Magee Thomas
Department of Radiology, Neuroskeletal Imaging, 255 N Sykes Creek Pkwy., Merritt Island, FL 32953, USA.
AJR Am J Roentgenol. 2009 Jan;192(1):80-5. doi: 10.2214/AJR.08.1089.
This study assesses the sensitivity and specificity of MRI at 3 T compared with arthroscopy for detection of intrinsic wrist ligament and triangular fibrocartilage complex (TFCC) tears.
MR wrist images in 300 consecutive patients underwent consensus review by two radiologists without knowledge of arthroscopy findings. Forty-nine of 300 patients underwent arthroscopy. Thirty-five of these 49 patients also underwent MR arthrography. Scans were assessed for full-thickness scapholunate, lunatotriquetral, or TFCC tears. After consensus review of MR images, arthroscopy results were compared with MR interpretations.
Of the 49 patients who underwent arthroscopy, 22 had TFCC tears, 18 had scapholunate tears, and 11 had lunatotriquetral tears (51 total tears at arthroscopy). Nineteen of 22 TFCC tears, 16 of 18 scapholunate tears, and nine of 11 lunatotriquetral tears seen at arthroscopy were seen on MRI. Four patients had both a TFCC tear and a lunatotriquetral ligament tear. One patient had a scapholunate ligament tear and a TFCC tear. There were no false-positive readings on MRI compared with arthroscopy. MR sensitivity for detection of TFCC tears was 86%, for detection of scapholunate tears was 89%, and for detection of lunatotriquetral tears was 82%. MR specificity for detection of tears was 100%. MR arthrography sensitivity for detection of ligament and TFCC tears was 100%. There were three patients in whom contrast media passed between joint spaces without an anatomic abnormality seen. These patients underwent arthroscopy with no tears seen.
MRI at 3 T is sensitive and specific for detection of wrist ligament tears. MR arthrography is more sensitive for ligament evaluation but can result in false-positive findings because of microperforations.
本研究评估3T磁共振成像（MRI）与关节镜检查相比，在检测腕关节内在韧带和三角纤维软骨复合体（TFCC）撕裂方面的敏感性和特异性。
300例连续患者的腕部MRI图像由两名放射科医生进行一致性评估，他们对关节镜检查结果不知情。300例患者中有49例接受了关节镜检查。这49例患者中的35例还接受了磁共振关节造影。对扫描结果进行评估，以确定是否存在舟月、月三角或TFCC全层撕裂。在对MRI图像进行一致性评估后，将关节镜检查结果与MRI解读结果进行比较。
在接受关节镜检查的49例患者中，22例有TFCC撕裂，18例有舟月撕裂，11例有月三角撕裂（关节镜检查共发现51处撕裂）。关节镜检查发现的22处TFCC撕裂中，MRI显示了19处；18处舟月撕裂中，MRI显示了16处；11处月三角撕裂中，MRI显示了9处。4例患者既有TFCC撕裂又有月三角韧带撕裂。1例患者有舟月韧带撕裂和TFCC撕裂。与关节镜检查相比，MRI没有假阳性结果。MRI检测TFCC撕裂的敏感性为86%，检测舟月撕裂的敏感性为89%，检测月三角撕裂的敏感性为82%。MRI检测撕裂的特异性为100%。磁共振关节造影检测韧带和TFCC撕裂的敏感性为100%。有3例患者造影剂在关节间隙之间通过，未发现解剖学异常。这些患者接受关节镜检查时未发现撕裂。
3T MRI对检测腕关节韧带撕裂具有敏感性和特异性。磁共振关节造影在韧带评估方面更敏感，但由于微穿孔可能导致假阳性结果。
