Oneson S R, Timins M E, Scales L M, Erickson S J, Chamoy L
Department of Radiology, Medical College of Wisconsin, Froedtert Memorial Lutheran Hospital, Milwaukee 53226, USA.
AJR Am J Roentgenol. 1997 Jun;168(6):1513-8. doi: 10.2214/ajr.168.6.9168716.
The goal of this study was to compare MR imaging with arthroscopy in evaluating triangular fibrocartilage (TFC) pathology.
The results of 178 MR imaging examinations of the wrist were independently reviewed by two musculoskeletal radiologists who were unaware of the the clinical history, including any subsequent surgery. One hundred forty-nine of these studies were obtained from symptomatic patients. Of these patients, 56 underwent arthroscopic evaluation of the TFC. The remaining 29 studies were obtained from control volunteers and duplicate cases to reduce bias. The data were divided into categories based on Palmer's classification of TFC injury. Diagnostic sensitivity, specificity, and accuracy were calculated for each category.
Of the 56 patients who underwent arthroscopic evaluation of the TFC, 27 had TFCs that were intact at surgery. Also, 27 complete perforations and two partial defects were found at surgery. Sensitivity for detecting central degenerative perforations was 91% for both observers I and II. Sensitivity for detecting radial slitlike tears was 100% and 86% for observers I and II, respectively. Sensitivity for detecting ulnar-sided avulsions was 25% and 50% for observers I and II, respectively.
MR imaging is accurate in revealing TFC perforations.
本研究的目的是比较磁共振成像（MR成像）与关节镜检查在评估三角纤维软骨（TFC）病变方面的效果。
两名肌肉骨骼放射科医生独立回顾了178例腕部MR成像检查的结果，他们对临床病史不知情，包括任何后续手术情况。其中149项研究来自有症状的患者。在这些患者中，56例接受了TFC的关节镜评估。其余29项研究来自对照志愿者和重复病例，以减少偏差。数据根据帕尔默（Palmer）对TFC损伤的分类进行分类。计算每个类别的诊断敏感性、特异性和准确性。
在56例接受TFC关节镜评估的患者中，27例患者的TFC在手术时完好无损。此外，手术中发现27例完全穿孔和2例部分缺损。观察者I和观察者II检测中央退行性穿孔的敏感性均为91%。观察者I和观察者II检测桡侧裂伤的敏感性分别为100%和86%。观察者I和观察者II检测尺侧撕脱的敏感性分别为25%和50%。
MR成像在揭示TFC穿孔方面是准确的。
