MR arthrography in the diagnosis of rotator cuff tears. Standard spin-echo alone or with fat suppression?

Purpose: To examine the value of fat-suppressed images in MR arthrography of the shoulder in patients with rotator cuff tears. Material and Methods: MR arthrography was performed in 25 patients (9 women, 16 men) ranging from 19 to 64 years. Standard T1-weighted spin-echo images (sSE) and fat-suppressed images (FS) were obtained after intraarticular injection of contrast material. The MR studies were analyzed according to contrast, image quality and conspicuity of pathology. A diagnosis was established without knowledge of the conventional arthrographic findings on the basis of sSE versus FS techniques. Results: The contrast between the intraarticular fluid and the adjacent structures in FS images was increased compared to sSE images in all patients. The conspicuity of anatomical structures was improved in 8 patients. Without fat suppression, 2 flase-negative and one false-positive full-thickness tears were diagnosed. With the FS technique, 14 full-thickness tears and 4 partial-thickness tears of the cuff were correctly classified. Conclusion: The results suggest that, if MR arthrography is chosen for a diagnosis of rotator cuff disorders, a fat suppression sequence should be included. (orig.)