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Yin Q, Kichari JR, Alebeek AHV, Korteweg MA, Teunissen BP, Ritt MJ. Using a Dedicated Extremity MRI Scanner for Depicting Anatomic Structures of Common Wrist Pathologies: A Pilot Comparison with a 3-Tesla MRI Scanner. J Wrist Surg 2023; 12:147-154. [PMID: 36926212 PMCID: PMC10010896 DOI: 10.1055/s-0042-1744366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/31/2022] [Indexed: 10/18/2022]
Abstract
Background This pilot study explored the value of a dedicated extremity magnetic resonance imaging (MRI) scanner by focusing on the qualitative depiction of important wrist structures in common wrist pathologies, the overall image quality, artifacts, and participant experience in undergoing the examinations. Methods Images of the right wrist of 10 healthy adult volunteers were acquired with a 0.31-Tesla (T) dedicated extremity MRI and a 3-T MRI system, using a dedicated wrist coil. Images were separately evaluated by three radiologists. Paired images were randomized and graded for the visibility of anatomical details, including the triangular fibrocartilage complex (TFCC; central disc, meniscus homolog, and ulnar attachment), carpal ligaments (scapholunate [SL] and lunotriquetral [LT] ligaments), intercarpal cartilage, and median and ulnar nerves. Mean values and standard deviations of evaluation results were calculated for each sequence. Participants' experience in undergoing the examination in both MRI scanners was explored using a questionnaire. Results The mean values of anatomic structures and overall image quality were significantly in favor of the 3-T MRI scanner, compared with the dedicated extremity MRI scanner. With respect to patient satisfaction in undergoing the examination, the overall trend suggested that patients were more in favor of the dedicated extremity MRI scanner. Conclusion For defining the real clinical value of the dedicated MRI scanner in the treatment of hand and wrist pathology, studies focused on pathologies are needed, which is certainly warranted, considering the important benefits of these devices including lower costs and higher accessibility for both patients and health care providers.
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Affiliation(s)
- Qi Yin
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, The Netherlands
| | - Jayant R. Kichari
- Department of Radiology, St. Jansdal hospital, Harderwijk, The Netherlands
| | | | | | | | - Marco J.P.F. Ritt
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, The Netherlands
- The Hand Clinic, Amsterdam, The Netherlands
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Götestrand S, Björkman A, Björkman-Burtscher IM, Ab-Fawaz R, Kristiansson I, Lundin B, Geijer M. Visualization of wrist ligaments with 3D and 2D magnetic resonance imaging at 3 Tesla. Acta Radiol 2022; 63:368-375. [PMID: 33657847 DOI: 10.1177/0284185121994044] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Wrist ligaments are challenging to visualize using magnetic resonance imaging (MRI). Injuries involving the scapholunate ligament (SLL), the lunotriquetral ligament (LTL), and the triangular fibrocartilage complex (TFCC) are common and difficult to diagnose, often requiring diagnostic arthroscopy. PURPOSE To compare the visualization of wrist ligaments on a three-dimensional (3D) sequence with two-dimensional (2D) sequences on 3-T MRI. MATERIAL AND METHODS Eighteen healthy volunteers were examined with a 3D SPACE (sampling perfection with application optimized contrasts using different flip angle evolution) sequence and 2D coronal, axial, and sagittal proton density-weighted (PD) sequences. Four musculoskeletal radiologists graded the anatomical visibility of the SLL, LTL, TFCC, and the image quality, using five grades in a visual grading characteristics (VGC) evaluation. After Bonferroni correction, a P value ≤0.005 was considered statistically significant. RESULTS The 3D images were graded significantly better than the 2D images in the visualization of the dorsal and palmar parts of the SLL and the LTL. Regarding the TFCC, the 3D images were graded significantly better for visualization of the foveal attachment. 2D imaging was not found significantly superior to 3D imaging in any aspect. CONCLUSION The 3D SPACE sequence was scored as superior to the 2D sequences at 3 T in the assessment of the SLL, the LTL, and the foveal attachment of the TFCC. Thus, 3D SPACE can replace 2D PD sequences when these ligaments need to be assessed.
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Affiliation(s)
- Simon Götestrand
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
- Department of Radiology, Clinical Sciences, Lund University, Lund, Sweden
| | - Anders Björkman
- Department of Translational Medicine – Hand Surgery, Skåne University Hospital, Malmö, Sweden
- The Wallenberg Center for Molecular Medicine, Lund University, Sweden
| | - Isabella M Björkman-Burtscher
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Rana Ab-Fawaz
- Department of Radiology, Kristianstad Hospital, Kristianstad, Sweden
- European Telemedicine Clinic, Department of Musculoskeletal Radiology, Barcelona, Spain
| | - Ingvar Kristiansson
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | - Björn Lundin
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
- Department of Radiology, Clinical Sciences, Lund University, Lund, Sweden
| | - Mats Geijer
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Sciences, Lund University, Lund, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Radiology, Gothenburg, Sweden
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Götestrand S, Björkman A, Björkman-Burtscher IM, Kristiansson I, Aksyuk E, Szaro P, Markenroth Bloch K, Geijer M. Visualization of wrist anatomy-a comparison between 7T and 3T MRI. Eur Radiol 2021; 32:1362-1370. [PMID: 34378077 PMCID: PMC8795032 DOI: 10.1007/s00330-021-08165-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/16/2021] [Accepted: 06/24/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Injuries to the wrist are, due to its small size and complex anatomical structures, difficult to assess by MR, and surgical interventions such as diagnostic arthroscopy are often necessary. Therefore, improved visualization using non-invasive methods could be of clinical value. As a first step of improvement, the purpose of this study was to evaluate visualization of anatomical structures at 7T compared with 3T MR. METHODS Eighteen healthy volunteers (three males and three females from each age decade between 20 and 49 years) were examined with 7T and 3T MR. Four musculoskeletal radiologists graded 2D and 3D images on a five-level grading scale for visibility of ligaments, cartilage, nerves, trabecular bone, and tendons, as well as overall image quality (i.e., edge sharpness, perceived tissue contrast, and presence of artefacts). Statistical analysis was done using a visual grading characteristics (VGC) analysis. RESULTS Visibility of cartilage, trabecular bone, tendons, nerves, and ligaments was graded significantly higher at 7T with an area under the curve (AUCVGC) of 0.62-0.88 (95% confidence interval [CI] 0.50-0.97, p = < 0.0001-0.03) using either 2D or 3D imaging. Imaging with 3T was not graded as superior to 7T for any structure. Image quality was also significantly superior at 7T, except for artefacts, where no significant differences were found. CONCLUSIONS Tendons, trabecular bone, nerves, and ligaments were all significantly better visualized at 7T compared to 3T. KEY POINTS • MRI of the wrist at 7T with a commercially available wrist coil is feasible at similar acquisition times as for 3T MRI. • The current study showed 7T to be superior to 3T in the visualization of anatomical structures of the wrist, including ligaments, tendons, nerves, and trabecular bone. • Image quality was significantly superior at 7T, except for artefacts, where no significant differences were found.
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Affiliation(s)
- Simon Götestrand
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden. .,Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
| | - Anders Björkman
- Department of Hand Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Isabella M Björkman-Burtscher
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Ingvar Kristiansson
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | - Elenya Aksyuk
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden.,Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Pawel Szaro
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Mats Geijer
- Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.,Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
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Yin Q, Manoliu RA, Kichari JR, Ritt MJPF. Using an Office-Based, Dedicated Extremity MRI Scanner for Depicting Important Structures in Common Wrist Pathologies: A Pilot Comparison with a Conventional MRI Scanner. J Wrist Surg 2021; 10:84-92. [PMID: 33552700 PMCID: PMC7850809 DOI: 10.1055/s-0040-1715799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/06/2020] [Indexed: 10/23/2022]
Abstract
Background Compared with the conventional magnetic resonance imaging (MRI), dedicated MRI scanners are more accessible. Images of a dedicated 1.0-T MRI specifically developed for the hand and wrist were compared with images of a conventional 1.5-T MRI. Methods Paired images of the right wrist were randomized and separately graded by two experienced radiologists for the quality of anatomical details, including the triangular fibrocartilage complex, carpal ligaments, intercarpal cartilage, median and ulnar nerves, overall image quality, and artifacts. Interrater reliability was measured with the percentage of exact agreement and agreement within a range of ± 1 score point. Participant experience of undergoing the examination in both MRI scanners was evaluated using a questionnaire. Results The overall image quality of all sequences was considered to be moderate to high. In 25 of 38 paired images, no statistically significant difference was found between the MRI scanners. Ten scores were found to be in favor of the dedicated extremity MRI. Within a range of ± 1 score point, the extremity MRI and the conventional MRI demonstrated an interrater agreement of 67 to 100% and 70 to 100%, respectively. Among the respondents of the questionnaire, the extremity MRI scored better for participant satisfaction when compared with the conventional MRI. Conclusions In healthy volunteers, the dedicated extremity MRI generally is similar or superior to the conventional MRI in the depiction of anatomical structures of the wrists, image quality, and artifacts, and significantly scored better on participant satisfaction. Future clinical studies should focus on defining the diagnostic value of the extremity MRI in wrist pathologies.
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Affiliation(s)
- Qi Yin
- Department of Plastic, Reconstructive, and Hand Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands
- Department of Radiology, St. Jansdal Hospital, Harderwijk, The Netherlands
| | | | - Jayant R. Kichari
- Department of Radiology, St. Jansdal Hospital, Harderwijk, The Netherlands
| | - Marco J. P. F. Ritt
- Department of Plastic, Reconstructive, and Hand Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands
- The Hand Clinic Amsterdam, Amsterdam, TheNetherlands
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Bae KJ, Jang HS, Gong HS, Kang Y, Kim J, Baek GH. Prevalence and distribution of MRI abnormalities in the articular cartilage and supporting ligaments in patients with early clinical stage first carpometacarpal joint osteoarthritis. Skeletal Radiol 2020; 49:1089-1097. [PMID: 32008110 DOI: 10.1007/s00256-020-03383-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/17/2020] [Accepted: 01/21/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE We used magnetic resonance imaging (MRI) to evaluate where articular degeneration begins and which ligaments are most often involved in the early clinical stage first carpometacarpal joint (CMCJ-1) osteoarthritis. MATERIALS AND METHODS We retrospectively analyzed the MRI findings of 26 patients with early clinical stage CMCJ-1 osteoarthritis and no radiologic abnormalities and 19 control patients without CMCJ-1 pain or osteoarthritis who underwent MRI for dorsal or ulnar wrist pain. Two observers blinded to group and clinical findings independently assessed the presence of chondral defects in four quadrants of the CMCJ-1: volar-ulnar (VU), volar-radial (VR), dorso-ulnar (DU), and dorso-radial (DR). The integrity of the four major ligaments of the CMCJ-1, i.e., the anterior oblique ligament (AOL), the intermetacarpal ligament (IML), the posterior oblique ligament (POL), and the dorsal radial ligament (DRL), was assessed. The observer reliability was analyzed using Cohen's kappa coefficient. The prevalence of cartilage lesions and ligament abnormalities in the osteoarthritic and control patients was compared using Fisher's exact test. RESULTS Cartilage lesions were significantly more common in the VU quadrant of the trapezium in the osteoarthritic patients than in the control patients (17/26 vs. 2/19; P = 0.002). AOL abnormalities were more common in the osteoarthritic patients than in the control patients (14/26 vs. 3/19; P = 0.009). CONCLUSION The MRI findings of early clinical stage CMCJ-1 osteoarthritis commonly demonstrated cartilage lesions in the VU quadrant of the trapezium and ligament abnormalities in the AOL.
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Affiliation(s)
- Kee Jeong Bae
- Department of Orthopedic Surgery, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Hyo Seok Jang
- Department of Orthopedic Surgery, Inje University Haeundae Paik Hospital, Busan, South Korea
| | - Hyun Sik Gong
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, Gyeonggi-do, 463-707, South Korea.
| | - Yusuhn Kang
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jihyeung Kim
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Goo Hyun Baek
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, South Korea
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Evaluation of diagnostic value and T2-weighted three-dimensional isotropic turbo spin-echo (3D-SPACE) image quality in comparison with T2-weighted two-dimensional turbo spin-echo (2D-TSE) sequences in lumbar spine MR imaging. Eur J Radiol Open 2018; 6:36-41. [PMID: 30619918 PMCID: PMC6312863 DOI: 10.1016/j.ejro.2018.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 12/17/2018] [Indexed: 11/21/2022] Open
Abstract
Purpose to evaluate diagnostic value and image quality of T2-weighted Three-dimensional isotropic turbo spin-echo (SPACE) in comparison with T2-weighted two-dimensional turbo spin-echo (TSE) sequences for comprehensive evaluation of lumbar spine pathologies. Materials and methods Thirty-five participants with lumbar discopathy were examined on a 1.5-T MRI system with both 2D TSE and 3D SPACE sequences. Obtained images were analyzed with synedra view personal (V 17.0.0.2) software in terms of calculating image quality factors such as signal to noise ratio (SNR) and contrast to noise ratio (CNR) for selected regions of interest. In addition, images were referred to radiologists to report their pathologic indexes. The visibility of anatomical structures in the 3D and 2D sequences was qualitatively assessed by two radiologists independently. Cohen's kappa (k) and Wilcoxon signed rank test was used for the statistical analysis. Results In this study, the 3D SPACE T2-weighted sequence showed significant higher SNR and CNR as well as visibility in all of the regions of interest except vertebrae and intervertebral discs (p-value < 0.05). Inter-observer agreement for visibility of regions of interest was substantial and perfect (k > 0.6). Also, inter-observer and inter-method agreements for pathologic indexes were substantial and perfect for all of the pathologic indexes (k > 0.6). Inter-observer agreement for 3D SPACE sequence was higher (k = 0.793) in comparison with 2D-TSE sequence (k = 0.603). 3D SPACE sequence and its multi-planar reconstructions (MPR) scan time were less (192 s) than 2D TSE in the sagittal, axial and coronal planes (209 s). Conclusion 3D SPACE sequence for lumbar spine MRI proved to have higher SNR, CNR, and visibility for all regions of lumbar spine except vertebrae and disc. Inter-observer and inter-method agreements for pathologic indexes between 3D SPACE and 2D TSE sequences were substantial and 3D SPACE had a higher inter-observer agreement and less scan time. Therefore, T2 weighted 3D SPACE sequence, and its MPR might be an excellent alternative for 2D TSE in sagittal, axial, and coronal planes, especially for patients with abnormal curvature of the lumbar spine.
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Altahawi F, Subhas N. 3D MRI in Musculoskeletal Imaging: Current and Future Applications. CURRENT RADIOLOGY REPORTS 2018. [DOI: 10.1007/s40134-018-0287-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Park HJ, Lee SY, Kang KA, Kim EY, Shin HK, Park SJ, Park JH, Kim E. Comparison of two-dimensional fast spin echo T 2 weighted sequences and three-dimensional volume isotropic T 2 weighted fast spin echo (VISTA) MRI in the evaluation of triangular fibrocartilage of the wrist. Br J Radiol 2018; 91:20170604. [PMID: 29260880 DOI: 10.1259/bjr.20170604] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare image quality of three-dimensional volume isotropic T2 weighted fast spin echo (3D VISTA) and two-dimensional (2D) T2 weighted images (T2WI) for evaluation of triangular fibrocartilage (TFC) and to investigate whether 3D VISTA can replace 2D T2 WI in evaluating TFC injury. METHODS This retrospective study included 69 patients who received wrist MRIs using both 2D T2 WI and 3D VISTA techniques for assessment of wrist pathology, including TFC injury. Two radiologists measured the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR) of the two sequences. The anatomical identification score and diagnostic performance were independently assessed by two interpreters. The diagnostic abilities of 3D VISTA and 2D T2 WI were analysed by sensitivity, specificity and accuracy for diagnosing TFC injury using surgically or clinically confirmed diagnostic reference standards. RESULTS 17 cases (25%) were classified as having TFC injury. 2 cases (12%) were diagnosed surgically, and 15 cases (88%) were diagnosed by physical examination. 52 cases (75%) were diagnosed as having intact TFC. 8 of these cases (15%) were surgically confirmed, while the others were diagnosed by physical examination and clinical findings. The 3D VISTA images had significantly higher SNR and CNR values for the TFC than 2D T2 WI images. The scores of 3D VISTA's total length, full width and sharpness were similar to those of 2D T2 WI. We were unable to find a significant difference between 3D VISTA and 2D T2 WI in the ability to diagnose TFC injury. CONCLUSION 3D VISTA image quality is similar to that of 2D T2 WI for TFC evaluation and is also excellent for tissue contrast. 3D VISTA can replace 2D images in TFC injury assessment. Advances in knowledge: 3D VISTA image quality is similar to that of 2D T2 WI for TFC evaluation and is also excellent for tissue contrast. 3D VISTA can replace 2D images in TFC injury assessment.
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Affiliation(s)
- Hee Jin Park
- 1 Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Seoul , Korea
| | - So Yeon Lee
- 1 Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Seoul , Korea
| | - Kyung A Kang
- 1 Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Seoul , Korea
| | - Eun Young Kim
- 1 Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Seoul , Korea
| | - Hun Kyu Shin
- 2 Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Seoul , Korea
| | - Se Jin Park
- 2 Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Seoul , Korea
| | - Jai Hyung Park
- 2 Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Seoul , Korea
| | - Eugene Kim
- 2 Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Seoul , Korea
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10
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Oh E, Yoon YC, Park MJ. Diagnostic performance of wrist magnetic resonance (MR) arthrography: comparison of three-dimensional isotropic T 1 weighted fast spin-echo MR arthrography and two-dimensional MR arthrography. Br J Radiol 2017; 90:20160867. [PMID: 28079395 DOI: 10.1259/bjr.20160867] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare the diagnostic performance of direct wrist MR arthrography (D-MRA) with two-dimensional (2D) T1 weighted fast spin-echo (FSE) and three-dimensional (3D) isotropic T1 weighted FSE sequences for detecting triangular fibrocartilage (TFC) central perforations and scapholunate ligament (SLL) and lunotriquetral ligament (LTL) tears. METHODS 26 patients who had undergone pre-operative wrist D-MRA with 2D and 3D isotropic T1 weighted FSE sequences and subsequent arthroscopic surgeries were included. Each MRI sequence was independently evaluated and scored by two readers retrospectively for the presence of TFC central perforations and SLL and LTL tears. Arthroscopic findings were used as the reference standard. Diagnostic performance was evaluated by using the area under the receiver operating characteristic curve. The sensitivity, specificity and accuracy of both sequences for diagnosing the injuries were calculated. RESULTS Arthroscopic surgery revealed 21 TFC central perforations, 7 SLL tears and 3 LTL tears. The area under the receiver operating characteristic curve value of 2D and 3D for central perforations in TFC and tears in SLL and LTL was identical or similar (0.667-0.947). The sensitivity, specificity and accuracy of both sequences for diagnosing the injury of each structure were not significantly different (TFC, 90.5/80/88.5% for both readers/sequences; SLL, 100/89.5/92.3% for both readers' 2D and Reader A's 3D, and 85.7/89.5/88.5% for Reader B's 3D; LTL, 66.7/100/96.2% for both readers' 2D and 33.3/100/92.3% for both readers' 3D). Interobserver agreements were substantial to excellent. CONCLUSION In wrist D-MRA, the diagnostic performances of 3D isotropic and 2D T1 weighted FSE sequences are comparable for TFC central perforations and SLL and LTL tears. Advances in knowledge: The diagnostic performance of 3D isotropic T1 weighted FSE D-MRA and that of 2D T1 weighted FSE D-MRA were not significantly different in the diagnosis of central perforations in the TFC and tears in the SLL and LTL. 3D isotropic T1 weighted FSE D-MRA has potential for substituting 2D imaging.
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Affiliation(s)
- Eunsun Oh
- 1 Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young C Yoon
- 1 Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Min J Park
- 2 Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Shahabpour M, Staelens B, Van Overstraeten L, De Maeseneer M, Boulet C, De Mey J, Scheerlinck T. Advanced imaging of the scapholunate ligamentous complex. Skeletal Radiol 2015. [PMID: 26219592 DOI: 10.1007/s00256-015-2182-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The scapholunate joint is one of the most involved in wrist injuries. Its stability depends on primary and secondary stabilisers forming together the scapholunate complex. This ligamentous complex is often evaluated by wrist arthroscopy. To avoid surgery as diagnostic procedure, optimization of MR imaging parameters as use of three-dimensional (3D) sequences with very thin slices and high spatial resolution, is needed to detect lesions of the intrinsic and extrinsic ligaments of the scapholunate complex. The paper reviews the literature on imaging of radial-sided carpal ligaments with advanced computed tomographic arthrography (CTA) and magnetic resonance arthrography (MRA) to evaluate the scapholunate complex. Anatomy and pathology of the ligamentous complex are described and illustrated with CTA, MRA and corresponding arthroscopy. Sprains, mid-substance tears, avulsions and fibrous infiltrations of carpal ligaments could be identified on CTA and MRA images using 3D fat-saturated PD and 3D DESS (dual echo with steady-state precession) sequences with 0.5-mm-thick slices. Imaging signs of scapholunate complex pathology include: discontinuity, nonvisualization, changes in signal intensity, contrast extravasation (MRA), contour irregularity and waviness and periligamentous infiltration by edema, granulation tissue or fibrosis. Based on this preliminary experience, we believe that 3 T MRA using 3D sequences with 0.5-mm-thick slices and multiplanar reconstructions is capable to evaluate the scapholunate complex and could help to reduce the number of diagnostic arthroscopies.
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Affiliation(s)
- Maryam Shahabpour
- Department of Radiology, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium.
| | - Barbara Staelens
- Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.
| | | | - Michel De Maeseneer
- Department of Radiology, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium.
| | - Cedric Boulet
- Department of Radiology, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium.
| | - Johan De Mey
- Department of Radiology, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium.
| | - Thierry Scheerlinck
- Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.
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He B, Wu JP, Kirk TB, Carrino JA, Xiang C, Xu J. High-resolution measurements of the multilayer ultra-structure of articular cartilage and their translational potential. Arthritis Res Ther 2014; 16:205. [PMID: 24946278 PMCID: PMC4061724 DOI: 10.1186/ar4506] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Current musculoskeletal imaging techniques usually target the macro-morphology of
articular cartilage or use histological analysis. These techniques are able to reveal
advanced osteoarthritic changes in articular cartilage but fail to give detailed
information to distinguish early osteoarthritis from healthy cartilage, and this
necessitates high-resolution imaging techniques measuring cells and the extracellular
matrix within the multilayer structure of articular cartilage. This review provides a
comprehensive exploration of the cellular components and extracellular matrix of
articular cartilage as well as high-resolution imaging techniques, including magnetic
resonance image, electron microscopy, confocal laser scanning microscopy, second
harmonic generation microscopy, and laser scanning confocal arthroscopy, in the
measurement of multilayer ultra-structures of articular cartilage. This review also
provides an overview for micro-structural analysis of the main components of normal
or osteoarthritic cartilage and discusses the potential and challenges associated
with developing non-invasive high-resolution imaging techniques for both research and
clinical diagnosis of early to late osteoarthritis.
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13
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Mugler JP. Optimized three‐dimensional fast‐spin‐echo MRI. J Magn Reson Imaging 2014; 39:745-67. [PMID: 24399498 DOI: 10.1002/jmri.24542] [Citation(s) in RCA: 248] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 10/31/2013] [Indexed: 11/10/2022] Open
Affiliation(s)
- John P. Mugler
- Department of Radiology and Medical ImagingUniversity of Virginia School of MedicineCharlottesville Virginia USA
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