Simon Götestrand1,2, Anders Björkman3,4, Isabella M Björkman-Burtscher5,6, Rana Ab-Fawaz7,8, Ingvar Kristiansson1, Björn Lundin1,2, Mats Geijer5,6,9. 1. Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden. 2. Department of Radiology, Clinical Sciences, Lund University, Lund, Sweden. 3. Department of Translational Medicine - Hand Surgery, Skåne University Hospital, Malmö, Sweden. 4. The Wallenberg Center for Molecular Medicine, Lund University, Sweden. 5. Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 6. Department of Clinical Sciences, Lund University, Lund, Sweden. 7. Department of Radiology, Kristianstad Hospital, Kristianstad, Sweden. 8. European Telemedicine Clinic, Department of Musculoskeletal Radiology, Barcelona, Spain. 9. Region Västra Götaland, Sahlgrenska University Hospital, Department of Radiology, Gothenburg, Sweden.
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.
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.
Authors: Henner Huflage; Karsten Sebastian Luetkens; Andreas Steven Kunz; Nora Conrads; Rafael Gregor Jakubietz; Michael Georg Jakubietz; Lenhard Pennig; Lukas Goertz; Thorsten Alexander Bley; Rainer Schmitt; Jan-Peter Grunz Journal: Eur Radiol Date: 2021-05-18 Impact factor: 5.315