High Resolution MRI 1.5 Tesla in Diagnostics of Hidden and Obvious Injuries of the Long Head Biceps Tendon Pulley

Aim. To determine the informativeness of native high resolution MRI of the shoulder joint with use Recon DL option in the diagnostics of various variants of hidden soft tissues injuries of the biceps tendon pulley structures.

Materials and methods. A study of 39 patients suffering from degenerative and traumatic injuries of the biceps tendon pulley structures was conducted. All patients underwent MRI of the shoulder joint (Signa Artist 1.5 T) with thin slices (2.0 mm) and a 288 × 384 matrix, in three planes — axial, oblique coronal and sagittal. The informativeness of the MRI method for various variants of injuries the of the biceps tendon pulley structures were calculated.

Results. The cases of medial subluxation of the long head biceps tendon at the level of its pulley were revealed in 67.6 % of cases, 20.6 % intra-articular dislocation of the long head biceps tendon and 5,9 % of cases of extra-articular dislocation of the long head biceps tendon. Two cases (5.9 %) of minor medial subluxation of the long head biceps tendon were not revealed by MRI. There was not a single case of superior glenohumeral ligament rupture detected on native MRI. The sensitivity and specificity indices of the MRI method are: for medial subluxation biceps tendon the sensitivity is 92.0 %, specificity is 77.8 %, for intra-articular dislocation biceps tendon the sensitivity and specificity are 100.0 %, for extra-articular dislocation of the biceps tendon the sensitivity and specificity are 100.0 %.

In 84.0 % of cases, a slight medial displacement of the long head biceps tendon was noted, in 16.0 % of cases — moderate medial displacement of the biceps tendon.

Degenerative changes in the long head biceps tendon were diagnosed in 100,0 %, degeneration of the subscapularis tendon in 67.6 %, rupture of the subscapularis tendon in 26.5 % of cases. In 5.9 % of cases degeneration of the subscapularis tendon was not recognized on MRI.

Conclusions. The method of native MRI with use Recon DL option has very high information content only in the cases of obvious medial subluxations and dislocations of the long head biceps tendon pulley, but does not always allow for the reliable detection of more subtle hidden and minor injuries of the ligaments accompanying the biceps tendon pulley. 

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