CT arthrography: Comparison with standard MRI and MR arthrography

Objective: To compare computed tomographic arthrography (CT arthrography) with standard magnetic resonance imaging (MRI) and magnetic resonance arthrography (MR arthrography) and also to evaluate whether CT arthrography can be used as an alternative imaging method instead of standard MRI and MR arthrography for the detection of intra-articular pathologies. Materials and Methods: A total of 84 cases were included to the study. MRI, MR arthrography and CT arthrography were used to evaluate hip joint in 42, shoulder joint in 26, wrist in 12, knee joint in 2, and ankle in 2 patients (47 males and 37 females, age range 16—66 years, mean 35.81 years ). Eighteen patients were operated. Presence of labral tear, paralabral cysts, cartilage loss of the hip and shoulder joints , rotator cuff tears, bone lesions such as osseous excrescence/bump on the femoral head-neck junction, acetabular retroversion, humeral head deformities, carpal instability in the wrist, postoperative recurrent or residual meniscal tears and cartilage loss in the knees, the stability of osteochondral lesions of the ankle were evaluated by a single observer. . MRI, MR arthrography and CT arthrography findings were compared to each other and surgical outcomes in order to determine the power of each modality to detect lesions. The McNemar chi-square test was used to compare radiological examinations, while the values of diagnostic accuracy were calculated for cases in which surgical outcomes can be used as a reference. A statistical evaluation could not be performed fort he wrist, ankle, and knee lesions due to small sample size for analysis. Results: While MR arthrography and CT arthrography results were statistically compatible with each other in detecting labral tear in the hip joint (p> 0.05), the diagnostic accuracy of MRI was lower than these two imaging techniques. In addition, CT arthrography has been found to have higher diagnostic accuracy in detecting hip joint cartilage lesions (sensitivity, specificity, and accuracy rates were 71.4%, 100% and 77.7%, respectively) and similar diagnostic accuracy with MR arthrography in detecting glenoid labral tears (sensitivity, specificity, and accuracy rates were 80%, 100% and 87.5%, respectively). Conclusion:. CT arthrography can be used as an alternative imaging method to MRI and MR arthrography for the detection of intra-articular pathologies in appropriate patients especially who have imaging challenges due to surgical hardwares and contraindications of the MRI procedure. Keywords: Joint, CT Arthrography, MRG, MR Arthrography