Sun Hwa Lee1, Seong Jong Yun2, Hyeon Hwan Jo2, Dong Hyeon Kim2, Jae Gwang Song3, Yong Sung Park4. 1. 1 Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea. 2. 2 Department of Radiology, Aerospace Medical Center, Republic of Korea Air Force, Chungcheongbuk-do, Republic of Korea. 3. 3 Department of Orthopedic Surgery, Aerospace Medical Center, Republic of Korea Air Force, Chungcheongbuk-do, Republic of Korea. 4. 4 Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
Abstract
OBJECTIVE: To compare contrast leakage, pain score, image quality and diagnostic performance at different doses and levels of local anaesthesia for direct shoulder magnetic resonance arthrography. METHODS:Patients (n = 157) were prospectively enrolled and allocated to Group 1 (no local anaesthetic), Group 2 (local anaesthesia to subcutaneous fat level; lidocaine 1-2 ml), Group 3 (to deltoid muscle level; 3-5 ml), or Group 4 (to subscapularis muscle level; 6-8 ml). We evaluated the frequency of contrast leakage, periprocedural/postprocedural pain, contrast-to-noise ratio of the intra-articular signal, and subjective image noise/image sharpness. Radiological diagnoses of superior anterior-to-posterior (SLAP) and Bankart lesions were assessed. All data were analysed by one-way analysis of variance/Kruskal-Wall, Χ2/Fisher's exact and DeLong's tests. RESULTS: The frequency of contrast leakage from the injection path and subjective image noise were significantly lower in Groups 1 and 2 than in Groups 3 and 4 (p = 0.001-0.04). Periprocedural/postprocedural pain scores among Groups 2-4 were similar and lower than those of Group 1. The contrast-to-noise ratio (p = 0.11-0.97) and image sharpness (p = 0.12-0.43) were similar among Groups 2-4 and significantly lower than those of Group 1 (p = 0.001-0.02). The diagnostic performance for the assessment of superior anterior-to-posterior and Bankart lesions was better in Groups 2-4 than in Group 1, although there were no significant differences (p = 0.23-0.99). CONCLUSION:Local anaesthesia with 1-2 ml lidocaine at subcutaneous fat level reduced pain and provided optimal image quality in direct shoulder magnetic resonance arthrography. Advances in knowledge: This method can increase image quality, reduce periprocedural/postprocedural pain and potentially reduce the need for re-examination.
RCT Entities:
OBJECTIVE: To compare contrast leakage, pain score, image quality and diagnostic performance at different doses and levels of local anaesthesia for direct shoulder magnetic resonance arthrography. METHODS:Patients (n = 157) were prospectively enrolled and allocated to Group 1 (no local anaesthetic), Group 2 (local anaesthesia to subcutaneous fat level; lidocaine 1-2 ml), Group 3 (to deltoid muscle level; 3-5 ml), or Group 4 (to subscapularis muscle level; 6-8 ml). We evaluated the frequency of contrast leakage, periprocedural/postprocedural pain, contrast-to-noise ratio of the intra-articular signal, and subjective image noise/image sharpness. Radiological diagnoses of superior anterior-to-posterior (SLAP) and Bankart lesions were assessed. All data were analysed by one-way analysis of variance/Kruskal-Wall, Χ2/Fisher's exact and DeLong's tests. RESULTS: The frequency of contrast leakage from the injection path and subjective image noise were significantly lower in Groups 1 and 2 than in Groups 3 and 4 (p = 0.001-0.04). Periprocedural/postprocedural pain scores among Groups 2-4 were similar and lower than those of Group 1. The contrast-to-noise ratio (p = 0.11-0.97) and image sharpness (p = 0.12-0.43) were similar among Groups 2-4 and significantly lower than those of Group 1 (p = 0.001-0.02). The diagnostic performance for the assessment of superior anterior-to-posterior and Bankart lesions was better in Groups 2-4 than in Group 1, although there were no significant differences (p = 0.23-0.99). CONCLUSION: Local anaesthesia with 1-2 ml lidocaine at subcutaneous fat level reduced pain and provided optimal image quality in direct shoulder magnetic resonance arthrography. Advances in knowledge: This method can increase image quality, reduce periprocedural/postprocedural pain and potentially reduce the need for re-examination.
Authors: Michael G Fox; W Banks Petrey; Bennett Alford; Bang H Huynh; James T Patrie; Mark W Anderson Journal: Radiology Date: 2011-12-05 Impact factor: 11.105
Authors: P C Hajek; D J Sartoris; V Gylys-Morin; P Haghighi; A Engel; F Kramer; C H Neumann; D Resnick Journal: Invest Radiol Date: 1990-02 Impact factor: 6.016