Won C Bae1,2, Thumanoon Ruangchaijatuporn3, Eric Y Chang4,5, Reni Biswas6, Jiang Du7, Sheronda Statum8, Christine B Chung9,10. 1. Radiology Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive, MC 114, San Diego, CA, 92161, USA. wbae@ucsd.edu. 2. Department of Radiology, University of California-San Diego, 408 Dickinson St., San Diego, CA, 92103-8226, USA. wbae@ucsd.edu. 3. Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Rachathewi, Bangkok, Thailand, 10400. thumanoon.rua@outlook.com. 4. Radiology Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive, MC 114, San Diego, CA, 92161, USA. ericchangmd@gmail.com. 5. Department of Radiology, University of California-San Diego, 408 Dickinson St., San Diego, CA, 92103-8226, USA. ericchangmd@gmail.com. 6. Department of Radiology, University of California-San Diego, 408 Dickinson St., San Diego, CA, 92103-8226, USA. rbiswas@gmail.com. 7. Department of Radiology, University of California-San Diego, 408 Dickinson St., San Diego, CA, 92103-8226, USA. jiangdu@ucsd.edu. 8. Department of Radiology, University of California-San Diego, 408 Dickinson St., San Diego, CA, 92103-8226, USA. sherondastatume@msn.com. 9. Radiology Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive, MC 114, San Diego, CA, 92161, USA. cbchung@ucsd.edu. 10. Department of Radiology, University of California-San Diego, 408 Dickinson St., San Diego, CA, 92103-8226, USA. cbchung@ucsd.edu.
Abstract
OBJECTIVE: To evaluate pathology of the triangular fibrocartilage complex (TFCC) using high-resolution morphologic magnetic resonance (MR) imaging, and compare with quantitative MR and biomechanical properties. MATERIALS AND METHODS: Five cadaveric wrists (22-70 years) were imaged at 3 T using morphologic (proton density weighted spin echo, PD FS, and 3D spoiled gradient echo, 3D SPGR) and quantitative MR sequences to determine T2 and T1rho properties. In eight geographic regions, morphology of TFC disc and laminae were evaluated for pathology and quantitative MR values. Samples were disarticulated and biomechanical indentation testing was performed on the distal surface of the TFC disc. RESULTS: On morphologic PD SE images, TFC disc pathology included degeneration and tears, while that of the laminae included degeneration, degeneration with superimposed tear, mucinous transformation, and globular calcification. Punctate calcifications were highly visible on 3D SPGR images and found only in pathologic regions. Disc pathology occurred more frequently in proximal regions of the disc than distal regions. Quantitative MR values were lowest in normal samples, and generally higher in pathologic regions. Biomechanical testing demonstrated an inverse relationship, with indentation modulus being high in normal regions with low MR values. The laminae studied were mostly pathologic, and additional normal samples are needed to discern quantitative changes. CONCLUSION: These results show technical feasibility of morphologic MR, quantitative MR, and biomechanical techniques to characterize pathology of the TFCC. Quantitative MRI may be a suitable surrogate marker of soft tissue mechanical properties, and a useful adjunct to conventional morphologic MR techniques.
OBJECTIVE: To evaluate pathology of the triangular fibrocartilage complex (TFCC) using high-resolution morphologic magnetic resonance (MR) imaging, and compare with quantitative MR and biomechanical properties. MATERIALS AND METHODS: Five cadaveric wrists (22-70 years) were imaged at 3 T using morphologic (proton density weighted spin echo, PD FS, and 3D spoiled gradient echo, 3D SPGR) and quantitative MR sequences to determine T2 and T1rho properties. In eight geographic regions, morphology of TFC disc and laminae were evaluated for pathology and quantitative MR values. Samples were disarticulated and biomechanical indentation testing was performed on the distal surface of the TFC disc. RESULTS: On morphologic PD SE images, TFC disc pathology included degeneration and tears, while that of the laminae included degeneration, degeneration with superimposed tear, mucinous transformation, and globular calcification. Punctate calcifications were highly visible on 3D SPGR images and found only in pathologic regions. Disc pathology occurred more frequently in proximal regions of the disc than distal regions. Quantitative MR values were lowest in normal samples, and generally higher in pathologic regions. Biomechanical testing demonstrated an inverse relationship, with indentation modulus being high in normal regions with low MR values. The laminae studied were mostly pathologic, and additional normal samples are needed to discern quantitative changes. CONCLUSION: These results show technical feasibility of morphologic MR, quantitative MR, and biomechanical techniques to characterize pathology of the TFCC. Quantitative MRI may be a suitable surrogate marker of soft tissue mechanical properties, and a useful adjunct to conventional morphologic MR techniques.
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