The carpal ligaments in MR arthrography of the wrist: Correlation with standard MRI and wrist arthroscopy

Abstract

We assessed the value of three‐compartment magnetic resonance (MR) wrist arthrography in comparison with non‐enhanced magnetic resonance imaging (MRI) for the evaluation of 13 individual wrist ligaments in 35 patients with refractory wrist pain. In 20 of these patients MR findings were correlated with the findings from multiportal wrist arthroscopy. For MR imaging (1.5‐T magnet) a three‐dimensional volume acquisition with a gradient‐recalled echo sequence and 0.6–1.0 mm effective slice thickness was used. The delineation of individual wrist ligaments was rated as “good” in 10% of non‐enhanced MR and 90% of MR arthrography images. Ligament evaluation was possible with high diagnostic confidence in 11% by non‐enhanced MR imaging and 90% by MR arthrography. With wrist arthroscopy as the standard of reference, average sensitivities/specificities/accuracies for the diagnosis of full‐thickness ligamentous defects were 0.81/0.75/0.77 for non‐enhanced MR imaging and 0.97/0.96/0.96 for MR arthrography. Our findings suggest that MR arthrography is more accurate than standard MRI in delineating and evaluating the ligaments of the wrist.J. Magn. Reson. Imaging 1999;9:468–474. © 1999 Wiley‐Liss, Inc.

Direct magnetic resonance arthrography of the wrist with axial traction: A feasibility study to assess joint cartilage

“…DIRECT MAGNETIC RESONANCE (MR) arthrography of the wrist is a useful modality to assess the intrinsic and extrinsic wrist ligaments (1)(2)(3)(4), as well as the triangular fibrocartilage complex (TFCC) (3,5). On the contrary, accurate evaluation of the hyaline cartilage remains challenging, even at 3 T (6).…”

“…The advantages of direct MR arthrography over conventional MRI lie in distention of the joint capsule and signal intensity differences between the injected contrast material and the intra-articular structures (2,3,8). Joint distention leads to separation of the opposing cartilage surfaces and allows contrast material to leak into abnormalities.…”

Diagnostic performance of wrist magnetic resonance (MR) arthrography: comparison of three-dimensional isotropic T 1 weighted fast spin-echo MR arthrography and two-dimensional MR arthrography

“…[1][2][3][4][5] In particular, direct MR arthrography (D-MRA) of the wrist joint provides high tissue contrast and can be more sensitive and accurate than conventional MRI in delineating and evaluating the ligaments of the wrist. 1,6,7 Three-dimensional (3D) isotropic MRI at 3.0 T can provide multiplanar reformation along arbitrary planes that can be helpful in evaluating complex musculoskeletal structures. 8,9 It has been commonly used for evaluating the knee, shoulder and ankle joints.…”

Ist ein ?Handradiologe? sinnvoll?

“…Während für die meisten der genannten Indikationen eine i. v. Kontrastmittelgabe die diagnostische Aussage erhöht,kann die Aussagekraft hinsichtlich der karpalen Ligamente und des ulnokarpalen Komplexes durch eine direkte MR-Arthrographie erheblich gesteigert werden [11,14,18,22] …”