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Archives of Orthopaedic and Trauma Surgery

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14.08.2017 | Handsurgery

High-resolution MRI (3T-MRI) in diagnosis of wrist pain: is diagnostic arthroscopy still necessary?

verfasst von: Sabine Ochman, B. Wieskötter, M. Langer, V. Vieth, M. J. Raschke, C. Stehling

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 10/2017

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Abstract

Introduction

3T MRI has become increasingly available for better imaging of interosseous ligaments, TFCC, and avascular necrosis compared with 1.5T MRI. This study assesses the sensitivity and specificity of 3T MRI compared with arthroscopy as the gold standard.

Patients and methods

Eighteen patients were examined with 3T MRI using coronal T1-TSE; PD-FS; and coronal, sagittal, and axial contrast-enhanced T1-FFE-FS sequences. Two musculoskeletal radiologists evaluated the images independently. Patients underwent diagnostic arthroscopy.

Results

The classifications of the cartilage lesions showed good correlations with the arthroscopy findings (κ = 0.8–0.9). In contrast to the arthroscopy, cartilage of the distal carpal row was very good and could be evaluated in all patients on MRI. The sensitivity for the TFCC lesion was 83%, and the specificity was 42% (radiologist 1) and 63% (radiologist 2). For the ligament lesions, the sensitivity and specificity were 75 and 100%, respectively, with a high interobserver agreement (κ = 0.8–0.9).

Discussion

3T MRI proved to be of good value in diagnosing cartilage lesions, especially in the distal carpal row, whereas wrist arthroscopy provided therapeutic options. When evaluating the surgical therapeutical options, 3T MRI is a good diagnostic tool for pre-operatively evaluating the cartilage of the distal carpal row.

Daunt N (2002) Magnetic resonance imaging of the wrist: anatomy and pathology of interosseous ligaments and the triangular fibrocartilage complex. Curr Probl Diagn Radiol 31(4):158–176CrossRefPubMed

Totterman SM, Miller RJ, McCance SE, Meyers SP (1996) Lesions of the triangular fibrocartilage complex: MR findings with a three-dimensional gradient-recalled-echo sequence. Radiology 199(1):227–232CrossRefPubMed

Totterman SM, Seo GS (2001) MRI findings of scapholunate instabilities in coronal images: a short communication. Semin Musculoskelet Radiol 5(3):251–256CrossRefPubMed

Savnik A, Malmskov H, Thomsen HS, Bretlau T, Graff LB, Nielsen H, Danneskiold-Samsoe B, Boesen J, Bliddal H (2001) MRI of the arthritic small joints: comparison of extremity MRI (0.2 T) vs high-field MRI (1.5 T). Eur Radiol 11(6):1030–1038CrossRefPubMed

Saupe N, Prussmann KP, Luechinger R, Bosiger P, Marincek B, Weishaupt D (2005) MR imaging of the wrist: comparison between 1.5- and 3-T MR imaging–preliminary experience. Radiology 234(1):256–264CrossRefPubMed

Amrami KK, Felmlee JP (2008) 3-Tesla imaging of the wrist and hand: techniques and applications. Semin Musculoskelet Radiol 12(3):223–237CrossRefPubMed

Anderson ML, Skinner JA, Felmlee JP, Berger RA, Amrami KK (2008) Diagnostic comparison of 1.5 Tesla and 3.0 Tesla preoperative MRI of the wrist in patients with ulnar-sided wrist pain. J Hand Surg Am 33(7):1153–1159CrossRefPubMed

Link TM, Stahl R, Woertler K (2007) Cartilage imaging: motivation, techniques, current and future significance. Eur Radiol 17(5):1135–1146CrossRefPubMed

Stehling C (2011) Scoring systems to semiquantitatively grage cartilage pathology with MRI. In: Link T (ed) Cartilage Imaging. Springer, New York. doi:10.1007/978-1-4419-8438-8_8

10.

Saupe N, Pfirrmann CW, Schmid MR, Schertler T, Manestar M, Weishaupt D (2007) MR imaging of cartilage in cadaveric wrists: comparison between imaging at 1.5 and 3.0 T and gross pathologic inspection. Radiology 243(1):180–187CrossRefPubMed

11.

Zanetti M, Saupe N, Nagy L (2007) Role of MR imaging in chronic wrist pain. Eur Radiol 17(4):927–938CrossRefPubMed

12.

Zlatkin MB, Rosner J (2006) MR imaging of ligaments and triangular fibrocartilage complex of the wrist. Radiol Clin North Am 44(4):595–623CrossRefPubMed

13.

Shionova K, Nakamura R, Imaeda T, Makino N (1998) Arthrography is superior to magnetic resonance imaging for diagnosing injuries of the triangular fibrocartilage. J Hand Surg Br 23(3):402–405CrossRefPubMed

14.

Gundry CR, Kursunoglu-Brahme S, Schwaighofer B, Kang HS, Sartoris DJ, Resnick D (1990) Is MR better than arthrography for evaluating the ligaments of the wrist? In vitro study. AJR Am J Roentgenol 154(2):337–341CrossRefPubMed

15.

Lee YH, Choi YR, Kim S, Song HT, Suh JS (2013) Intrinsic ligament and triangular fibrocartilage complex (TFCC) tears of the wrist: comparison of isovolumetric 3D-THRIVE sequence MR arthrography and conventional MR image at 3 T. Magn Reson Imaging 31(2):221–226CrossRefPubMed

16.

Adolfsson L (1994) Arthroscopic diagnosis of ligament lesions of the wrist. J Hand Surg Br 19(4):505–512CrossRefPubMed

17.

Adolfsson L, Povlsen B (2004) Arthroscopic findings in wrists with severe post-traumatic pain despite normal standard radiographs. J Hand Surg Br 29(3):208–213CrossRefPubMed

18.

Cooney WP (1993) Evaluation of chronic wrist pain by arthrography, arthroscopy, and arthrotomy. J Hand Surg 18(5):815–822CrossRef

19.

Meier R, Schmitt R, Krimmer H (2005) Wrist lesions in MRI arthrography compared with wrist arthroscopy. Handchir Mikrochir Plast Chir 37(2):85–89CrossRefPubMed

20.

Vanden Eynde S, De Smet L, Fabry G (1994) Diagnostic value of arthrography and arthroscopy of the radiocarpal joint. Arthroscopy 10(1):50–53CrossRefPubMed

21.

Zlatkin MB, Chao PC, Osterman AL, Schnall MD, Dalinka MK, Kressel HY (1989) Chronic wrist pain: evaluation with high-resolution MR imaging. Radiology 173(3):723–729CrossRefPubMed

22.

Cerofolini E, Luchetti R, Pederzini L, Soragni O, Colombini R, D’Alimonte P, Romagnoli R (1990) MR evaluation of triangular fibrocartilage complex tears in the wrist: comparison with arthrography and arthroscopy. J Comput Assist Tomogr 14(6):963–967CrossRefPubMed

23.

Pederzini L, Luchetti R, Soragni O, Alfarano M, Montagna G, Cerofolini E, Colombini R, Roth J (1992) Evaluation of the triangular fibrocartilage complex tears by arthroscopy, arthrography, and magnetic resonance imaging. Arthroscopy 8(2):191–197CrossRefPubMed

24.

Johnstone DJ, Thorogood S, Smith WH, Scott TD (1997) A comparison of magnetic resonance imaging and arthroscopy in the investigation of chronic wrist pain. J Hand Surg Br 22(6):714–718CrossRefPubMed

25.

Rettig ME, Amadio PC (1994) Wrist arthroscopy. Indications and clinical applications. J Hand Surg Br 19(6):774–777CrossRefPubMed

26.

Morley J, Bidwell J, Bransby-Zachary M (2001) A comparison of the findings of wrist arthroscopy and magnetic resonance imaging in the investigation of wrist pain. J Hand Surg [Br] 26(6):544–546CrossRef

27.

Shionova K, Nakamura R, Imaeda T, Makino N (1998) Arthrography is superior to magnetic resonance imaging for diagnosing injuries of the triangular fibrocartilage. J Hand Surg [Br] 23(3):402–405CrossRef

28.

Kato H, Nakamura R, Shionoya K, Makino N, Imaeda T (2000) Does high-resolution MR imaging have better accuracy than standard MR imaging for evaluation of the triangular fibrocartilage complex? J Hand Surg [Br] 25(5):487–491CrossRef

29.

Haims AH, Schweitzer ME, Morrison WB, Deely D, Lange R, Osterman AL, Bednar JM, Taras JS, Culp RW (2002) Limitations of MR imaging in the diagnosis of peripheral tears of the triangular fibrocartilage of the wrist. AJR Am J Roentgenol 178(2):419–422CrossRefPubMed

30.

Smith DK (1995) MR imaging of normal and injured wrist ligaments. Magn Reson Imaging Clin N Am 3(2):229–248PubMed

31.

Stehling C, Langer M, Bachmann R, Kraemer S, Kooijman H, Heindel W, Vieth V (2009) Three-Tesla magnetic resonance imaging of the wrist: diagnostic performance compared to 1.5-T. J Comput Assist Tomogr 33(6):934–939CrossRefPubMed

32.

Lenk S, Ludescher B, Martirosan P, Schick F, Claussen CD, Schlemmer HP (2004) 3.0 T high-resolution MR imaging of carpal ligaments and TFCC. Rofo 176(5):664–667CrossRefPubMed

33.

Ludescher B, Martirosian P, Lenk S, Machann J, Dammann F, Schick F, Claussen C, Schlemmer H (2005) High-resolution magnetic resonance imaging of trabecular bone in the wrist at 3 tesla: initial results. Acta Radiol 46(3):306–309CrossRefPubMed

34.

Masi JN, Sell CA, Phan C, Han E, Newitt D, Steinbach L, Majumdar S, Link TM (2005) Cartilage MR imaging at 3.0 versus that at 1.5 T: preliminary results in a porcine model. Radiology 236(1):140–150CrossRefPubMed

35.

Wong S, Steinbach L, Zhao J, Stehling C, Ma CB, Link TM (2009) Comparative study of imaging at 3.0 T versus 1.5 T of the knee. Skeletal Radiol 38(8):761–769CrossRefPubMedPubMedCentral

36.

Stehling C, Bachmann R, Langer M, Nassenstein I, Heindel W, Vieth V (2009) High-resolution magnetic resonance imaging of triangular fibrocartilage complex lesions in acute wrist trauma: image quality at different field strengths. J Comput Assist Tomogr 33(4):579–583CrossRefPubMed

37.

Wieners G, Detert J, Streitparth F, Pech M, Fischbach F, Burmester G, Ricke J, Backhaus M, Bruhn H (2007) High-resolution MRI of the wrist and finger joints in patients with rheumatoid arthritis: comparison of 1.5 Tesla and 3.0 Tesla. Eur Radiol 17(8):2176–2182CrossRefPubMed

38.

Spies CK, Prommersberger KJ, Langer M, Muller LP, Hahn P, Unglaub F (2015) Instability of the distal radioulnar joint: treatment options for ulnar lesions of the triangular fibrocartilage complex. Unfallchirurg 118(8):701–717. doi:10.1053/jhsu.2000.6467 CrossRefPubMed

39.

Spies CK, Muller LP, Oppermann J, Hahn P, Unglaub F (2014) Instability of the distal radioulnar joint—an overview of clinical and radiological procedures regarding their efficacies. Handchir Mikrochir Plast Chir 46(3):137–150CrossRefPubMed

40.

Magee T (2009) Comparison of 3-T MRI and arthroscopy of intrinsic wrist ligament and TFCC tears. AJR Am J Roentgenol 192(1):80–85. doi:10.2214/AJR.08.1089 CrossRefPubMed

41.

Lindau TR (2016) The role of arthroscopy in carpal instability. J Hand Surg Eur 41(1):35–47CrossRef

42.

Chennagiri RJ, Lindau TR (2013) Assessment of scapholunate instability and review of evidence for management in the absence of arthritis. J Hand Surg Eur 38(7):727–738CrossRef

43.

Low S, Herold A, Eingartner C (2014) Standard wrist arthroscopy: technique and documentation. Oper Orthop Traumatol 26(6):539–546CrossRefPubMed

44.

Low S, Pillukat T, Prommersberger KJ, van Schoonhoven J (2013) The effect of additional video documentation to photo documentation in wrist arthroscopies on intra- and interobserver reliability. Arch Orthop Trauma Surg 133(3):433–438CrossRefPubMed

45.

Kirchberger MC, Unglaub F, Muhldorfer-Fodor M, Pillukat T, Hahn P, Muller LP, Spies CK (2015) Update TFCC: histology and pathology, classification, examination and diagnostics. Arch Orthop Trauma Surg 135(3):427–437CrossRefPubMed

46.

Sachar K (2012) Ulnar-sided wrist pain: evaluation and treatment of triangular fibrocartilage complex tears, ulnocarpal impaction syndrome, and lunotriquetral ligament tears. J Hand Surg Am 37(7):1489–1500CrossRefPubMed

47.

Hahn P, Hausler A, Bruckner T, Unglaub F (2012) Quality rating of MRI regarding TFCC lesions in the clinical practice. Handchir Mikrochir Plast Chir 44(5):310–313CrossRefPubMed

48.

Nobauer-Huhmann IM, Pretterklieber M, Erhart J, Bar P, Szomolanyi P, Kronnerwetter C, Lang S, Friedrich KM, Trattnig S (2012) Anatomy and variants of the triangular fibrocartilage complex and its MR appearance at 3 and 7T. Semin Musculoskelet Radiol 16(2):93–103CrossRefPubMed

49.

Slutsky DJ, Nagle DJ (2008) Wrist arthroscopy: current concepts. J Hand Surg Am 33(7):1228–1244CrossRefPubMed

50.

Hermansdorfer JD, Kleinman WB (1991) Management of chronic peripheral tears of the triangular fibrocartilage complex. J Hand Surg Am 16(2):340–346CrossRefPubMed

51.

Atzei A (2009) New trends in arthroscopic management of type 1-B TFCC injuries with DRUJ instability. J Hand Surg Eur 34(5):582–591CrossRef

52.

Unglaub F, Muller LP, Oppermann J, Hahn P, Spies CK (2014) Push-off needle test for traumatic triangular fibrocartilage complex lesions. J Hand Surg Am 39(7):1448–1449CrossRefPubMed

Titel: High-resolution MRI (3T-MRI) in diagnosis of wrist pain: is diagnostic arthroscopy still necessary?
verfasst von: Sabine Ochman
B. Wieskötter
M. Langer
V. Vieth
M. J. Raschke
C. Stehling
Publikationsdatum: 14.08.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 10/2017
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-017-2747-2

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