Artroresonancia directa, indirecta y artrotomografía para lesiones del mango rotador y Slap. Estado actual / Direct magnetic resonance arthrography, indirect magnetic resonance arthrography, and computed tomography arthrography for rotator cuff lesions and superior labral anterior and posterior tears: state of the art

La evolución constante de las modalidades diagnósticas para el hombro han mejorado la resolución, la sensibilidad y la especificidad. No hay consenso sobre cuál es el mejor método entre la resonancia magnética simple, artroRM directa, indirecta y artrotomografía computarizada. Las publicaciones, de orígenes muy diversos, plantean diferentes criterios para seleccionar la técnica a emplear. La aplicación de protocolos de estudio rígidos que no incluyan todas las alternativas de imágenes no ayudan a los pacientes y restringen la creatividad, particularmente en nuestros países donde la limitación de los recursos es una constante. Es importante usar racionalmente las técnicas dependiendo del paciente y del lugar, teniendo en cuenta la edad, las enfermedades relacionadas, la posibilidad quirúrgica, las complicaciones y los equipos disponibles. En este artículo se revisa el estado actual de las imágenes para las lesiones del manguito de los rotadores y del labrum, considerando sus indicaciones, ventajas y desventajas (AU)

Continual improvements in diagnostic modalities used for shoulder imaging have led to better resolution, sensitivity, and specificity. There is no consensus about whether conventional MRI, direct MR arthrography, indirect MR arthrography, or CT arthrography is the best method. Many publications from very diverse origins propose different criteria for selecting the technique to apply in different patients. However, the application of rigid protocols that do not include all the imaging options does not help patients. Moreover, this approach also restricts radiologists’ creativity, especially in countries in which resources are more limited. It is important to ensure the rational use of the techniques depending on the patient and the place, considering the patient’s age, associated diseases, surgical possibilities, complications, and available equipment. This article reviews the state of the art in imaging rotator cuff and superior labral anterior and posterior lesions, considering the indications, advantages, and advantages of the different techniques in different cases (AU)

[Direct magnetic resonance arthrography, indirect magnetic resonance arthrography, and computed tomography arthrography for rotator cuff lesions and superior labral anterior and posterior tears: state of the art]. / Artroresonancia directa, indirecta y artrotomografía para lesiones del mango rotador y Slap. Estado actual.

Continual improvements in diagnostic modalities used for shoulder imaging have led to better resolution, sensitivity, and specificity. There is no consensus about whether conventional MRI, direct MR arthrography, indirect MR arthrography, or CT arthrography is the best method. Many publications from very diverse origins propose different criteria for selecting the technique to apply in different patients. However, the application of rigid protocols that do not include all the imaging options does not help patients. Moreover, this approach also restricts radiologists' creativity, especially in countries in which resources are more limited. It is important to ensure the rational use of the techniques depending on the patient and the place, considering the patient's age, associated diseases, surgical possibilities, complications, and available equipment. This article reviews the state of the art in imaging rotator cuff and superior labral anterior and posterior lesions, considering the indications, advantages, and advantages of the different techniques in different cases.