How, When, Why in Magnetic Resonance Arthrography: an International Survey by the European Society of Musculoskeletal Radiology (ESSR)
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To perform an online survey about the use of magnetic resonance arthrography (MRA) in clinical practice.
We administered an online survey to all 1,550 members of the European Society of Musculoskeletal Radiology (ESSR) about MRA asking ten different questions. Subgroup analysis was performed between general and orthopaedic hospitals using χ2 and Mann-Whitney U statistics.
One-hundred forty-eight answers were included (148/1,550, 9.5% of ESSR members). A median of 3,000 (interquartile range: 1,567.5-5,324.5) musculoskeletal MR examinations and a median of 125.5 MRAs (50.75-249) per institution were performed in 2016. Ratio between MRA and musculoskeletal MR was 4.7% (1.6%-9.0%). Using MRA, the most investigated joint was the shoulder followed by the hip (96.6%). The most common indications were the evaluation of instability, labrum, and rotator cuff (85.1%). Fluoroscopy represented the preferred injection guidance. A self-prepared mixture of Gadolinium/saline is preferred in general hospitals, while pre-diluted Gadolinium-based syringes are mainly used in orthopaedic hospitals (P=.010). The number of MRA performed at orthopaedic hospitals (284;83.75-449.50) was higher (P=.006) than that performed at general hospitals (115.50;44.75-234.25).
One out of twenty MR examinations is a MRA, with higher prevalence in orthopaedic hospitals. The shoulder and the hip are the most investigated joints. Instability, labrum, and cuff are the most common indications.
• The most common MRAs are shoulder and hip (96.6% of answers).
• Most common clinical indications for MRA are instability, labrum, and rotator cuff (85.1% of answers).
• Fluoroscopy represents the preferred guidance to inject joints (61.0% of answers).
• The median number of MRA performed at orthopaedic hospitals (n=284) was significantly higher (P=.006) than that performed at general hospitals (n=115.50).
• A self-prepared mixture of Gadolinium/saline solution is preferred in general hospitals (64.8%) compared to orthopaedic hospitals (36.0%; P=0.010).
KeywordsMagnetic Resonance Arthrography Shoulder Hip Fluoroscopy Gadolinium
Magnetic resonance imaging
Magnetic resonance arthrography
European Society of Musculoskeletal Radiology
All authors are ESSR Members. Luca Maria Sconfienza and Alberto Tagliafico are past and present chairs of the ESSR Research committee, respectively. Luca Maria Sconfienza is currently chair of the Ultrasound ESSR subcommittee. The present work was approved by the ESSR Executive committee in April 2017 and financed with a 500 Euro grant.
The authors want to thank all ESSR members who completed the survey in full and gave their consent to publish their names: José Acosta Batlle, Andrea Alcalá-Galiano, Eduardo Alvarez-Hornia, Natalia Alvarez de Eulate, Maurizio Amato, Rahul Anaspure , Pilar Aparisi-Gómez, Jesús D. Aquerreta, Gulgun Atilla, Ustun Aydingoz, Ali Balci, Hasan Banitalebi, Antonio Barile, Bruno Beber Machado, Fabio Becce, Adan Bello Baez, Guillaume Bierry, Antonia Bintoudi, Bård T. Bjørnarå, Sana Boudabbous, Hugues Brat, Federico Bruno, Carolina Calvo Corbella, Wilson Campos Tavares Junior, Jaime Cardenal, Yves Carillon, Mislav Čavka, Can Cevikol, Ranjana Chaudhuri, Sylvia Connolly, Michel Court-Payen, Francesco Cravero, Ferdinando Cusmano, Keivan Daneshvar , Matias de Albert, Giorgio De Conti, Massimo De Filippo, Jeroen De Groote, Milko de Jonge, Eline De Smet, Dhafer Deeab, Francesco Di Pietto, Fernando Diez Renovales, Jürgen Ederer, Thomas Egelhof, Isabel Elía, Víctor M. Encinas-Tobajas, Carlo Faletti, Daniel Fascia, Javier Fernández-Jara, Giulio Ferrero, Claudio Fonda, Veronique Freire, Lars Benjamin Fritz, Alexandre Fuchs, Sorin Ghiea, Silvana Giannini, Jose Luis González Montané, Thomas Grieser, James Francis Griffith, Benjamin Henninger, Jozsef Illes, Syed Intekhab, Gordana Ivanac, Jon Jacobson, Maciej Jonczy, Achim Kaim, Maria Karamesini, Apostolos Karantanas, Alla Karpenko, Katarzyna Kasiek, Benedikt Kislinger, Josef Kramer, Guenther J. Kraus, Karl Friedrich Kreitner, Dinuka Kuruppu, Lauren Ladd, Radesh Lalam, Robert Lambert, Guillaume Lefebvre, Eva Llopis, Christos Loupatatzis, Enrico Lubin, Nicola Magarelli, Petra Margetic, Daliborka Maric, Silvia Martin, Esteban Mayayo, Paul Michelin , Manuel Montero Jaime, Jerome Mouly, Emanuele Muraro, Margarita Natsika, Vesna Njagulj, Miguel Oliveira e Castro, Davide Orlandi, Erik Pallares Villareal, Giulio Pasquotti, René Patzwahl, Robert Rau, Georg Riegler, Benoît Rizk, Mercedes Roca, Frank Roemer, Mitja Rupreht, Vladka Salapura, Francesca Sambataro, Ricardo Sampaio, Nicolae Sarbu, Gerwin Schmidt, Armin Seifarth, Alireza Semnani, Asad Shah, Casimiro Simonetti, Vasileios Skiadas, Žiga Snoj, Priya Suresh , Linus Swinnen, Tomasz Szalaj, Xavier Tomas, Ioannis Tsifountoudis, Filip Vanhoenacker, Joan C Vilanova, Marianna Vlychou, Marc-André Weber, Herbert Wegmueller, Engin Yeter Kurt, Marco Zanetti, Carlo Zanolini, Marcello Zappia, Amin Zoqurti, and Ivana Zupetic
The authors state that a 500 Euro grant issued by the European Society of Musculoskeletal Radiology was used to purchase 10 e-coupons to encourage the participation to the online poll.
Compliance with ethical standards
The scientific guarantor of this publication is Luca Maria Sconfienza.
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Informed consent was not required because the paper does not involve patients.
Institutional review board approval was not required because the paper does not involve patients’ data directly.
• multicentre study
- 5.European Society of Radiology https://essr.org/society/. Accessed 15 Nov 2017
- 6.Research Committee of the European Society of Radiology https://essr.org/society/committees/. Accessed 15 Nov 2017
- 7.Google documents https://docs.google.com/forms/. Accessed 15 Nov 2017
- 12.European Commission. 2013/59/EURATOM directive. Available at http://eur-lex.europa.eu/legal-content/EN/TXT/? uri=uriserv:OJ.L_.2014.013.01.0001.01.ENG Accessed 27 Sept 2017
- 13.van Grinsven S, Hagenmaier F, van Loon CJ, van Gorp MJ, van Kints MJ, van Kampen A (2014) Does the experience level of the radiologist, assessment in consensus, or the addition of the abduction and external rotation view improve the diagnostic reproducibility and accuracy of MRA of the shoulder? Clin Radiol 69:1157–1164CrossRefPubMedGoogle Scholar