Effects of Axial Traction during Direct MR-Arthrography of the Wrist in Sports Injuries

Abstract

Purpose:To evaluate the degree of joint distraction during direct MR arthrography with axial traction in sports injuries. To confirm the effect of axial traction on the quality of wrist opacification.Patients and methods:Seventeen patients (11 male, 6 female) underwent wrist MR arthrography without (mean: 39 years (SD 11.6))., and 20 patients (16 male, 4 female) with axial traction (mean: 28 years (SD 7.1)). Subgroups were defined according to pathology: degenerative, ligamentous, traumatic, normal (ie patients without MR-arthrography lesions). Radioscaphoid, radiolunate, lunocapitate, ulna Triangular Fibrocartilage (TFC), scapho-lunate, luno-triquetral, ulnocarpal, Carpo-Metacarpal (CMC) I and III and distal radio-ulnar spaces were measured for all patients. Differences in joint space width were compared between subgroups. Joint space opacification was subjectively scored from 0 (no opacification) to 3 (fully opacified), and compared between the groups with and without traction.Results:The difference in joint space was statistically significant (p<0.05) for radioscaphoid, radiolunate, lunocapitate and ulnocarpal spaces, but only in patients with ligamentous tears. Opacification score was significantly higher for ulnocarpal (p=0.0275) and CMC III joint spaces (p=0.0272) with axial traction.Conclusion:Axial traction resulted in a significantly higher radioscaphoid, radio-lunate, lunocapitate and ulnocarpal joint spaces width. This positive effect of axial traction raises the suspicion of sports ligamentous lesions.

3D MRI of the Hand and Wrist: Technical Considerations and Clinical Applications

“…New-generation 3D turbo spin-echo (TSE) variants, such as 3D controlled aliasing in parallel imaging (CAIPIRINHA) SPACE TSE and 3D compressed sensing SPACE TSE, permit fourfold and sixfold acceleration for faster acquisition times for standard T1-, proton-density, intermediate-, and T2-weighting, optimized contrast resolution, and less blurring. 7,[23][24][25][26] The orientation of the in-plane phase encoding and partition phase encoding directions directly relates to the incidence of wraparound artifacts, whereas the voxel size is the major determinant for the overall SNR and overall image quality. 27 Negotiations and trade-offs between spatial resolution, acquisition time, and image contrast should be carefully chosen according to the clinical indications and the size and morphology of the structures that need to be assessed.…”