• Sun Hwa Lee, Seong Jong Yun, Wook Jin, So Young Park, Ji Seon Park, and Kyung Nam Ryu.
• Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea.
• J Magn Reson Imaging. 2018 Oct 1; 48 (4): 1034-1045.

BackgroundAlthough 3D-isotropic MR arthrography has been characterized as a substitute imaging tool for rotator cuff tear (RCT) and labral lesions, it has not been commonly used in clinical practice because of controversy related to image blurring and indistinctness of structural edges.PurposeTo perform a comparison of the diagnostic performance of 3D-isotropic MR arthrography and 2D-conventional MR arthrography for diagnosis of RCT (solely RCT, full/partial-thickness supraspinatus [SST]-infraspinatus [IST] tear, or subscapularis [SSc] tear) and labral lesions.Study TypeMeta-analysis.PopulationPatients with shoulder pain.Field Strength/Sequence3D-isotropic and 2D-conventional MR arthrography at 3.0T or 1.5T.AssessmentPubMed and EMBASE were searched following the PRISMA guidelines.Statistical TestsBivariate modeling and hierarchical summary receiver operating characteristic modeling were performed to compare the overall diagnostic performance of 3D-isotropic and 2D-conventional MR arthrography. Multiple-subgroup analyses were performed for diagnosing RCT, full/partial-thickness SST-IST tear, SSc tear, and labral lesions. Meta-regression analyses were performed according to subject, study, and MR arthrography characteristics including 3D-isotropic sequences (turbo spine echo [TSE] vs. gradient echo [GRE]).ResultsEleven studies (825 patients) were included. Overall, 3D-isotropic MR arthrography had similar pooled sensitivity (0.90 [95% CI, 0.87-0.93]) (P = 0.95) and specificity (0.92 [95% CI, 0.87-0.95]) (P = 0.99), relative to 2D-conventional MR arthrography (sensitivity, 0.91 [95% CI, 0.86-0.94]); specificity, 0.92 [95% CI, 0.87-0.95]). Multiple-subgroup analyses showed that sensitivities (P = 0.13-0.91) and specificities (P = 0.26-0.99) on 3D-isotropic MR arthrography for diagnosing RCT, full/partial-thickness SST-IST tear, SSC tear, and labral lesions were not significantly different from 2D-conventional MR arthrography. On meta-regression analysis, 3D-TSE sequence demonstrated higher sensitivity (P < 0.01) than 3D-GRE for RCT and labral lesions.Data Conclusion3D-isotropic MR arthrography can replace 2D-conventional MR arthrography. 3D-isotropic MR arthrography using TSE sequence is recommended for more accurate diagnosis, as it demonstrates increased sensitivity.Level Of Evidence2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;48:1034-1045.© 2018 International Society for Magnetic Resonance in Medicine.

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