2000
DOI: 10.2214/ajr.174.1.1740141
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Usefulness of Gadolinium-Enhanced MR Imaging in the Evaluation of the Vascularity of Scaphoid Nonunions

Abstract: Gadolinium-enhanced MR imaging is the most reliable imaging method for investigating the vascularity of the proximal pole in scaphoid nonunions.

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Cited by 139 publications
(134 citation statements)
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“…In our series, on preoperative images there was evidence of an increase in signal intensity after contrast administration in 6 patients, with a marked increase in signal intensity in 3 of these patients (Fig. 4) in the proximal pole of the scaphoid, which according to the current literature [11] should be evidence of bone marrow viability. However, this was not the case as these 3 cases were avascular with no evidence of punctate bleeding intraoperatively.…”
Section: Discussionsupporting
confidence: 64%
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“…In our series, on preoperative images there was evidence of an increase in signal intensity after contrast administration in 6 patients, with a marked increase in signal intensity in 3 of these patients (Fig. 4) in the proximal pole of the scaphoid, which according to the current literature [11] should be evidence of bone marrow viability. However, this was not the case as these 3 cases were avascular with no evidence of punctate bleeding intraoperatively.…”
Section: Discussionsupporting
confidence: 64%
“…In stage III, which represented AVN, there was no contrast enhancement. In 2000 Cerezal et al advocated the use of preoperative contrast enhancement to quantify the extent of necrosis of the proximal pole, stating that lack of contrast strongly correlated with AVN and that contrast enhancement showed good correlation with surgical and histological findings with a positive vascular status of the proximal pole of the scaphoid and good healing potential of the pseudoarthrosis [11]. In our series, on preoperative images there was evidence of an increase in signal intensity after contrast administration in 6 patients, with a marked increase in signal intensity in 3 of these patients (Fig.…”
Section: Discussionmentioning
confidence: 99%
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“…Unenhanced MR examination included a coronal and sagittal T1-weighted spin-echo sequence; a coronal intermediate-weighted, turbo spin-echo sequence with fat saturation; and a transverse true fast imaging with steady-state precession sequence. Dynamic gadolinium-enhanced MR imaging was performed after intravenous administration of 10 mL of a gadolinium chelate (Gadovist 1.0; Bayer [Schweiz], viability of the scaphoid aids in the preoperative planning of the most appropriate grafting procedure (eg, vascularized vs nonvascularized bone graft) and in predicting the healing capacity of a fracture ( 9 ). The purpose of our study was to compare the accuracy of dynamic gadolinium-enhanced MR imaging with that of standard MR imaging for assessing the viability of the proximal pole of the scaphoid in patients with nonunion.…”
Section: Mr Imaging Protocolmentioning
confidence: 99%
“…MRI might be the most accurate, but it is not infallible [16]. Diagnostic confirmation, however, is possible only with a histological examination [17].…”
Section: Introductionmentioning
confidence: 99%