Abstract
Background Magnetic resonance (MR) is the most important imaging technique to assess intra-articular
pathology of the wrist. Among various MR imaging protocols, the diagnostic performance
of indirect MR arthrography needs further investigation.
Purpose The purpose of this study was to assess the diagnostic performance of pre- and postcontrast,
3 T indirect MR arthrography in the diagnosis of scapholunate intrinsic ligament (SLIL)
and triangular fibrocartilage complex (TFCC) injuries, using wrist arthroscopy as
reference standard.
Patients and Methods We retrospectively evaluated consecutive patients with suspected SLIL or TFCC injury,
who had indirect MR arthrography done before arthroscopy. Images were assessed independently
by two senior radiologists.
Results Arthroscopy of the 53 wrists demonstrated 16 Geissler stages II and III partial tears
and 6 stage IV total SLIL ruptures. Central perforation of the TFCC was found in 24
wrists, and 12 wrists had an ulnar class 1B lesion. To detect any SLIL tear, accuracy
was higher for the two observers using postcontrast indirect MR arthrography (0.77
and 0.72) than for precontrast MR imaging (0.60 and 0.60). No difference was found
for total SLIL ruptures “0.85 and 0.89” versus “0.85 and 0.89.” To diagnose class
1B TFCC injuries, accuracy was higher using postcontrast indirect MR arthrography
(0.85 and 0.75) than for precontrast MR imaging (0.70 and 0.72). No difference in
accuracy was demonstrated for TFCC central tears “0.75 and 0.75” versus “0.70 and
0.77.”
Conclusion Postcontrast images at 3 T indirect MR arthrography, compared with precontrast images,
have an improved diagnostic performance for the overall detection of SLIL injuries
and as well as class 1B TFCC tears.
Level of Evidence This is a Level II, diagnostic study.
Keywords
arthroscopy - diagnostic performance - indirect MR arthrography - MR imaging - scapholunate
ligament - triangular fibrocartilage complex - wrist
