抄録
The purpose of this study was to evaluate the clinical usefulness of multidetector-row CT (MD-CT) arthrography for recurrent dislocation of the shoulder and rotator cuff tear. This study involved 11 patients (7 : recurrent dislocation of the shoulder and 4 : rotator cuff tear) who were diagnosed for their manifestations by arthroscopy and open surgery. There were 8 males and 3 females with a mean age of 42 years old (range ; 23 to 71 years old). In recurrent dislocation of the shoulder, all patients had a labral Bankart lesion of which two had a bony Bankart, and two patients had Type II SLAP lesion. Arthrography followed by MD-CT (SOMATOM Plus 4 Volume Zoom : derector-row : 4, collimation : 1 mm, and rotation speed : 0.5s/revolution) were performed, then reconstruction images were obtained. The findings of MD-CT arthrography were compared with those of the MRI according to the arthroscopic and surgical findings. In two patients with a bony Bankart's lesion, MD-CT arthrography could diagnose both although one could not be detected by MRI. One of the two Type II SLAP lesion were detected by MD-CT arthrography, which were not apparent on MRI. However, AIGHL was confirmed by MD-CT arthrography in only one patient who had Type II arthroscopic finding outlined by Yoneda. In all the patients with a rotator cuff tear, MD-CT arthrography showed a precise shape of the acromion. In three patients with a fullthickness tear, the location and the size of the tear was apparent on MD-CT arthrography. One joint side tear was clearly demonstrated on MD-CT arthrography although it was not diagnosed by MRI. MD-CT can easily display the optional section of a reconstructive image and 3D image by fast scanning (about 10 seconds). It was useful for diagnosing particularly the precise configuration of the acromion, bony Bankart's lesion, and joint side tears of the rotator cuff.
