Comparison of MRI &amp; direct MR arthrography with arthroscopy in diagnosing ligament injuries of wrist

Cherian, Blessin S.; Bhat, Anil K.; Rajagopal, KV; Maddukuri, Satish Babu; Paul, D. McK.; Mathai, Naveen Joseph

doi:10.1016/j.jor.2019.11.014

Cited by 11 publications

(14 citation statements)

References 22 publications

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“…Even if MRI can confirm the presence of the ligament lesion, it fails to provide more information which is extremely important for determining surgical indication. 3.0-T MRI and magnetic resonance angiography (MRA) 33,35,36,[40][41][42][43][44][45][46][47][48] increase the detection power of the radiological investigations, but we will never get an accurate amount of information about the extent of ligament damage. This information concerning the exact location and extension of the ligament lesion, damaged tissue quality, and chondral-and osteochondral-associated lesions are all imperative information that is necessary when planning and choosing the most appropriately indicated surgical repair or reconstruction technique to the damaged ligament.…”

Section: Discussionmentioning

confidence: 99%

Comparison between MRI and Arthroscopy of the Wrist for the Assessment of Posttraumatic Lesions of Intrinsic Ligaments and the Triangular Fibrocartilage Complex

et al. 2021

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Background Magnetic resonance imaging (MRI) has been considered the most appropriate examination for wrist ligament injuries diagnosis, but it frequently fails to assess the intrinsic ligament lesion. Therefore, wrist arthroscopy is required to enhance and define the diagnosis. Purpose We compare the MRI imaging with wrist arthroscopy for intrinsic wrist ligaments (scapholunate [SL] and lunotriquetral [LT]) and triangular fibrocartilage complex (TFCC) injuries detection. Patients and Methods From 2007 to 2014, 532 patients affected by suspected SL, LT, and TFCC posttraumatic ligament injury have been investigated by 1.5-Tesla MRI and wrist arthroscopy. Inclusion and exclusion criteria were adopted. Only for SL ligament injury, the arthroscopic findings of complete (stage IV) and partial (stages I–III) SL ligament injury were compared with MRI findings. Statistical analysis, including sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and the diagnostic odds ratio, was used to compare MRI with arthroscopic findings. Results A total of 146 patients were accepted in the study. In 68 cases of arthroscopic SL ligament lesion, MRI confirmed the diagnosis only in 50% of the cases. In partial SL lesions, MRI was positive in 24.3% and in complete SL lesions, MRI was positive in 80.6% of the cases. In 10 cases of arthroscopic LT ligament lesion, MRI was positive in 30.0% of the cases. In 33 patients with arthroscopic TFCC lesion, MRI was positive in 66.7% of the cases. Conclusion 1.5-T MRI demonstrated to fail in confirming the lesion of SL, LP, and TFCC ligaments respectively in 50, 70, and 33.3% of the cases positive at arthroscopy. In complete SL ligament lesion, MRI reaches a higher sensitivity than in partial lesion. Arthroscopy remains the best method to demonstrate the ligament lesion and obtain more information regarding the extent and quality of the ligament damage. Level of Evidence This is a Level II, retrospective comparative study.

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Section: Discussionmentioning

confidence: 99%

Comparison between MRI and Arthroscopy of the Wrist for the Assessment of Posttraumatic Lesions of Intrinsic Ligaments and the Triangular Fibrocartilage Complex

et al. 2021

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“…Although less commonly performed nowadays due to improved MRI quality, some surgeons still prefer MR arthrograms for the assessment of the TFCC and intrinsic ligaments. 41 This subjects the patient to the additional step of image-guided injection and associated risks. In this regard, the 24-channel glove array and improved resolution of the small carpal structures compared to standard wrist coils may circumvent the need for intra-articular injection.…”

Section: Discussionmentioning

confidence: 99%

Twenty‐four–channel high‐impedance glove array for hand and wrist MRI at 3T

Zhang

Wang

et al. 2021

Magnetic Resonance in Med

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To present a novel 3T 24-channel glove array that enables hand and wrist imaging in varying postures. Methods:The glove array consists of an inner glove holding the electronics and an outer glove protecting the components. The inner glove consists of four main structures: palm, fingers, wrist, and a flap that rolls over on top. Each structure was constructed out of three layers: a layer of electrostatic discharge flameresistant fabric, a layer of scuba neoprene, and a layer of mesh fabric. Lightweight and flexible high impedance coil (HIC) elements were inserted into dedicated tubes sewn into the fabric. Coil elements were deliberately shortened to minimize the matching interface. Siemens Tim 4G technology was used to connect all 24 HIC elements to the scanner with only one plug. Results:The 24-channel glove array allows large motion of both wrist and hand while maintaining the SNR needed for high-resolution imaging. Conclusion:In this work, a purpose-built 3T glove array that embeds 24 HIC elements is demonstrated for both hand and wrist imaging. The 24-channel glove array allows a great range of motion of both the wrist and hand while maintaining a high SNR and providing good theoretical acceleration performance, thus enabling hand and wrist imaging at different postures to extract kinematic information.

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“…Direct MR arthrography has a higher sensitivity in detecting central TFCC tears but a lower specificity and is furthermore an invasive technique. Conventional 1.5 T MRI has been reported to achieve just as good results with a sensitivity of 94.4 % and specificity of 100 % for detecting any type of TFCC tear (Cherian, Bhat et al 2020). However, sensitivity and specificity are very userand equipment-dependent, and a meta-analysis from 2018 found the sensitivity and specificity for MRI to be 0.76 and 0.82 respectively, for MRA 0.78 and 0.85, and for CT arthrography 0.89 and 0.89.…”

Section: Diagnostic Imagingmentioning

confidence: 99%

Ulnar fractures and ligament injuries of the wrist

Moloney

2022

Linköping University Medical Dissertations

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Comparison of MRI & direct MR arthrography with arthroscopy in diagnosing ligament injuries of wrist

Cited by 11 publications

References 22 publications

Comparison between MRI and Arthroscopy of the Wrist for the Assessment of Posttraumatic Lesions of Intrinsic Ligaments and the Triangular Fibrocartilage Complex

Comparison between MRI and Arthroscopy of the Wrist for the Assessment of Posttraumatic Lesions of Intrinsic Ligaments and the Triangular Fibrocartilage Complex

Twenty‐four–channel high‐impedance glove array for hand and wrist MRI at 3T

Ulnar fractures and ligament injuries of the wrist

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