Department of Radiology, Research Institute of Radiological Science, Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul 120-752, Republic of Korea.
Magn Reson Imaging. 2013 Feb;31(2):221-6. doi: 10.1016/j.mri.2012.06.024. Epub 2012 Sep 7.
The purpose of the study was to validate the diagnostic performance of high-resolution isovolumetric magnetic resonance arthrography (MRA) for intrinsic ligament and triangular fibrocartilage complex (TFCC) tears of the wrist as compared to conventional MR imaging (MRI).
Forty-eight patients with traumatic TFCC tears at arthroscopy were enrolled. All patients had underwent proton-density- and T2-weighted MRI before arthrography and three-dimensional T1 high-resolution isovolumetric examination (3D-THRIVE) MRA on a 3-T MR. We assessed the presence of scapholunate interosseous ligament (SLIL)/lunotriquetral interosseous ligament (LTIL) or TFCC tears using the arthroscopy as a gold standard.
Arthroscopy revealed 37 TFCC central tears, 15 TFCC peripheral tears, 20 SLIL tears and 13 LTIL tears. Sensitivities of MRI and MRA were 70.3% and 94.6% for detection of TFCC central tears, 60.0% and 93.3% for detection of TFCC peripheral tears, 65.0% and 85.0% for SLIL tears, and 61.5% and 84.6% for LTIL tears. The specificity of the MRI was 100% for the detection of ligaments and TFCC tears. The specificities of the MRA for detection of TFCC central tears, TFCC peripheral tears, SLIL tears and LTIL tears were 100%, 97%, 96.4% and 100%, respectively.
Isovolumetric 3D-THRIVE wrist MRA provided better results for depiction of intrinsic ligament and TFCC tears than wrist MRI.
本研究旨在验证高分辨率等容磁共振关节造影术（MRA）在诊断腕关节固有韧带和三角纤维软骨复合体（TFCC）撕裂方面的诊断性能，与常规磁共振成像（MRI）相比。
纳入 48 例经关节镜证实的创伤性 TFCC 撕裂患者。所有患者均在关节造影术前接受质子密度加权和 T2 加权 MRI 检查，并在 3TMR 上进行三维 T1 高分辨率等容检查（3D-THRIVE）MRA。我们以关节镜检查为金标准，评估掌侧舟月骨间韧带（SLIL）/月三角骨间韧带（LTIL）或 TFCC 撕裂的存在情况。
关节镜检查显示 37 例 TFCC 中央撕裂，15 例 TFCC 外周撕裂，20 例 SLIL 撕裂和 13 例 LTIL 撕裂。MRI 和 MRA 检测 TFCC 中央撕裂的敏感性分别为 70.3%和 94.6%，检测 TFCC 外周撕裂的敏感性分别为 60.0%和 93.3%，检测 SLIL 撕裂的敏感性分别为 65.0%和 85.0%，检测 LTIL 撕裂的敏感性分别为 61.5%和 84.6%。MRI 检测韧带和 TFCC 撕裂的特异性为 100%。MRA 检测 TFCC 中央撕裂、TFCC 外周撕裂、SLIL 撕裂和 LTIL 撕裂的特异性分别为 100%、97%、96.4%和 100%。
等容 3D-THRIVE 腕关节 MRA 比腕关节 MRI 更能清晰显示固有韧带和 TFCC 撕裂。
