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Intrinsic ligament and triangular fibrocartilage complex tears of the wrist: comparison of MDCT arthrography, conventional 3-T MRI, and MR arthrography

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Abstract

Purpose

This study compares the diagnostic performance of multidetector CT arthrography (CTA), conventional 3-T MR and MR arthrography (MRA) in detecting intrinsic ligament and triangular fibrocartilage complex (TFCC) tears of the wrist.

Materials and methods

Ten cadaveric wrists of five male subjects with an average age 49.6 years (range 26–59 years) were evaluated using CTA, conventional 3-T MR and MRA. We assessed the presence of scapholunate ligament (SLL), lunotriquetral ligament (LTL), and TFCC tears using a combination of conventional arthrography and arthroscopy as a gold standard. All images were evaluated in consensus by two musculoskeletal radiologists with sensitivity, specificity, and accuracy being calculated.

Results

Sensitivities/specificity/accuracy of CTA, conventional MRI, and MRA were 100 %/100 %/100 %, 66 %/86 %/80 %, 100 %/86 %/90 % for the detection of SLL tear, 100 %/80 %/90 %, 60 %/80 %/70 %, 100 %/80 %/90 % for the detection of LTL tear, and 100 %/100 %/100 %, 100 %/86 %/90 %, 100 %/100 %/100 % for the detection of TFCC tear. Overall CTA had the highest sensitivity, specificity, and accuracy among the three investigations while MRA performed better than conventional MR. CTA also had the highest sensitivity, specificity, and accuracy for identifying which component of the SLL and LTL was torn. Membranous tears of both SLL and LTL were better visualized than dorsal or volar tears on all three imaging modalities.

Conclusion

Both CT and MR arthrography have a very high degree of accuracy for diagnosing tears of the SLL, LTL, and TFCC with both being more accurate than conventional MR imaging.

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Acknowledgments

The work described in this paper was partially supported by a grant from the Research Grants Council of the Hong Kong Special Administrative Region, China (Project No.SEG_CUHK02).

Conflict of interest

No conflict of interest.

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Authors and Affiliations

  1. Department of Imaging and Interventional Radiology, Prince Of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong

    Ryan K. L. Lee, Alex W. H. Ng, Cina S. L. Tong, James F. Griffith, W. L. Tse, C. Wong & P. C. Ho

  2. Department of Orthopedics, Prince Of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong

    W. L. Tse, C. Wong & P. C. Ho

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  1. Ryan K. L. Lee
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  2. Alex W. H. Ng
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Correspondence to Ryan K. L. Lee.

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Lee, R.K.L., Ng, A.W.H., Tong, C.S.L. et al. Intrinsic ligament and triangular fibrocartilage complex tears of the wrist: comparison of MDCT arthrography, conventional 3-T MRI, and MR arthrography. Skeletal Radiol 42, 1277–1285 (2013). https://doi.org/10.1007/s00256-013-1666-8

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  • DOI: https://doi.org/10.1007/s00256-013-1666-8

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