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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2014; 24(03): 259-267
DOI: 10.4103/0971-3026.137038
Musculoskeletal Radiology

Comparison of conventional MRI and MR arthrography in the evaluation of wrist ligament tears: A preliminary experience

Shivani Pahwa
Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
,
Deep N Srivastava
Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
,
Raju Sharma
Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
,
Shivanand Gamanagatti
Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
,
Prakash P Kotwal
Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, India
,
Vijay Sharma
Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, India
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Abstract

Aims: To compare conventional magnetic resonance imaging (MRI) and direct magnetic resonance (MR) arthrography in the evaluation of triangular fibrocartilage complex (TFCC) and intrinsic wrist ligament tears. Materials and Methods: T1-weighted, fat suppressed (FS) proton density plus T2-weighted (FS PD/T2), 3D multiple-echo data image combination (MEDIC) sequences and direct MR arthrography were performed in 53 patients with wrist pain. Images were evaluated for the presence and location of TFCC, scapholunate ligament (SLL) and lunatotriquetral ligament (LTL) tears, and imaging findings were compared with operative findings in 16 patients who underwent arthroscopy or open surgery (gold standard). Results: Sixteen patients underwent arthroscopy/open surgery: 12 TFCC tears were detected arthroscopically out of which 9 were detected on FS PD/T2 sequence, 10 on MEDIC sequence, and all 12 were detected on MR arthrography. The sensitivities of FS PD/T2, MEDIC sequences, and MR arthrography in the detection of TFCC tears were 75%, 83.3%, and 100%, respectively. Out of the eight arthroscopically confirmed SLL tears, three tears were detected on FS PD/T2 sequence, five on MEDIC sequence, and all eight were visualized on MR arthrography. The sensitivities of FS PD/T2, MEDIC sequences, and MR arthrography in detecting SLL tears were 37.5%, 62.5%, and 100%, respectively. One arthroscopically confirmed LTL tear was diagnosed on FS PD/T2 sequence, three on MEDIC sequence, and all five arthroscopically confirmed LTL tears were detected with MR arthrography. The sensitivities of PD, MEDIC sequences, and MR arthrography in detecting LTL tears were 20%, 40%, and 100%, respectively. Conclusions: MR arthrography is the most sensitive and specific imaging modality for the evaluation of wrist ligament tears.

Keywords

TFCC - scapholunate ligament - lunatotriquetral ligament - MR arthrography - wrist ligament tear - wrist arthroscopy - TFCC tear


Publication History

Article published online:
02 August 2021

© 2014. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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