labral tears were arthroscopically repaired with 1–4 anchors (mean 1.8). All patients were evaluated with University of California, Los Angeles (UCLA) and Visual Analogue Scale (VAS) scores. There were the following injury mechanisms: compression-type, 10; traction-type, 9; combined or other-type, 5 patients. We also compared the clinical results according to the injury mechanisms. Preoperatively, the mean of UCLA and VAS scores were 22.7 and 6.4 points, respectively. At an average of 33 months postoperatively, the mean of UCLA and VAS scores were 29.9 and 2.1 points, respectively. There was statistical improvement in the subjective scores from the pre- to post-operation. UCLA and VAS scores of the pre- and post-operation were not statistically different according to the injury mechanisms. Arthroscopic repair is effective in the treatment of isolated SLAP lesion and injury mechanisms do not affect the clinical outcomes.     

SLAP lesions: a treatment algorithm

Tears of the superior labrum involving the biceps anchor are a common entity, especially in athletes, and may highly impair shoulder function. If conservative treatment fails, successful arthroscopic repair of symptomatic SLAP lesions has been described in the literature particularly for young athletes. However, the results in throwing athletes are less successful with a significant amount of patients who will not regain their pre-injury level of performance. The clinical results of SLAP repairs in middle-aged and older patients are mixed, with worse results and higher revision rates as compared to younger patients. In this population, tenotomy or tenodesis of the biceps tendon is a viable alternative to SLAP repairs in order to improve clinical outcomes. The present article introduces a treatment algorithm for SLAP lesions based upon the recent literature as well as the authors’ clinical experience. The type of lesion, age of patient, concomitant lesions, and functional requirements, as well as sport activity level of the patient, need to be considered. Moreover, normal variations and degenerative changes in the SLAP complex have to be distinguished from “true” SLAP lesions in order to improve results and avoid overtreatment. The suggestion for a treatment algorithm includes: type I: conservative treatment or arthroscopic debridement, type II: SLAP repair or biceps tenotomy/tenodesis, type III: resection of the instable bucket-handle tear, type IV: SLAP repair (biceps tenotomy/tenodesis if >50 % of biceps tendon is affected), type V: Bankart repair and SLAP repair, type VI: resection of the flap and SLAP repair, and type VII: refixation of the anterosuperior labrum and SLAP repair.     

A biomechanical comparison of repair techniques for type II SLAP lesions

BACKGROUND: Multiple options exist for repair of superior labral tears. PURPOSE: To compare commonly used fixation techniques for superior labral tears. STUDY DESIGN: Biomechanical cadaveric study. METHODS: A comparison of the initial strengths of fixation for type II superior labral anterior posterior (SLAP) lesions was performed in three cadaveric shoulder groups, each containing seven specimens. Two groups were repaired with screw-in anchors; one group had vertical sutures, the other horizontal. Group 3 was repaired using bioabsorbable tacks. Cyclic traction was applied to the biceps tendon. Repair failure (2 mm of permanent displacement) and ultimate failure were measured. RESULTS: Specimen stiffness was similar between groups. The mean load to repair failure was 123 +/- 17 N in group 1, 114 +/- 11 N in group 2, and 95 +/- 13 N in group 3. The mean load to ultimate failure was 163 +/- 15 N, 161 +/- 12 N, and 145 +/- 12 N, respectively. Although the repair failure loads of groups 1 and 2 were 29% and 17%, respectively, greater than the tack group, the differences were not statistically significant (P >.05). All ultimate failures occurred at the labral-implant interface. CONCLUSION: Initial fixation strength of tissue tack and suture anchor repairs of SLAP lesions are comparable.     

Superior labrum anterior posterior lesions of the shoulder: Operative techniques of management

Since the advent of shoulder arthroscopy, pathology of the superior glenoid labrum and biceps anchor has been increasingly recognized as a source of shoulder pain and disability. Additional biomechanical testing has substantiated the role of the superior labrum and biceps anchor in glenohumeral stability. The diagnosis of superior labral injury such as the superior labrum anterior posterior (SLAP) lesion remains difficult, as the history, clinical examination, and radiographic evaluation can only raise suspicion. The ultimate diagnosis of the SLAP lesion can only be made with a well-directed diagnostic glenohumeral arthroscopy. The treatment of SLAP lesions depends on the type of SLAP lesion encountered at arthroscopy. This includes debridement of most type I and III lesions, and repair of type II and many type IV SLAP lesions. In this report, we will present our basic approach towards evaluation and treatment of SLAP lesions at the Southern California Orthopedic Institute.     

MR-arthrography in superior instability of the shoulder: correlation with arthroscopy

Purpose

This study was undertaken to evaluate magnetic resonance (MR) arthrography in the detection and classification of lesions that may cause superior instability.

Materials and methods

Forty-two consecutive patients with clinical signs of chronic superior instability of the shoulder underwent MR arthrography followed by arthroscopic surgery. For each patient we retrospectively reviewed the MR arthrography and surgical findings.

Results

We detected 31 superior labral anterior posterior (SLAP) lesions, all confirmed on arthroscopy with three cases of underestimation: in the detection of SLAP lesions, the sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of MR arthrography were 100%; in the evaluation of the type of SLAP lesion, sensitivity was 100%, specificity was 78.5%, accuracy was 92.8%, PPV was 71.7% and NPV was 100%. All cases of capsular laxity (13/42) and biceps tendon lesions (3/42) were confirmed on arthroscopy with sensitivity, specificity, accuracy, PPV and NPV of 100%. Eleven cuff lesions were detected on MR arthrography, 10 of which confirmed at arthroscopy: sensitivity was 100%, specificity was 96.8%, accuracy was 97.6%, PPV was 90.9% and NPV was 100%. Associated lesions were found in 38/42 patients.

Conclusions

Superior instability is frequently associated with different anatomical variants or pathological conditions, such as SLAP lesions. The role of MR arthrography is to describe the key features of lesions affecting the superior portion of the shoulder, including location, morphology, extent, and associated injuries and leanatomical variants and to correlate these features with clinical symptoms.     

SLAP tears of the glenoid labrum in contact athletes.

OBJECTIVE: To describe the distribution and clinical presentation of labral injuries in rugby players and the time taken for them to return to sports. DESIGN: Retrospective cohort study. SETTING: Busy shoulder practice in the North West of England, treating a large number of professional athletes. PATIENTS: A review of 51 shoulder arthroscopies performed on professional rugby players over a 35 month period. All patients diagnosed with a SLAP lesion at arthroscopy were identified. Eighteen patients had a documented SLAP tear; this group represented our study population. INTERVENTIONS: Arthroscopic debridement and/or stabilization was carried out for all labral injuries using Panaloc anchors and No. 2 PDS via a 2 portal technique. MAIN OUTCOME MEASUREMENTS: Classification of injury, Satisfaction, Time to return to play. RESULTS: The incidence of SLAP tears in our study population was 35%. There were 11 isolated SLAP tears (61%), 3 SLAP tears associated with a Bankart lesion (17%), 2 SLAP tears associated with a posterior labral lesion (11%), and 2 SLAP tears associated with an anterior and posterior labral injuries (11%). Of the 18 SLAP tears, 14 (78%) were type 2, 3 (17%) were type 3, and 1 (5%) was type 4. None of the patients with a SLAP tear presented with symptoms of instability. MR Arthrogram had a 76% sensitivity for detecting SLAP tears. By 6 months postsurgery, 89% of patients were satisfied. Patients with isolated SLAP tears were the quickest to return to sports, at an average of 2.6 months postsurgery. CONCLUSIONS: SLAP tears are a common injury in rugby players. These can often be diagnosed with MR arthrography. Arthroscopic repair is associated with excellent results and early return to sports.     

Quantitative assessment of glenohumeral translation after anterior shoulder dislocation and subsequent arthroscopic bankart repair

BACKGROUND: During the past decade, developments in arthroscopic technology have made arthroscopic repair of labral lesions feasible. However, results with the use of the transglenoid suture technique, or with the use of bioabsorbable tacks, have remained variable in the literature, and the recurrence rates are still inferior to those of open Bankart repair. HYPOTHESIS: Arthroscopic Bankart repair with suture anchors can re-create translational and rotational range of motion of the intact glenohumeral joint, and the number of preoperative dislocations has an influence on the result. STUDY DESIGN: Controlled laboratory study. MATERIALS: Twelve cadaveric shoulders were tested in a robot-assisted shoulder simulator. Anterior and posterior translation and external rotation were measured for intact, dislocated (shoulders were randomly selected to 1 of 3 groups, which were dislocated 1, 3, or 7 times), and repaired conditions at 0 degrees and 90 degrees of glenohumeral elevation. RESULTS: After shoulder dislocation, a significant increase was found in translation and rotation, confirming the creation of a traumatic shoulder instability model. Further testing of the specimen revealed that translational and rotational ranges of motion were reduced by arthroscopic Bankart repair at both testing positions. External rotation was decreased significantly at 0 degrees and 90 degrees of abduction. No significant differences were found between the 3 dislocation groups. CONCLUSION: The results demonstrate a sufficient biomechanical performance of arthroscopic Bankart repair using suture anchors in a traumatic anterior shoulder instability model. With the numbers available, no relationship was found between the number of dislocations and the postoperative result concerning translational or rotational motion. CLINICAL RELEVANCE: Glenohumeral translation and rotation after arthroscopic Bankart repair with use of suture anchors approached near normal values, confirming the clinical success of this technique.     

How often do surgeons intervene on shoulder labral lesions detected at MR examination? A retrospective review of MR examinations correlated with arthroscopy

Objective:

We report the prevalence of surgical intervention on shoulder labral lesions detected at MR examinations and how surgeons describe labral tears seen at MR examinations in their arthroscopy reports.

Methods:

A retrospective review of 100 consecutive patients aged 50 years or younger who had shoulder labral tears on MR and went on to have surgery performed. It was determined whether surgical intervention was performed on the MR lesions.

Results:

Of these 100 patients, 72 had superior labral anterior to posterior (SLAP) tears, 38 had posterior labral tears and 28 had anterior labral tears on MR examination. All 100 patients went on to arthroscopy. All lesions described on MRI were described on arthroscopy. Of the 72 SLAP tears, 64 were described as fraying on arthroscopy with 51 debrided. The remaining eight SLAP tears were tacked surgically. Of the 38 posterior labral tears, 36 were described as fraying on arthroscopy with 29 debrided and 2 had surgical tacking performed. Of the 28 anterior labral tears described on MR examination, 26 had surgical tacking performed and 2 were debrided. There were four SLAP tears, two anterior labral tears and three posterior labral tears seen on arthroscopy but not seen on MR examination.

Conclusion:

In this series, a high percentage of SLAP tears and posterior labral tears described on MR examination did not have surgical tacking. Most anterior labral tears had surgical tacking. Based on the above, our surgeons request we describe superior and posterior labral lesions as fraying and/or tearing, unless we can see a displaced tear. Most anterior labral lesions are treated with surgical tacking.

Advances in knowledge:

MRI allows for sensitive detection of labral tears. The tears often are not clinically significant.Labral tears are common injuries that often require surgical intervention. In our practice, we commonly see labral tears on MR examination and report them to surgeons. With modern high-resolution MRI, as well as increased awareness of labral tears by radiologists, labral tears are commonly reported findings on MR examinations. Sensitivities and specificities for detection of labral tears as compared with those from arthroscopy at 3.0 T have been reported as follows: superior labral anterior to posterior (SLAP) tears (90% sensitive and 100% specific), anterior labral tears (89% sensitive and 100% specific) and posterior labral tears (86% sensitivity and 100% specific).¹ Sensitivities of 100% for anterior labral tears, 86% for superior labral tears and 74% for posterior labral tears as compared with those from arthroscopy have been reported using high-resolution 1.5 T conventional MR examinations.²In our practice, we have been told by our surgeons that we describe some SLAP tears and posterior labral tears on MR that they find on arthroscopy to be degenerative fraying. For this reason, we sought to find (1) how often does a surgeon intervene on labral tears and (2) how do surgeons describe labral tears seen at MR examinations in their arthroscopy reports.     

Schultergelenkverletzungen bei Überkopfsportarten

Overhead sport places great demands on the shoulder joint. Shoulder pain in overhead athletes and throwers can in the majority of cases be attributed to lesions resulting from chronic overuse of tendons and capsuloligamentous structures or to sequels of microinstability and secondary impingement. Due to its great impact on therapeutic decisions, imaging in athletes with unclear shoulder pain is a challenge. In this connection, magnetic resonance (MR) arthrography represents the cross-sectional imaging modality of first choice, as it allows depiction and exclusion of pathologic alterations of all relevant joint structures with sufficient confidence. This article reviews the biomechanical and clinical aspects and MR arthrographic features of the most common shoulder pathologies in overhead athletes, including biceps tendinopathy, superior labral anterior-posterior (SLAP) lesions, rotator cuff lesions, as well as extrinsic and intrinsic impingement syndromes.     

SLAP lesions of the glenoid labrum: CT arthrographic and arthroscopic correlation.

Tears in the superior part of the glenoid labrum in the anterior and posterior directions (SLAP, superior labrum anterior, posterior) result from injuries that place excessive stress on the tendon of the long head of the biceps brachii muscle. The intimate relationship of the tendon and the superior glenoid labrum promotes injury to the latter structure. Four types of SLAP lesions are seen at arthroscopy. Images from 17 patients with surgically proved SLAP lesions who had undergone preoperative computed tomographic (CT) arthrography were retrospectively reviewed to evaluate the value of CT arthrography in the detection and accurate depiction of these labral injuries. The authors compared the findings at videotaped arthroscopic surgery with those from CT arthrography and found that abnormalities of the labral-capsular apparatus could be detected with CT arthrography in 16 of the 17 patients. Furthermore, the CT arthrographic criteria developed during this review helped determine the type of tear in 15 of the 17 patients. CT arthrography appears to be useful in the evaluation of patients with suspected SLAP lesions.     

上方盂唇前后向撕裂的肩关节MR造影评价

目的 评价肩关节MR造影对上方盂唇前后向撕裂(SLAP损伤)的诊断价值.方法 由2名影像诊断医师独立回顾分析137例经肩关节镜证实的肩关节造影MR图像,判定有无SLAP损伤,并进行分型.SLAP损伤分4型:Ⅰ型为上盂唇毛糙,Ⅱ型为肱二头肌腱盂唇复合体从关节孟撕裂,Ⅲ型为上盂唇桶柄状撕裂,Ⅳ型为上盂唇桶柄状撕裂并同时累及肱二头肌长头腱.计算肩关节MR造影对SLAP损伤的敏感度、特异度和准确度,以及与肩关节镜分型的符合率.采用Kappa统计计算2名影像诊断医师评价的一致性.结果 137例患者中,肩关节镜证实SLAP损伤59例,包括SLAP损伤Ⅰ型6例(10.2%)、Ⅱ型50例(84.7%)、Ⅲ型3例(5.1%).肩关节MR造影的敏感度、特异度和准确度医师甲分别为86.4%(51/59)、78.2%(61/78)和81.8%(112/137),医师乙分别为88.1%(52/59)、84.6%(66/78)和86.1%(118/137).2名影像诊断医师的评价一致性极好(K=0.796).肩关节MR造影与肩关节镜的分型符合率医师甲为83.1%(49/59),医师乙为79.7%(47/59).结论 肩关节MR造影是评价SLAP损伤比较可靠的影像方法.