Virtual MR arthroscopy of the shoulder: image gallery with arthroscopic correlation of major pathologies in shoulder instability

Background  The purpose of this study was to compare virtual MR arthroscopic reconstructions with arthroscopic images in patients affected by shoulder joint instability. MR arthrography (MR-AR) of the shoulder is now a well-assessed technique, based on the injection of a contrast medium solution, which fills the articular space and finds its way between the rotator cuff (RC) and the glenohumeral ligaments. In patients with glenolabral pathology, we used an additional sequence that provided virtual arthroscopy (VA) post-processed views, which completed the MR evaluation of shoulder pathology. Materials and methods  We enrolled 36 patients, from whom MR arthrographic sequence data (SE T1w and GRE T1 FAT SAT) were obtained using a GE 0.5 T Signa—before any surgical or arthroscopic planned treatment; the protocol included a supplemental 3D, spoiled GE T1w positioned in the coronal plane. Dedicated software loaded on a work-station was used to elaborate VAs. Two radiologists evaluated, on a semiquantitative scale, the visibility of the principal anatomic structures, and then, in consensus, the pathology emerging from the VA images. Results  These images were reconstructed in all patients, except one. The visualization of all anatomical structures was acceptable. VA and MR arthrographic images were fairly concordant with intraoperative findings. Conclusions  Although in our pilot study the VA findings did not change the surgical planning, the results showed concordance with the surgical or arthroscopic images.