SHOULDER MRI                                                                     

MRI and MRA Protocols                                                                                                                                             

1- Axial Fat-Sat PD spin echo (SE)

Particularly useful for assessment of the long head of the biceps tendon and subscapularis tendon. Glenohumeral ligaments, glenoid labrum and acramioclavicular joint are also assessed.
 Normal Long head of the biceps tendon demonstrates high signal and distortion, consistent with a tendon tear.  Bony bankart lesion Small paralabral cyst

2- Coronal Fat-Sat PD spin echo (SE): 

Supraspinatus tendons and acromioclavicular joint are assessed. Superior labrum is also visualized well on this sequence.  
 Normal There is complete tear of the supraspinatus tendon, with some fluid in the subacromian subdeltoid bursa as expected.  There is tendinosis - tendinopathy involving the rotator cuff. There is also irregularity and signal abnormality in the superior labrum, consistent with a SLAP lesion.   

3- Coronal Fat-Sat T2 spin echo (SE) 

Particularly useful to determine if the signal abnormalities in the supraspinatus tendons and superior labrum is truly due to degeneration or tear, and also to see if there is any fluid in the subacromian and subdeltoid bursa (which would be due to bursitis or rotator cuff tear). Bone edema like abnormalities also easily appreciated.    

4- Sagittal T1 spin echo (SE)

T1 sequence is useful to assess the bone marrow. Bone marrow replacing conditions are best evaluated with this sequence. Supraspinatus tendon impingement is also easily appreciated. 
 Normal Hypertrophic degenerative acromioclaicular joint clearly compressing the supraspinatus tendon.  Complete rotator cuff tear with typical atrophic change in the supraspinatus tendon - best appreciated on sagittal T1 weighted images.  Quadrilateral space syndrome

5- Sagittal Fat-Sat PD spin echo (SE) 

Useful to confirm findings appreciated on coronal plane and also useful for further assessment of the biceps tendon and its superior labral attachment.  
 Normal  SLAP lesion