Boer B C, Vestering M, van Raak S M, van Kooten E O, Huis In 't Veld R, Vochteloo A J H
Hand and Wrist Unit, Centre for Orthopaedic Surgery OCON, PO Box 546, 7550 AM, Hengelo, The Netherlands.
Department of Radiology, Ziekenhuisgroep Twente, PO Box 546, 7550 AM, Hengelo, The Netherlands.
Eur J Orthop Surg Traumatol. 2018 Dec;28(8):1549-1553. doi: 10.1007/s00590-018-2215-x. Epub 2018 Apr 26.
In case of clinical suspicion of triangular fibrocartilage complex (TFCC) injury, different imaging techniques are used. The aim of this study was to determine whether MRA is superior to MRI and whether 3.0 T is better than 1.5 T (expresses in sensitivity, specificity and accuracy) in detecting TFCC injury, using arthroscopy as the gold standard.
The arthroscopic and MR findings of 150 patients who underwent arthroscopy for ulnar-sided wrist pain between January 2009 and November 2016 were retrospectively reviewed.
MRA was slightly more accurate compared to conventional MRI, and 1.5 T was slightly more accurate than 3.0 T. 1.5 T wrist MRA had a sensitivity of 80%, a specificity of 100% and accuracy of 90%; 3.0 T wrist MRA 73, 100 and 86%, resp. Conventional 1.5 T wrist MRI had a sensitivity of 71%, a specificity of 75% and accuracy of 73%. For 3.0 T conventional MRI, this was 73, 67 and 70%, resp.
MRA seems slightly superior to conventional MRI, but one could question whether this difference in diagnostic accuracy outweighs the burden and risks of an invasive procedure for patients with its additional costs. Furthermore, we could not confirm the superiority of 3 T compared to 1.5 T.
在临床怀疑三角纤维软骨复合体(TFCC)损伤的情况下,会使用不同的成像技术。本研究的目的是确定在以关节镜检查为金标准检测TFCC损伤时,磁共振血管造影(MRA)是否优于磁共振成像(MRI),以及3.0T是否比1.5T更好(以敏感性、特异性和准确性表示)。
回顾性分析了2009年1月至2016年11月期间因尺侧腕部疼痛接受关节镜检查的150例患者的关节镜检查和磁共振成像结果。
与传统MRI相比,MRA的准确性略高,1.5T的准确性略高于3.0T。1.5T腕部MRA的敏感性为80%,特异性为100%,准确性为90%;3.0T腕部MRA分别为73%、100%和86%。传统1.5T腕部MRI的敏感性为71%,特异性为75%,准确性为73%。对于3.0T传统MRI,分别为73%、67%和70%。
MRA似乎略优于传统MRI,但对于患者而言,这种诊断准确性的差异是否超过侵入性检查带来的负担、风险及其额外费用,值得质疑。此外,我们无法证实3T比1.5T更具优势。