Chronic wrist pain: spin-echo and short tau inversion recovery MR imaging and conventional and MR arthrography.

Abstract

The accuracy of T1-, proton-density-, and T2-weighted magnetic resonance (MR) imaging sequences and gadolinium-enhanced MR arthrography in evaluation of the triangular fibro-cartilage complex (TFCC) and the scapholunate (SL) and lunotriquetral (LT) ligaments was studied in 15 patients with chronic wrist pain. Arthrography and arthroscopy were used as standards of reference. Twelve patients also underwent imaging with short tau inversion recovery (STIR) sequences. MR imaging was more reliable in evaluation of the morphology of the TFCC and SL ligament than in that of the LT ligament. With arthrography as the standard, sensitivity was 0.721, specificity was 0.947, and accuracy was 0.887 for the TFCC; these values were 0.500, 0.864, and 0.765 for the SL ligament and 0.519, 0.455, and 0.490 for the LT ligament. No visualization of the SL ligament indicated a tear, but this sign was not helpful in evaluation of the LT ligament. Fluid in the distal radioulnar joint had a high association with TFCC tears. Accuracy with MR arthrography was higher than with the other sequences. STIR images were effective in evaluation of the TFCC. The combination of proton-density-and T2-weighted images appears to be useful because morphologic characteristics and the presence of fluid can be evaluated.

Quantitative Analysis of T1 Weighted Images due to Change in TI by Using the Inversion Recovery in 3.0T Brain MRI Examination

“…Nevertheless, it is used occasionally instead of the Spin Echo because of its outstanding T1 Contrast. For the IR, the contrast of an image varies with the inversion time (TI) [6]. Therefore, the purpose of this study was to acquire an optimal TI when a T1 weighted image is gained through the IR technique.…”

“…Unlike the spin echo, the IR first inverts the ordinate magnetization axis in the opposite direction and then obtains an echo using the spin echo or turbo spin echo. The contrast of an image varies with the inversion time (TI) [6]. The purpose of this study was to determine the optimal TI when gaining a T1 weighted image in a brain examination.…”

TFCC-L�sionen

“…Einschlägige Untersuchungen über deren Treffsicherheit zeigen jedoch eine relativ geringe Sensitivität und Spezifität. Technische und methodische Begrenzungen führten bislang nur zu limitierten Zusatzinformation durch die radiologischen Schnittbildverfahren [19]. So war bei Verletzungen am Handgelenk die MRT allenfalls Ausnahmeindikationen vorbehalten.…”

Magnetic resonance imaging in the evaluation of ligament injuries

“…In the evaluation of SL ligament perforations, MR arthrography has been shown to be slightly more accurate than conventional MRI with arthroscopy as the standard, but conventional MRI and MR arthrography were equally accurate for detection of LT tears [12]. Thus, there does not appear to be sufficient significance to justify intra-articular injection on a routine basis.…”