Bendre Hersh H, Oflazoglu Kamilcan, van Leeuwen Wouter F, Rakhorst Hinne, Ring David, Chen Neal C
Department of Orthopedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Department of Plastic and Reconstructive Surgery, Medisch Spectrum Twente, Enschede, The Netherlands.
J Hand Surg Am. 2018 Sep;43(9):819-826.e1. doi: 10.1016/j.jhsa.2018.06.117.
To determine the prevalence of triangular fibrocartilage complex (TFCC) signal changes in patients undergoing magnetic resonance imaging (MRI) of the wrist and its relationship to a clinical suspicion of TFCC pathology. The secondary purpose was to study factors that are associated with TFCC signal changes.
In this retrospective study, we looked for any TFCC signal changes in the reports of MRI findings performed during a 3-year period in 1,134 patients. Demographic characteristics, the categorized indications for MRI, and symptoms at the time of the MRI were also retrieved from the medical records. Patients were divided into 6 groups, based on age, to calculate the proportions of TFCC signal changes in the entire cohort and as an incidental finding among patients without a clinical suspicion of TFCC pathology within each age group.
A total of 321 patients (28%) had incidental TFCC signal changes. The prevalence among 18- to 30 year-olds was 19%, and increased to 64% in patients older than 70 years. Multivariable logistic regression analysis demonstrated that an increase in age is significantly associated with having TFCC signal changes on MRI in patients who have a low clinical suspicion of TFCC pathology. The rate of incidental TFCC signal changes steadily increases with age.
The TFCC signal abnormalities on MRI are more common with increasing age in patients with low clinical suspicion of TFCC pathology. At age 70, more than half of all patients will have TFCC signal changes, and more than 90% are present in patients with a low clinical suspicion of TFCC pathology.
TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic IV.
确定接受腕关节磁共振成像(MRI)检查的患者中三角纤维软骨复合体(TFCC)信号改变的发生率及其与TFCC病变临床怀疑之间的关系。次要目的是研究与TFCC信号改变相关的因素。
在这项回顾性研究中,我们在1134例患者3年期间的MRI检查报告中寻找任何TFCC信号改变。还从病历中获取了人口统计学特征、MRI的分类适应证以及MRI检查时的症状。根据年龄将患者分为6组,以计算整个队列中TFCC信号改变的比例,以及在每个年龄组中无TFCC病变临床怀疑的患者中作为偶然发现的比例。
共有321例患者(28%)有偶然的TFCC信号改变。18至30岁患者中的发生率为19%,70岁以上患者中增至64%。多变量逻辑回归分析表明,在临床对TFCC病变怀疑程度较低的患者中,年龄增加与MRI上出现TFCC信号改变显著相关。偶然的TFCC信号改变发生率随年龄稳步增加。
在临床对TFCC病变怀疑程度较低的患者中,MRI上的TFCC信号异常随年龄增加更为常见。70岁时,所有患者中有一半以上会出现TFCC信号改变,在临床对TFCC病变怀疑程度较低的患者中,这一比例超过90%。
研究类型/证据水平:诊断性IV级。