Hahn P, Häusler A, Bruckner T, Unglaub F
Handchirurgie, Vulpius Klinik, Bad Rappenau.
Handchir Mikrochir Plast Chir. 2012 Oct;44(5):310-3. doi: 10.1055/s-0032-1323799. Epub 2012 Oct 1.
MRI diagnostic is used for wrist pain diagnostic frequently. Clinical studies in specialized centers show high sensitivity and specificity concerning TFCC lesions. The aim of this study is a comparison of MRI and arthroscopy regarding TFCC lesions not in a specialized but in a common medical environment.
PATIENTS/MATERIAL AND METHODS: We retrospectively recorded all patients between January 2004 and April 2012 who went through a wrist arthroscopy and had a preoperative MRI. 401 patients were identified, 218 males and 183 females. The average age was 42.4 (12-84) years. 88 examiners of radiological practices in the region of our hospital reported the MRI results used for this research.
In 334 cases TFCC lesions could be identified during arthroscopy. MRI showed an average sensitivity of 69% and a specificity of 60%. A Palmer classification was reported through MRI in 58 cases. Most frequently, the MRI examiners reported a Palmer 1b lesion. That result could only be verified by arthroscopy in 11 cases.
Although MRI has an acceptable degree of diagnostic test accuracy in controlled clinical studies, we do not recommend the general use of MRI in diagnosis of ulnocarpal wrist pain.
MRI诊断常用于腕部疼痛的诊断。专业中心的临床研究表明,其对三角纤维软骨复合体(TFCC)损伤具有较高的敏感性和特异性。本研究的目的是在普通医疗环境而非专业环境中,比较MRI和关节镜检查对TFCC损伤的诊断情况。
患者/材料与方法:我们回顾性记录了2004年1月至2012年4月期间所有接受腕关节镜检查且术前行MRI检查的患者。共识别出401例患者,其中男性218例,女性183例。平均年龄为42.4(12 - 84)岁。我院所在地区88名放射科医生报告了用于本研究的MRI结果。
在334例病例中,关节镜检查时可识别出TFCC损伤。MRI显示平均敏感性为69%,特异性为60%。通过MRI报告了58例Palmer分类。MRI检查者最常报告的是Palmer 1b损伤。该结果仅在11例中通过关节镜检查得到证实。
尽管在对照临床研究中MRI具有可接受程度的诊断测试准确性,但我们不建议在诊断尺腕关节疼痛时普遍使用MRI。