This study was designed to evaluate the efficiency of contrast-enhanced fat-suppressed proton-density images (CE-FS-PDI) for shoulder MRI.

We retrospectively reviewed 54 shoulder MR precontrast fat-suppressed proton-density images (FS-PDI), CE-FS-PDI and contrast-enhanced fat-suppressed T1 weighted images (CE-FS-T1WI). Signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs) of the posterior labrum, infraspinatus muscle, synovium, biceps brachii long head tendon and subcutaneous fat were analyzed on each sequence. Subsequently, 53 cases were reviewed where patients had undergone both shoulder arthroscopy and shoulder MRI. We analyzed the diagnostic agreement rates between the CE-FS-PDI and CE-FS-T1WI and the diagnostic accuracy of arthroscopically proven tears of the supraspinatus tendon.

On CE-FS-PDI, the SNRs and CNRs of all structures were statistically higher than on precontrast FSPDI and CE-FS-T1WI. Diagnostic agreement rates between CE-FS-PDI and CE-FS-T1WI were 70-96% in labrums and 75-96% in rotator cuffs. The diagnostic accuracy rates for a tear of the supraspinatus tendon were 83% on CE-FS-PDI and 75% on CE-FS-T1WI, respectively.

The SNR and CNR on CE-FS-PDI were increased in the shoulder structures, and the diagnostic rate for a tear of the supraspinatus tendon on CE-FS-PDI was superior as compared to CE-FS-T1WI. Therefore, CE-FS-PDI will be useful for shoulder MRI.