الفهرس 
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Abstract
Shoulder pain is among the most common skeletal problems for which the patients seek consultation from a physician, probably ranking a second issue to lower back pain; where rotator cuff disorders are by far the leading cause of shoulder pain. 1 Owing to increasing requirements of modern shoulder surgical techniques; MR imaging of the shoulder may be quite demanding. MR imaging should not only confirm obvious clinical or sonographic findings such as major tears of the supraspinatus, but also rather provide additional relevant information such as the detection of rotator cuff abnormalities in unusual positions, fatty degeneration of the muscles of the rotator cuff, abnormalities of the biceps tendon, and others. 2- Shoulder magnetic resonance (MR) arthrography is a more sensitive method in detection of intra-articular pathologies compared with the conventional technique. While it can be conducted via direct injection of diluted gadolinium contrast medium into the joint, it may also be applied indirectly.
Indirect MR arthrography is generally not preferred due to use of higher amounts of contrast medium and inadequate distinction of intra-articular structures as a result of failure to fill the joint proficiently. 3-
Direct magnetic resonance arthrography (D-MRA) of the shoulder has been widely used to evaluate abnormalities of the labroligamentous complex and rotator cuff. 4 However, this method is mildly invasive as it exposes patients to ionizing radiation with intra-articular needle placement for joint injection using fluoroscopic guidance. Also, it requires the coordination of scheduling two procedure rooms, which becomes impractical if the fluoroscopy suite is distant from the MRI scanner.
5.It has been shown that the intravenous administration of gadopentetate dimeglumine
enhances the joint cavity and thus indirectly produces an arthrographic effect.6 This technique,
which is known as indirect MRA (I-MRA), was proposed as a practical alternative to D-MRA.
7-However, to our knowledge, there are no studies in the literature regarding the diagnostic accuracy of labral lesions, rotator cuff tears, and long head of biceps tendon (LHBT) tears using I-MRA compared to DMRA.8
Magnetic resonance (MR) arthrography of the glenohumeral joint is generally accepted as the best imaging modalities for detecting intracapsular lesions associated with sports injury or instability, such as SLAP (superior labrum, anterior-posterior) lesion, Bankart lesion, abnormalities of rotator cuff, glenohumeral ligaments, or long head of biceps tendon.