Shin Yong-Eun, Kim Sung-Joon, Kim Jeong-Sang, Kwak Kwon-Young, Kim Ji-Hyo, Kim Jong-Pil
Department of Orthopedic Surgery, College of Medicine, Dankook University, Cheonan, Republic of Korea.
Department of Teaching Education, College of Liberal Arts, Dankook University, Cheonan, Republic of Korea.
J Orthop Surg (Hong Kong). 2020 Sep-Dec;28(3):2309499020978308. doi: 10.1177/2309499020978308.
This study aimed to assess the accuracy of MRI in identifying ulnar collateral ligament (UCL), radial collateral ligament (RCL), and volar plate (VP) injuries of the metacarpophalangeal joint (MCPJ) of the thumb by comparing with diagnostic arthroscopy.
A total of 56 consecutive patients (56 thumbs) who underwent arthroscopy of MCPJ of thumb were enrolled. MRI findings reviewed by consensus reading of two blinded radiologists were compared with arthroscopic examination. Statistical data, including sensitivity, specificity, accuracy, were analyzed. Additionally, the performance characteristics between 3.0-tesla (39 thumbs) and 1.5-tesla (17 thumbs) MRI and acute (≤4 weeks after injury) and chronic (>4 weeks) injuries were compared.
Of the 56 thumbs, 38 thumbs (67.9%) showed complete correspondence between MRI and arthroscopic findings. The sensitivity, specificity and accuracy of MRI for detecting UCL injuries were 78.8%, 87.0%, and 82.1%, respectively. The sensitivity, specificity and accuracy of MRI for detecting RCL injuries were 85.7%, 91.4%, and 85.7%, respectively. The sensitivity, specificity, and accuracy of MRI for detecting VP injuries were 89.5%, 89.2%, and 81.0%, respectively. 3.0-tesla MRI showed higher correspondence with arthroscopic observation (76.9%) than 1.5-tesla MRI (47.1%) (p = 0.028). For acute injuries, 78.4% showed complete correspondence between MRI and arthroscopic findings, whereas 47.4% with chronic injuries revealed complete agreement (p = 0.019).
Overall, MRI is moderately effective in evaluating ligamentous lesions around MCPJ of thumb, but MRI is more sensitive in diagnosing acute injuries. Furthermore, 3.0-tesla MRI can provide results with better accuracy for diagnosing ligamentous lesions around MCPJ of thumb. However, the sensitivity and the specificity are not applicable to all ligament injuries, but only the severe one which would agree for surgical options.
本研究旨在通过与诊断性关节镜检查进行比较，评估磁共振成像（MRI）在识别拇指掌指关节（MCPJ）尺侧副韧带（UCL）、桡侧副韧带（RCL）和掌板（VP）损伤方面的准确性。
共纳入56例连续接受拇指MCPJ关节镜检查的患者（56个拇指）。由两名不知情的放射科医生通过共识解读对MRI结果进行审查，并与关节镜检查结果进行比较。分析了包括敏感性、特异性、准确性在内的统计数据。此外，还比较了3.0特斯拉（39个拇指）和1.5特斯拉（17个拇指）MRI以及急性损伤（损伤后≤4周）和慢性损伤（>4周）之间的性能特征。
在56个拇指中，38个拇指（67.9%）的MRI和关节镜检查结果完全一致。MRI检测UCL损伤的敏感性、特异性和准确性分别为78.8%、87.0%和82.1%。MRI检测RCL损伤的敏感性、特异性和准确性分别为85.7%、91.4%和85.7%。MRI检测VP损伤的敏感性、特异性和准确性分别为89.5%、89.2%和81.0%。3.0特斯拉MRI与关节镜观察的一致性（76.9%）高于1.5特斯拉MRI（47.1%）（p = 0.028）。对于急性损伤，78.4%的MRI和关节镜检查结果完全一致，而慢性损伤患者中这一比例为47.4%（p = 0.019）。
总体而言，MRI在评估拇指MCPJ周围韧带损伤方面具有中等效果，但MRI在诊断急性损伤时更敏感。此外，3.0特斯拉MRI在诊断拇指MCPJ周围韧带损伤时能提供更准确的结果。然而，敏感性和特异性并不适用于所有韧带损伤，而仅适用于那些与手术选择相符的严重损伤。
