MR arthrography of the glenohumeral joint: two concentrations of gadoteridol versus Ringer solution as the intraarticular contrast material.

Abstract

To compare two concentrations of gadoteridol with Ringer solution as the contrast material for magnetic resonance (MR) arthrography of the glenohumeral joint. One hundred fifty-six consecutive MR arthrograms were randomly obtained with either 2 mmol/L gadoteridol (n = 52), 4 mmol/L gadoteridol (n = 52), or Ringer solution (n = 52). MR arthrograms were assessed quantitatively (for contrast-to-noise ratio [CNR]) and qualitatively (for overall image quality, image contrast, degree of joint distention, and motion artifacts). MR diagnoses were compared with arthroscopic or surgical reports in 88 patients. The mean CNR at imaging was 40.4 with 2 mmol/L gadoteridol, 45.6 with 4 mmol/L gadoteridol, and 48.7 with Ringer solution. The CNR with 2 mmol/L gadoteridol was significantly lower than that with 4 mmol/L gadoteridol (P =.025) and Ringer solution (P =.012). Qualitative differences between the two gadoteridol concentrations were not significant. Ringer solution was significantly worse with regard to overall quality, motion artifacts, image contrast, and joint distention compared with both gadoteridol concentrations. Ringer solution was slightly more sensitive and less specific than the gadoteridol solutions in the detection of supraspinatus tears and less sensitive and more specific in enabling diagnosis of superior labrum anteroposterior lesions. MR arthrograms of the shoulder obtained with gadoteridol and those obtained with Ringer solution provided equivalent diagnostic accuracy. The authors, however, preferred the image quality of the gadoteridol-enhanced arthrograms.