Haramati N, Hiller N, Dowdle J, Jacobson M, Barax C N, Lieberfarb R I, Lester B, Kulick R G
Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10467, USA.
Skeletal Radiol. 1995 Oct;24(7):515-8. doi: 10.1007/BF00202149.
To assess the utility of MR in detecting surgically induced Stener lesions (displaced thumb ulnar collateral ligaments) in cadaveric models.
Six cadaver thumbs had ulnar collateral ligament (UCL) tears created surgically. MR examinations (2D STIR and 3D GRASS) were performed identically on all specimens both before displacement (non-Stener) and after displacement (Stener lesion) of the UCL. The MR images were then randomly numbered. Each image was evaluated separately in blinded fashion by four musculoskeletal radiologists for the presence or absence of a Stener lesion. Each radiologist reinterpreted the images after an interval of several days. The interpretation was based on previously published criteria for Stener lesion diagnosis by MR.
The sensitivity of GRASS ranged from 0.17 to 0.67 with the most experienced reader scoring the lowest. The specificity of GRASS ranged from 0.33 to 1.0 (most experienced reader 0.67, 0.83). STIR had a sensitivity of 0.00-0.17 and a specificity of 0.53-0.83. The kappa values for inter- and intraobserver agreement were measured. The intraobserver kappa for GRASS was 0.27-0.75 (most experienced reader 0.75).
2D imaging is probably inadequate for the evaluation of Stener lesions. The most likely reason is that the STIR slice thickness of 3 mm limits resolution of small UCLs. The poor sensitivity and specificity of GRASS as well as poor interobserver agreement suggest that MR may not be sufficiently accurate for Stener lesion evaluation.
评估磁共振成像（MR）在检测尸体模型中手术诱发的斯滕纳损伤（拇指尺侧副韧带移位）的效用。
对六具尸体拇指进行手术造成尺侧副韧带（UCL）撕裂。在UCL移位前（非斯滕纳损伤）和移位后（斯滕纳损伤），对所有标本进行相同的MR检查（二维短反转恢复序列（STIR）和三维梯度回波扰相稳态进动序列（GRASS））。然后对MR图像进行随机编号。四位肌肉骨骼放射科医生以盲法分别评估每张图像是否存在斯滕纳损伤。每位放射科医生在数天后重新解读这些图像。解读基于先前发表的通过MR诊断斯滕纳损伤的标准。
GRASS序列的敏感度在0.17至0.67之间，经验最丰富的读者评分最低。GRASS序列的特异度在0.33至1.0之间（经验最丰富的读者为0.67、0.83）。STIR序列的敏感度为0.00 - 0.17，特异度为0.53 - 0.83。测量了观察者间和观察者内一致性的kappa值。GRASS序列的观察者内kappa值为0.27 - 0.75（经验最丰富的读者为0.75）。
二维成像可能不足以评估斯滕纳损伤。最可能的原因是STIR序列3毫米的层厚限制了小UCL的分辨率。GRASS序列较差的敏感度和特异度以及观察者间较差的一致性表明，MR可能对斯滕纳损伤评估不够准确。
