Redeker J, Meyer-Marcotty M, Urbanek F, Hankiss J, Flügel M
Klinik für Plastische, Hand- und Wiederherstellungschirurgie, Medizinische Hochschule Hannover.
Handchir Mikrochir Plast Chir. 2009 Jun;41(3):129-34. doi: 10.1055/s-2008-1039066. Epub 2008 Dec 19.
The purpose of this study was to evaluate the diagnostic value of MRI for detecting intracarpal lesions in clinical routine.
In a retrospective study, we reviewed the charts of 506 patients who had undergone wrist arthroscopy in our department between May 1998 and November 2002. Out of 506 patients 217 had an MRI. The MRI was performed at 31 different radiology facilities using a number of techniques. The MRI results were compared with the arthroscopic findings, taking the arthroscopic results as a "gold standard" (sensitivity = SEN, specificity = SPE, positive predictive value = PPV, negative predictive value = NPV, accuracy = ACC).
The following results were found: For tears of the scapholunate ligament the avalues are SEN 18.5 %, SPE 95 %, PPV 71 %, NPV 66 %, ACC66 %. Not one of 16 tears of the lunotriquetral ligament was found by MRI.
In our data we found a low sensitivity for unspecific requested and implemented MRI for detecting intracarpal lesions. Therefore the indication for MRI should only be made after experienced hand surgeons have examined the wrist. In our opinion, only direct MR-arthrography is equal to arthroscopy, so that only an experienced radiologist who is familiar with this technique should perform the MRI diagnostics of the hand.
本研究旨在评估磁共振成像（MRI）在临床常规中检测腕骨内病变的诊断价值。
在一项回顾性研究中，我们查阅了1998年5月至2002年11月间在我院接受腕关节镜检查的506例患者的病历。506例患者中217例进行了MRI检查。MRI检查在31个不同的放射科使用多种技术进行。将MRI结果与关节镜检查结果进行比较，以关节镜检查结果作为“金标准”（敏感性 = SEN，特异性 = SPE，阳性预测值 = PPV，阴性预测值 = NPV，准确性 = ACC）。
发现以下结果：对于舟月韧带撕裂，各项值为敏感性18.5%，特异性95%，阳性预测值71%，阴性预测值66%，准确性66%。MRI未发现16例月三角韧带撕裂中的任何一例。
在我们的数据中，发现非特异性要求和实施的MRI检测腕骨内病变的敏感性较低。因此，只有在经验丰富的手外科医生检查腕关节后才能进行MRI检查的指征。我们认为，只有直接磁共振关节造影与关节镜检查相当，因此只有熟悉该技术的经验丰富的放射科医生才能进行手部的MRI诊断。
