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Freehand direct arthrography of the shoulder using near real-time guidance in an open 1.0-T MRI scanner

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Abstract

Objective

To assess the technical success and duration of magnetic resonance imaging (MRI)-guided freehand direct shoulder arthrography (FDSA) with near real-time imaging implemented in a routine shoulder MRI examination on an open 1.0-T MRI scanner, and to assess the learning curve of residents new to this technique.

Methods

An experienced MRI interventionalist (the expert) performed 125 MRI-guided FDSA procedures, and 75 patients were treated by one of three residents without previous experience in MRI-guided FDSA. Technical success rate and duration of MRI-guided FDSA of the expert and the residents were compared. The residents’ learning curves were assessed. The occurrence of extra-articular deposition and leakage of contrast media from the puncture site and the subsequent impairment of image interpretation were retrospectively analyzed.

Results

Overall technical success was 97.5 %. The expert needed overall fewer puncture needle readjustments and was faster at puncture needle positioning (p < 0.01). The learning curve of the residents, however, was steep. They leveled with the performance of the expert after ≈ 15 interventions. With a minimal amount of training all steps of MRI-guided FDSA can be performed in ≤10 min.

Conclusion

Magnetic resonance-guided FDSA in an open 1.0-T MRI scanner can be performed with high technical success in a reasonably short amount of time. Only a short learning curve is necessary to achieve expert level.

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Author information

Authors and Affiliations

  1. Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany

    Christian Wybranski

  2. Department of Radiology and Nuclear Medicine, Otto-von-Guericke University Medical School, Magdeburg, Germany

    Ilya Adamchic, Jens Ricke, Frank Fischbach & Katharina Fischbach

  3. Institute of Biometry and Medical Informatics, Otto-von-Guericke University Medical School, Magdeburg, Germany

    Friedrich-Wilhelm Röhl

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  1. Christian Wybranski
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  2. Ilya Adamchic
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  3. Friedrich-Wilhelm Röhl
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  4. Jens Ricke
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  5. Frank Fischbach
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  6. Katharina Fischbach
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Corresponding author

Correspondence to Christian Wybranski.

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Conflicts of interest

Katharina and Frank Fischbach received research and consultant grants from Philips Healthcare, but these were not related to this work. Employees of Philips Healthcare had no access to the data presented in this article and did not participate in the preparation of this manuscript. The other authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. All patients provided written informed consent. The study has been approved by the institutional review board of the Otto-von-Guericke University Magdeburg. All authors have read and approved the manuscript.

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Wybranski, C., Adamchic, I., Röhl, FW. et al. Freehand direct arthrography of the shoulder using near real-time guidance in an open 1.0-T MRI scanner. Skeletal Radiol 46, 51–58 (2017). https://doi.org/10.1007/s00256-016-2507-3

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  • DOI: https://doi.org/10.1007/s00256-016-2507-3

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