Indirekte MR-Arthrographie des Handgelenks bei TFCC-Läsionen

Herold, Thomas; Lenhart, Markus; Held, Paul; Babel, M.; Ruf, Susan D. Meierhans; Feuerbach, Stefan; Link, J.

doi:10.1055/s-2001-18318

Cited by 27 publications

(5 citation statements)

References 11 publications

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“…Consequently, indirect MR arthrography works best in the wrist, ankle, fingers, and toes because these joints are small, or in the shoulder, which has a fair amount of synovial invagination (Figs 30, 31) (61)(62)(63)(64)(65)(66)(67)(68). Such joints are small or have large amounts of synovial invagination.…”

Section: Indirect Mr Arthrographymentioning

confidence: 99%

Special Focus Session

Steinbach

Palmer

Schweitzer³

2002

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Direct magnetic resonance (MR) arthrography with injection of saline solution or diluted gadolinium can be useful for evaluating certain pathologic conditions in the joints. It is most helpful for outlining labral-ligamentous abnormalities in the shoulder and distinguishing partial-thickness from full-thickness tears in the rotator cuff, demonstrating labral tears in the hip, showing partial- and full-thickness tears of the collateral ligament of the elbow and delineating bands in the elbow, identifying residual or recurrent tears in the knee following meniscectomy, increasing the certainty of perforations of the ligaments and triangular fibrocartilage in the wrist, correctly identifying ligament tears in the ankle and increasing the sensitivity for ankle impingement syndromes, assessing the stability of osteochondral lesions in the articular surface of joints, and delineating loose bodies in joints. Indirect MR arthrography with intravenous administration of diluted gadolinium may be performed when direct arthrography is inconvenient or not logistically feasible. Although indirect MR arthrography has some disadvantages vis-à-vis direct MR arthrography, it does not require fluoroscopic guidance or joint injection and it is superior to conventional MR imaging in delineating structures when there is minimal joint fluid. In addition, vascularized or inflamed tissue will enhance with this method. Indirect MR arthrography can be used to rule in or diagnose abnormalities and to exclude abnormalities.

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Section: Indirect Mr Arthrographymentioning

confidence: 99%

Special Focus Session

Steinbach

Palmer

Schweitzer³

2002

RadioGraphics

275

151

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“…In indirect MR arthrography, active joint movement induces an intraarticular diffusion of the previously applied contrast agent, thus yielding an improved contrast ratio in T1-weighted sequences [59,60]. However, the distending effect of the intraarticular structures obtained with indirect MR arthrography is only slight.…”

Section: Indirect Mr Arthrographymentioning

confidence: 98%

Carpal instability

et al. 2006

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This review addresses the pathoanatomical basics as well as the clinical and radiological presentation of instability patterns of the wrist. Carpal instability mostly follows an injury; however, other diseases, like CPPD arthropathy, can be associated. Instability occurs either if the carpus is unable to sustain physiologic loads ("dyskinetics") or suffers from abnormal motion of its bones during movement ("dyskinematics"). In the classification of carpal instability, dissociative subcategories (located within proximal carpal row) are differentiated from non-dissociative subcategories (present between the carpal rows) and combined patterns. It is essential to note that the unstable wrist initially does not cause relevant signs in standard radiograms, therefore being "occult" for the radiologic assessment. This paper emphasizes the high utility of kinematographic studies, contrast-enhanced magnetic resonance imaging (MRI) and MR arthrography for detecting these predynamic and dynamic instability stages. Later in the natural history of carpal instability, static malalignment of the wrist and osteoarthritis will develop, both being associated with significant morbidity and disability. To prevent individual and socio-economic implications, the hand surgeon or orthopedist, as well as the radiologist, is challenged for early and precise diagnosis.

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“…Andere Autoren [6] halten wiederum die Arthrographie als einzige aussagekräftige präoperative Untersuchungsmethode bei Verletzungen der skapholunären Bänder beziehungsweise des Discus ulnocarpalis und die MRT als nicht aussagekräftig. Zur Diskussion steht die alleinig eingesetzte indirekte MR-Arthrographie (Magnetresonanztomographie mit Kontrastmittel) als Screeningmethode [8], da hier Rupturen des Discus ulnocarpalis beziehungsweise der skapholunären Bänder besser als in der konventionellen MRT dargestellt werden konnten [11] -eine Meinung, die andere Autoren nicht teilen [14]. Es gibt aber auch die Aussage [3], die alleinige klinische Untersuchung des Handgelenkes gemeinsam mit einer ausführlichen Anamnese durch geübte Ärzte reiche präoperativ aus und man könne auf jegliche apparative Diagnostik wie Röntgen, Arthrographie oder MRT verzichten.…”

Section: Diskussionunclassified