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How, When, Why in Magnetic Resonance Arthrography: an International Survey by the European Society of Musculoskeletal Radiology (ESSR)

  • Musculoskeletal
  • Published:
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Abstract

Objectives

To perform an online survey about the use of magnetic resonance arthrography (MRA) in clinical practice.

Methods

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.

Results

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).

Conclusions

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.

Key Points

• 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).

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Abbreviations

MRI:

Magnetic resonance imaging

MRA:

Magnetic resonance arthrography

ESSR:

European Society of Musculoskeletal Radiology

ABER:

Abduction-external rotation

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Acknowledgements

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

Funding

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.

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Authors and Affiliations

  1. Unità Operativa di Radiologia Diagnostica e Interventistica, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milano, Italy

    Luca Maria Sconfienza & Carmelo Messina

  2. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milano, Italy

    Luca Maria Sconfienza

  3. Sezione di Scienze Radiologiche, Di.Bi.Med., Università di Palermo, Via del Vespro 127, 90127, Palermo, Italy

    Domenico Albano

  4. Servizio di Radiologia, Ospedale Evangelico Internazionale, Piazzale Gianasso 4, 16158, Genova, Italy

    Enzo Silvestri

  5. Dipartimento di Medicina Sperimentale and Policlinico San Martino IST, Largo Rosanna Benzi 10, 16129, Genova, Italy

    Alberto Stefano Tagliafico

Authors
  1. Luca Maria Sconfienza
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  2. Domenico Albano
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  3. Carmelo Messina
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  4. Enzo Silvestri
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  5. Alberto Stefano Tagliafico
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Corresponding author

Correspondence to Luca Maria Sconfienza.

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The scientific guarantor of this publication is Luca Maria Sconfienza.

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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.

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Sconfienza, L.M., Albano, D., Messina, C. et al. How, When, Why in Magnetic Resonance Arthrography: an International Survey by the European Society of Musculoskeletal Radiology (ESSR). Eur Radiol 28, 2356–2368 (2018). https://doi.org/10.1007/s00330-017-5208-y

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