Abstract
BACKGROUND: There are only a few isolated studies that have examined ultrasound-guided magnetic resonance arthrography (USMRA) of the glenohumeral joint and subacromial bursa with the use of gadolinium contrast agent. This study aimed to determine the clinical value of USMRA in the diagnosis of supraspinatus tendon tears and its subtypes. METHODS: Musculoskeletal ultrasound (MSKUS) was performed in 207 patients with shoulder pain as confirmed by arthroscopic examination, 103 of whom underwent shoulder joint magnetic resonance imaging (MRI), and 104 of whom underwent USMRA. Based on tear subtypes and grading matching, the diagnostic value of MSKUS, MRI, and USMRA was assessed in terms of identifying the presence of supraspinatus tendon tears and its subtypes. RESULTS: The results demonstrated statistically significant differences between the three groups in terms of diagnostic sensitivity, specificity, positive and negative predictive values, and accuracy in identifying supraspinatus tendon tears (P<0.05). The analysis of area under the receiver operating characteristic curve (AUC) indicated that MSKUS (AUC =0.76) and MRI (AUC =0.86) had moderate diagnostic value, while USMRA (AUC =0.95) had a higher diagnostic value. Regarding the tear subtypes in the MSKUS, MRI, and USMRA groups, the AUCs for articular-sided tears were 0.62, 0.75, and 0.87, respectively, while those for intratendinous tears were 0.57, 0.72, and 0.89, respectively, indicating moderate diagnostic value across the three groups; meanwhile, the AUCs for bursal-sided tears were 0.71, 0.73, and 0.92, respectively, while those for full-thickness tears were 0.75, 0.87, and 0.93, respectively, indicating moderate diagnostic values in the MSKUS group and MRI group and high diagnostic values in the USMRA group. The incidence of adverse reactions in the USMRA group was 1.92% (2/104). CONCLUSIONS: USMRA demonstrated high diagnostic value for the diagnosis of supraspinatus tendon tears and bursal-sided and full-thickness tears.