Limits...
Comparison of conventional MRI and MR arthrography in the evaluation wrist ligament tears: A preliminary experience.

Pahwa S, Srivastava DN, Sharma R, Gamanagatti S, Kotwal PP, Sharma V - Indian J Radiol Imaging (2014)

Bottom Line: One arthroscopically confirmed LTL tear was diagnosed on FS PD/T2 sequence, three on MEDIC sequence, and all five arthroscopically confirmed LTL tears were detected with MR arthrography.The sensitivities of PD, MEDIC sequences, and MR arthrography in detecting LTL tears were 20%, 40%, and 100%, respectively.MR arthrography is the most sensitive and specific imaging modality for the evaluation of wrist ligament tears.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT

Aims: To compare conventional magnetic resonance imaging (MRI) and direct magnetic resonance (MR) arthrography in the evaluation of triangular fibrocartilage complex (TFCC) and intrinsic wrist ligament tears.

Materials and methods: T1-weighted, fat suppressed (FS) proton density plus T2-weighted (FS PD/T2), 3D multiple-echo data image combination (MEDIC) sequences and direct MR arthrography were performed in 53 patients with wrist pain. Images were evaluated for the presence and location of TFCC, scapholunate ligament (SLL) and lunatotriquetral ligament (LTL) tears, and imaging findings were compared with operative findings in 16 patients who underwent arthroscopy or open surgery (gold standard).

Results: SIXTEEN PATIENTS UNDERWENT ARTHROSCOPY/OPEN SURGERY: 12 TFCC tears were detected arthroscopically out of which 9 were detected on FS PD/T2 sequence, 10 on MEDIC sequence, and all 12 were detected on MR arthrography. The sensitivities of FS PD/T2, MEDIC sequences, and MR arthrography in the detection of TFCC tears were 75%, 83.3%, and 100%, respectively. Out of the eight arthroscopically confirmed SLL tears, three tears were detected on FS PD/T2 sequence, five on MEDIC sequence, and all eight were visualized on MR arthrography. The sensitivities of FS PD/T2, MEDIC sequences, and MR arthrography in detecting SLL tears were 37.5%, 62.5%, and 100%, respectively. One arthroscopically confirmed LTL tear was diagnosed on FS PD/T2 sequence, three on MEDIC sequence, and all five arthroscopically confirmed LTL tears were detected with MR arthrography. The sensitivities of PD, MEDIC sequences, and MR arthrography in detecting LTL tears were 20%, 40%, and 100%, respectively.

Conclusions: MR arthrography is the most sensitive and specific imaging modality for the evaluation of wrist ligament tears.

No MeSH data available.


Related in: MedlinePlus

TFC and scapholunate ligament tears in a 35 year old man. Coronal PD (A) and MEDIC (B) images show a central TFC tear (bold arrow) with fluid in distal radioulnar joint, but the scapholunate ligament appears intact (arrow). However, MR arthrogram (C) clearly depicts a scapholunate ligament tear with contrast extending into the midcarpal joint through the gap between scaphoid and lunate. The frayed, coapted ends of the torn scapholunate ligament have now separated; lunatotriquetral ligament is intact
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4126141&req=5

Figure 3: TFC and scapholunate ligament tears in a 35 year old man. Coronal PD (A) and MEDIC (B) images show a central TFC tear (bold arrow) with fluid in distal radioulnar joint, but the scapholunate ligament appears intact (arrow). However, MR arthrogram (C) clearly depicts a scapholunate ligament tear with contrast extending into the midcarpal joint through the gap between scaphoid and lunate. The frayed, coapted ends of the torn scapholunate ligament have now separated; lunatotriquetral ligament is intact

Mentions: Scapholunate ligament tears were diagnosed in 13 (25.5%) patients. Eight SLL tears were found in 16 patients who underwent arthroscopy/open surgery and statistical analysis was done for these patients [Figures 2, 3, and 5]. All eight tears were detected on MR arthrography, five tears were detected on MEDIC, and only three tears were picked up on FS PD/T2 sequence. FS PD/T2 sequence showed a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 37.5%, 100%, 100%, 61.5%, and 68.8%, respectively, for detecting SLL tears. MEDIC sequence showed a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 62.5%, 100%, 100%, 72.7%, and 81.3%, respectively, and MR arthrography showed a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 100%, 100%, 100%, 100%, and 100%, respectively. It was possible to make a diagnosis of SLL tear with a high confidence level (probable/definite tear) in all the patients on MR arthrogram.


Comparison of conventional MRI and MR arthrography in the evaluation wrist ligament tears: A preliminary experience.

Pahwa S, Srivastava DN, Sharma R, Gamanagatti S, Kotwal PP, Sharma V - Indian J Radiol Imaging (2014)

TFC and scapholunate ligament tears in a 35 year old man. Coronal PD (A) and MEDIC (B) images show a central TFC tear (bold arrow) with fluid in distal radioulnar joint, but the scapholunate ligament appears intact (arrow). However, MR arthrogram (C) clearly depicts a scapholunate ligament tear with contrast extending into the midcarpal joint through the gap between scaphoid and lunate. The frayed, coapted ends of the torn scapholunate ligament have now separated; lunatotriquetral ligament is intact
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126141&req=5

Figure 3: TFC and scapholunate ligament tears in a 35 year old man. Coronal PD (A) and MEDIC (B) images show a central TFC tear (bold arrow) with fluid in distal radioulnar joint, but the scapholunate ligament appears intact (arrow). However, MR arthrogram (C) clearly depicts a scapholunate ligament tear with contrast extending into the midcarpal joint through the gap between scaphoid and lunate. The frayed, coapted ends of the torn scapholunate ligament have now separated; lunatotriquetral ligament is intact
Mentions: Scapholunate ligament tears were diagnosed in 13 (25.5%) patients. Eight SLL tears were found in 16 patients who underwent arthroscopy/open surgery and statistical analysis was done for these patients [Figures 2, 3, and 5]. All eight tears were detected on MR arthrography, five tears were detected on MEDIC, and only three tears were picked up on FS PD/T2 sequence. FS PD/T2 sequence showed a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 37.5%, 100%, 100%, 61.5%, and 68.8%, respectively, for detecting SLL tears. MEDIC sequence showed a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 62.5%, 100%, 100%, 72.7%, and 81.3%, respectively, and MR arthrography showed a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 100%, 100%, 100%, 100%, and 100%, respectively. It was possible to make a diagnosis of SLL tear with a high confidence level (probable/definite tear) in all the patients on MR arthrogram.

Bottom Line: One arthroscopically confirmed LTL tear was diagnosed on FS PD/T2 sequence, three on MEDIC sequence, and all five arthroscopically confirmed LTL tears were detected with MR arthrography.The sensitivities of PD, MEDIC sequences, and MR arthrography in detecting LTL tears were 20%, 40%, and 100%, respectively.MR arthrography is the most sensitive and specific imaging modality for the evaluation of wrist ligament tears.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT

Aims: To compare conventional magnetic resonance imaging (MRI) and direct magnetic resonance (MR) arthrography in the evaluation of triangular fibrocartilage complex (TFCC) and intrinsic wrist ligament tears.

Materials and methods: T1-weighted, fat suppressed (FS) proton density plus T2-weighted (FS PD/T2), 3D multiple-echo data image combination (MEDIC) sequences and direct MR arthrography were performed in 53 patients with wrist pain. Images were evaluated for the presence and location of TFCC, scapholunate ligament (SLL) and lunatotriquetral ligament (LTL) tears, and imaging findings were compared with operative findings in 16 patients who underwent arthroscopy or open surgery (gold standard).

Results: SIXTEEN PATIENTS UNDERWENT ARTHROSCOPY/OPEN SURGERY: 12 TFCC tears were detected arthroscopically out of which 9 were detected on FS PD/T2 sequence, 10 on MEDIC sequence, and all 12 were detected on MR arthrography. The sensitivities of FS PD/T2, MEDIC sequences, and MR arthrography in the detection of TFCC tears were 75%, 83.3%, and 100%, respectively. Out of the eight arthroscopically confirmed SLL tears, three tears were detected on FS PD/T2 sequence, five on MEDIC sequence, and all eight were visualized on MR arthrography. The sensitivities of FS PD/T2, MEDIC sequences, and MR arthrography in detecting SLL tears were 37.5%, 62.5%, and 100%, respectively. One arthroscopically confirmed LTL tear was diagnosed on FS PD/T2 sequence, three on MEDIC sequence, and all five arthroscopically confirmed LTL tears were detected with MR arthrography. The sensitivities of PD, MEDIC sequences, and MR arthrography in detecting LTL tears were 20%, 40%, and 100%, respectively.

Conclusions: MR arthrography is the most sensitive and specific imaging modality for the evaluation of wrist ligament tears.

No MeSH data available.


Related in: MedlinePlus