• Superior Labral Anteroposterior Tears: Accuracy and Interobserver Reliability of Multidetector CT Arthrography for Diagnosis

    Radiology: Volume 260: Number 1 -July 2011

    Yeo Ju Kim, MD Jung-Ah Choi, MD Joo Han Oh, MD Sung II Hwang, MD Sung Hwan Hong, MD Heung Sik Kang, MD

    Purpose: To evaluate the accuracy and interobserver reliability of multidetector computed tomographic (CT) arthrography for the diagnosis and classification of superior labral an­teroposterior (SLAP) lesions.

    Materials and Methods: Institutional review board approval and informed consent were obtained. Retrospective review of images from 161 multidetector CT arthrographic examinations was per­formed by two radiologists independently for detection and classification of SLAP lesions (type I-X), and sensi­tivity, specificity, accuracy, and interobserver agreement were evaluated.

    Results: The SLAP group included 94 patients, and the no-SLAP group included 67 patients with normal labrum. At ar­throscopy, a total of 88 SLAP lesions (excluding type I) were found. For detection of SLAP lesions excluding SLAP type I lesions, sensitivity, specificity, and accuracy were 94.3%, 76.7%, and 86.3% for reader 1 and 97%, 72.6%, and 86.3% for reader 2, respectively, and the interob­server agreement was very good (k = 0.87). The distribu­tion of SLAP lesions was as follows: six type I, 58 type II, one type III, one type IV, 16 type V, one type VI, five type VII, three type VIII, one type IX, one type V and VI, and one type V and VII. Percentages of correct classification of SLAP lesions were variable according to the types, but the overall percentage was noted to be 69.2% for reader 1 and 68.1% for reader 2. The interobserver agreement of classification of SLAP lesions was good (k = 0.72).

    Conclusion: Multidetector CT arthrography shows high accuracy and good interobserver reliability for diagnosis of SLAP lesions in spite of its limitations in specific classification.