Shoulder MR arthrography: intraarticular anesthetic reduces periprocedural XXXX and major motion artifacts but does not decrease imaging time.

@entity1 @entity7241 @entity158 @entity1342
PURPOSE: To prospectively determine whether the addition of an intraarticular anesthetic to the magnetic resonance (MR) arthrography solution has an effect on periprocedural @entity158 , motion artifacts, and imaging time. MATERIALS AND METHODS: This study was approved by the institutional review board, and written informed consent was obtained from all @entity1 . From September 2009 to March 2010, 127 @entity1 , most imaged for shoulder @entity158 , were randomized into two groups. The first group (group A, 63 @entity1 ) received intraarticular injection of @entity7241 , @entity1342 0.5%, and normal saline in a ratio of 1:100:100. The second group (group B, 64 @entity1 ) received intraarticular injection of @entity7241 and normal saline in a ratio of 1:200. @entity158 was assessed before and after injection and immediately after 1.5-T MR imaging and rated on a scale of 0 to 10. Motion artifact was assessed by two musculoskeletal radiologists and two fellows by using a scale of 0 to 3 (0=no artifact, 1=artifact present but not affecting diagnostic image quality, 2=artifact present and diminishing diagnostic image quality, and 3=artifact present and rendering image nondiagnostic). MR imaging time and examinations with repeated sequences were recorded. Wilcoxon rank sum, analysis of covariance, and permutation data analyses were performed. RESULTS: The mean @entity158 levels before injection, after injection, and after MR imaging were 3.5, 2.3, and 2.5, respectively, for group A and 3.6, 3.1, and 3.2 for group B. After adjusting for age, sex, and preinjection @entity158 level, the mean differences in pre- and postinjection @entity158 and preinjection @entity158 and post-MR imaging @entity158 between the two groups were -0.9 (P=.017) and -0.8 (P=.056), respectively. No significant difference in mean total MR imaging time or number of @entity1 with repeat sequences was noted. Radiologists 1 and 2 recorded grade 2 or 3 motion in six and five @entity1 , respectively, in group A and 15 and 14 @entity1 , respectively, in group B (P=.047 and .048, respectively). Radiologists 3 and 4 recorded grade 2 or 3 motion in 13 and 23 @entity1 , respectively, in group A and 23 and 33 @entity1 , respectively, in group B (P=.093 and .110, respectively). CONCLUSION: The use of an intraarticular anesthetic significantly reduces periprocedural @entity158 and major motion artifacts associated with MR shoulder arthrography; however, total MR imaging time is not reduced.
