Rofo 2009; 181(5): 441-446
DOI: 10.1055/s-0028-1109103
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Indikationen der MR- und CT-Arthrografie – Empfehlungen der AG Muskuloskelettale Radiologie der DRG

Indications for CT and MR Arthrography – Recommendations of the Musculoskeletal Workgroup of the DRGW. Fischer1 , K. Bohndorf2 , K.-F Kreitner3 , R. Schmitt4 , K. Wörtler5 , J. Zentner2
  • 1Hessingpark Clinic, Radiologengemeinschaft Augsburg
  • 2Klinik für Diagnostische Radiologie und Neuroradiologie, Zentralklinikum, Augsburg
  • 3Klinik und Poliklinik für Radiologie, Uni-Klinik Mainz
  • 4Institut für Diagnostische und Interventionelle Radiologie, Herz- und Gefäßklinik GmbH, Bad Neustadt an der Saale
  • 5Klinikum rechts der Isar, Institut für Röntgendiagnostik, München
Further Information

Publication History

eingereicht: 8.10.2008

angenommen: 4.12.2008

Publication Date:
11 March 2009 (online)

Zusammenfassung

Der anhaltenden Diskussion über die CT-Arthrografie und MR-Arthrografie liegt nicht zuletzt der Umstand zugrunde, dass bisher klare Leit- oder Richtlinien zur Indikationsstellung fehlen. Das Bestreben der AG Muskuloskelettale Radiologie der DRG war die Erstellung von Empfehlungen, die als Orientierungshilfe dienen sollen. Nach Durchsicht der aktuellen Literatur erfolgte zu diesem Zweck ein Konsensustreffen, bei dem die Indikationsfragen diskutiert wurden. Da der qualitativ oft unzureichenden und widersprüchlichen Literatur keine klaren Aussagen zu entnehmen sind, basieren die formulierten Empfehlungen vorrangig auf Expertenmeinungen. In dieser Übersicht werden die wichtigsten Aussagen der Literaturdurchsicht zusammengefasst und die Empfehlungen der AG Muskuloskelettale Radiologie vorgestellt.

Abstract

The ongoing discussion about CT and MR arthrography is at least in part due to the lack of definite guidelines. The intention of the musculoskeletal workgroup of the DRG (Deutsche Röntgengesellschaft) was the establishment of recommendations for general guidance. After review of the recent literature, the indications for arthrographic examinations were discussed during a consensus meeting. Since the published data are insufficient and partially contradictory, no precise statements could be extracted from the literature. Therefore, the proposed recommendations are mainly based on expert opinions. In this review the main statements of the published literature are summarized and the recommendations of the musculoskeletal workgroup of the DRG are presented.

Literatur

  • 1 Arrivé L, Renard R, Carrat F. et al . A scale of methodological quality for clinical studies of radiologic examinations.  Radiology. 2000;  217 69-74
  • 2 Waldt S, Metz S, Burkart A. et al . Variants of the superior labrum and labro-bicipital complex: a comparative study of shoulder specimens using MR arthrography, multi-slice CT arthrography and anatomical dissection.  Eur Radiol. 2006;  16 451-458
  • 3 Waldt S, Bruegel M, Ganter K. et al . Comparison of multislice CT arthrography and MR arthrography for the detection of articular cartilage lesions of the elbow.  Eur Radiol. 2005;  15 784-791
  • 4 Moser T, Dosch J, Moussaoui A. et al . Wrist ligament tears: evaluation of MRI and combined MDCT and MR arthrography.  AJR. 2007;  188 1278-1286
  • 5 Schmid M R, Pfirrmann C WA, Hodler J. et al . Cartilage lesions in the ankle joint: comparison of MR arthrography and CT arthrography.  Skeletal Radiol. 2003;  32 259-265
  • 6 Parmar H, Jhankaria B, Maheshwari M. et al . Magnetic resonance arthrography in recurrent anterior shoulder instability as compared to arthroscopy: a prospective comparative study.  J Postgrad Med. 2002;  48 270-274
  • 7 Applegate G R, Hewitt M, Snyder S J. et al . Chronic labral tears: value of magnetic resonance arthrography in evaluating the glenoid labrum and labral-bicipital complex.  Arthroscopy. 2004;  20 959-963
  • 8 Waldt S, Burkart A, Lange P. et al . Diagnostic performance of MR arthrography in the assessment of superior labral anteroposterior lesions of the shoulder.  AJR. 2004;  182 1271-1278
  • 9 Waldt S, Burkart A, Imhoff A B. et al . Anterior shoulder instability: accuracy of MR arthrography in the classification of anteroinferior labroligamentous injuries.  Radiology. 2005;  237 578-583
  • 10 Reuss B L, Schwartzberg R, Zlatkon M B. et al . Magnetic resonance imaging accuracy for the diagnosis of superior labrum anterior-posterior lesions in the community setting: eighty-three arthroscopically confirmed cases.  J Shoulder Elbow Surg. 2006;  15 580-585
  • 11 Probyn L J, White L M, Salonen D C. et al . Recurrent symptoms after shoulder instability repair: direct MR arthrographic assessment – correlation with second-look surgical evaluation.  Radiology. 2007;  245 814-823
  • 12 Guntern D V, Pfirrmann C WA, Schmid M R. et al . Articular cartilage lesions of the glenohumeral joint: diagnostic effectiveness of MR arthrography and prevalence in patients with subacromial impingement syndrome.  Radiology. 2003;  226 165-170
  • 13 Waldt S, Bruegel K, Mueller D. et al . Rotator cuff tears: assessment with MR arthrography in 275 patients with arthroscopic correlation.  Eur Radiol. 2007;  17 491-498
  • 14 Lecouvet F E, Dorzee B, Dubuc J E. et al . Cartilage lesions of the glenohumeral joint: diagnostic effectiveness of multidetector spiral CT arthrography and comparison with arthroscopy.  Eur Radiol. 2007;  17 1763-1771
  • 15 Dubberley J H, Faber K J, Patterson S D. et al . The detection of loose bodies in the elbow. The value of MRI and CT arthrography.  J Bone Joint Surg. 2005;  87-B 684-686
  • 16 Schmitt R, Christopoulos G, Meier R. et al . Direkte MR-Arthrographie des Handgelenks im Vergleich zur Arthroskopie: Eine prospektive Studie an 125 Patienten.  Fortschr Röntgenstr. 2003;  175 911-919
  • 17 Joshy S, Lee K, Deshmukh S C. Accuracy of direct magnetic resonance arthrography in the diagnosis of triangular fibrocartilage complex tears of the wrist.  Int Orthop. 2008;  32 251-253
  • 18 Berná-Serna J D, Martinez F, Reus M. et al . Evaluation of the triangular fibrocartilage in cadaveric wrists by means of arthrography, magnetic resonance (MR) imaging, and MR arthrography.  Acta Radiol. 2007;  48 96-103
  • 19 Rüegger C, Schmid M R, Pfirrmann C W. et al . Peripheral tear of the triangular fibrocartilage: depiction with MR arthrography of the distal radioulnar joint.  Am J Radiol. 2007;  188 187-192
  • 20 Bille B, Harley B, Cohen H. A comparison of CT arthrography of the wrist to findings during wrist arthroscopy.  J Hand Surg. 2007;  32A 834-841
  • 21 Haims A H, Schweitzer M E, Morrison W B. et al . Internal derangement of the wrist: indirect MR arthrography versus unenhanced MR imaging.  Radiology. 2003;  227 701-707
  • 22 Schmid M R, Schertler T, Pfirrmann C W. et al . Interosseous ligament tears of the wrist: comparison of multi-detector row CT arthrography and MR imaging.  Radiology. 2005;  237 1008-1013
  • 23 Schmid M R, Nötzli H P, Zanetti M. et al . Cartilage lesions in the hip: Diagnostic effectiveness of MR arthrography.  Radiology. 2003;  226 382-386
  • 24 Byrd J WT, Jones K S. Diagnostic accuracy of clinical assessment, magnetic resonance imaging, magnetic resonance arthrography, and intra-articular injection in hip arthroscopy patients.  Am J Sports Med. 2004;  32 1668-1674
  • 25 Mintz M DN, Hooper T, Connell D. et al . Magnetic resonance imaging of the hip: detection of labral and chondral abnormalities using noncontrast imaging.  Arthroscopy. 2005;  21 385-393
  • 26 James S LJ, Ali K, Malara F. et al . MRI findings of femoroacetabular impingement.  AJR. 2006;  187 1412-1419
  • 27 Toomayan G A, Holman W R, Major N M. et al . Sensitivity of MR arthrography in the evaluation of acetabular labral tears.  AJR. 2006;  186 449-453
  • 28 Freedman B A, Potter B K, Dinauer P A. et al . Prognostic value of magnetic resonance arthrography for Czerny stages II and III acetabular labral tears.  Arthroscopy. 2006;  22 742-747
  • 29 Magee T, Shapiro M, Rodriguez J. et al . MR arthrography of postoperative knee: for which patients is it useful?.  Radiology. 2003;  229 159-163
  • 30 Vives M J, Homesley D, Ciccotti M G. et al . Evaluation of recurring meniscal tears with Gadolinium-enhanced magnetic resonance imaging.  Am J Sports Med. 2003;  31 868-873
  • 31 Vande Berg B C, Lecouvet F E, Poilvache P. Assessment of knee cartilage in cadavers with dual-detector spiral CT arthrography and MR imaging.  Radiology. 2002;  222 430-436
  • 32 Muratli H H, Bicimoglu A, Celebi L. et al . Magnetic resonance arthrographic evaluation of syndesmotic diastasis in ankle fractures.  Arch Orthop Trauma Surg. 2005;  125 222-227
  • 33 Chou M, Yeh L, Chen C K. et al . Comparison of plain MRI and MR arthrography in the evaluation of lateral ligamentous injury of the ankle joint.  J Chin Med Assoc. 2006;  69 26-31
  • 34 De Filippo M, Bertellini A, Sverzellati N. et al . Multidetector computed tomography arthrography of the shoulder: diagnostic accuracy and indications.  Acta Radiol. 2008;  49 540-549
  • 35 Joshy S, Lee K, Deshmukh S C. Accuracy of direct magnetic resonance arthrography in the diagnosis of triangular fibrocartilage complex tears of the wrist.  Int Orthop. 2008;  32 251-253
  • 36 Wyler A, Bousson V, Bergot C. et al . Comparison of MR-arthrography and CT-arthrography in hyaline cartilage-thickness measurement in radiographically normal cadaver hips with anatomy as gold standard.  Osteoarthritis Cartilage. 2009;  17 19-25
  • 37 Ciliz D, Ciliz A, Elverici E. Evaluation of postoperative menisci with MR arthrography and routine conventional MRI.  Clin Imaging. 2008;  32 212-219
  • 38 De Filippo M, Bertellini A, Pogliacomi F. et al . Multidetector computed tomography arthrography of the knee: diagnostic accuracy and indications.  Eur J Radiol. 2008;  doi: 10.1016/j.ejrad.2008.01.034
  • 39 Sasyniuk T M, Mohtadi N GH, Hollinshead R M. et al . The inter-rater reliability of shoulder arthroscopy.  Arthroscopy. 2007;  23 971-977
  • 40 Schulte-Altedorneburg G, Gebhard M, Wohlgemuth W A. et al . MR arthrography: pharmacology, efficacy and safety in clinical trials.  Skeletal Radiol. 2003;  32 1-12

Dr. Wolfgang Fischer

Radiologengemeinschaft Augsburg, Hessingpark-Clinic

Hessingstr. 17

86199 Augsburg

Phone: + + 49/8 21/9 09 90 18

Fax: + + 49/8 21/9 09 90 24

Email: wolfgang.fischer@hessingpark-clinic.de