Table 2.
Sample MRI protocol for assessment of the post-operative rotator cuffa
| Pulse sequence | Utilityb |
|---|---|
| Anatomic sequences (provide high SNR and spatial resolution) | |
| Axial intermediate weighted | Assess tendons (particularly subscapularis), acromioclavicular anatomy, heterotopic ossification |
| Coronal intermediate weighted (substitute T1 weighted imaging for MRA) | Assess tendons (particularly supraspinatus/infraspinatus), acromial arch anatomy, heterotopic ossification |
| Sagittal intermediate-weighted (substitute T1 weighted imaging for MRA) | Assess cuff tendons, acromial arch anatomy, adhesive capsulitis, heterotopic ossification, muscle bulk |
| Fluid-sensitive sequences (show fluid around abnormalities to best advantage) | |
| Coronal fat-suppressed intermediate-weighted images (or STIR if metal artefact is heavy) | Assess cuff tendons (supraspinatus, infraspinatus primarily), deltoid, joint fluid/synovitis, BME |
| Sagittal fat-suppressed intermediate-weighted images (or STIR if metal artefact is heavy) | Assess cuff tendons, deltoid tendon and muscle, BME |
| Optional: axial images in abduction–internal rotation | For assessment of the post-operative labrum |
| Optional: fat-suppressed T2 weighted images for added sensitivity to fluid signal, but results in decreased SNR | Assess cuff tendons and muscles, BME, joint fluid/synovitis |
BME, bone marrow oedema-like signal; MRA, MR arthrography; SNR, signal-to-noise ratio; STIR, short tau inversion recovery.
a
This table does not comprehensively describe the utility of these sequences for assessing all shoulder structures (such as the labrum and biceps tendon).
b
The utility column describes features of the post-operative rotator cuff, including the cuff tendons and acromial arch anatomy.