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Feasibility and preliminary results of SPECT/CT arthrography of the wrist in comparison with MR arthrography in patients with suspected ulnocarpal impaction

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the feasibility and performance of SPECT/CT arthrography of the wrist in comparison with MR arthrography in patients with suspected ulnocarpal impaction.

Methods

This prospective study included 28 wrists of 27 patients evaluated with SPECT/CT arthrography and MR arthrography. Iodine contrast medium and gadolinium were injected into the distal radioulnar and midcarpal joints. Late-phase SPECT/CT was performed 3.5 h after intravenous injection of approximately 650 MBq 99mTc-DPD. MR and SPECT/CT images were separately reviewed in relation to bone marrow oedema, radionuclide uptake, and tears in the scapholunate (SL) and lunotriquetral (LT) ligaments and triangular fibrocartilage complex (TFCC), and an overall diagnosis of ulnar impaction. MR, CT and SPECT/CT imaging findings were compared with each other, with the surgical findings in 12 patients and with clinical follow-up.

Results

The quality of MR arthrography and SPECT/CT arthrography images was fully diagnostic in 23 of 28 wrists (82 %) and 25 of 28 wrists (89 %), respectively. SPECT/CT arthrography was not diagnostic for ligament lesions due to insufficient intraarticular contrast in one wrist. MR and SPECT/CT images showed concordant findings regarding TFCC lesions in 22 of 27 wrists (81 %), SL ligament in 22 of 27 wrists (81 %) and LT ligament in 23 of 27 wrists (85 %). Bone marrow oedema on MR images and scintigraphic uptake were concordant in 21 of 28 wrists (75 %). MR images showed partial TFCC defects in four patients with normal SPECT/CT images. MR images showed bone marrow oedema in 4 of 28 wrists (14 %) without scintigraphic uptake, and scintigraphic uptake was present without MR bone marrow oedema in three wrists (11 %). Regarding diagnosis of ulnar impaction the concordance rate between CT and SPECT/CT was 100 % and reached 96 % (27 of 28) between MR and SPECT/CT arthrography. The sensitivity and specificity of MR, CT and SPECT/CT arthrography were 93 %, 100 % and 100 %, and 93 %, 93 % and 93 %, respectively.

Conclusion

SPECT/CT arthrography of the wrist is feasible. Regarding diagnosis of ulnar impaction we found a high concordance with MR arthrography. SPECT/CT arthrography of the wrist is an alternative to MR arthrography in patients with contraindications to MR imaging.

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References

  1. Friedman SL, Palmer AK. The ulnar impaction syndrome. Hand Clin. 1991;7(2):295–310.

    CAS  PubMed  Google Scholar 

  2. Cerezal L, Abascal F, Garcia-Valtuille R, Del Pinal F. Wrist MR arthrography: how, why, when. Radiol Clin North Am. 2005;43(4):709–31. viii.

    Article  PubMed  Google Scholar 

  3. Cerezal L, del Pinal F, Abascal F. MR imaging findings in ulnar-sided wrist impaction syndromes. Magn Reson Imaging Clin N Am. 2004;12(2):281–99; vi.

    Article  PubMed  Google Scholar 

  4. Cerezal L, del Pinal F, Abascal F, Garcia-Valtuille R, Pereda T, Canga A. Imaging findings in ulnar-sided wrist impaction syndromes. Radiographics. 2002;22(1):105–21.

    Article  PubMed  Google Scholar 

  5. Moser T, Khoury V, Harris PG, Bureau NJ, Cardinal E, Dosch JC. MDCT arthrography or MR arthrography for imaging the wrist joint? Semin Musculoskelet Radiol. 2009;13(1):39–54.

    Article  PubMed  Google Scholar 

  6. Guggenberger R, Fischer MA, Hodler J, Pfammatter T, Andreisek G. Flat-panel CT arthrography: feasibility study and comparison to multidetector CT arthrography. Invest Radiol. 2012;47(5):312–8.

    Article  PubMed  Google Scholar 

  7. Huellner MW, Burkert A, Schleich FS, Schurch M, Hug U, von Wartburg U, et al. SPECT/CT versus MRI in patients with nonspecific pain of the hand and wrist – a pilot study. Eur J Nucl Med Mol Imaging. 2012;39(5):750–9.

    Article  PubMed  Google Scholar 

  8. Huellner MW, Strobel K, Hug U, von Wartburg U, Veit-Haibach P. SPECT/CT in diagnostics of the hand joint. Radiologe. 2012;52(7):621–8.

    Article  CAS  PubMed  Google Scholar 

  9. Kruger T, Hug U, Hullner MW, Schleich F, Veit-Haibach P, von Wartburg U, et al. SPECT/CT arthrography of the wrist in ulnocarpal impaction syndrome. Eur J Nucl Med Mol Imaging. 2011;38(4):792.

    Article  PubMed  Google Scholar 

  10. Strobel K, Wiesmann R, Tornquist K, Steurer-Dober I, Muller U. SPECT/CT arthrography of the knee. Eur J Nucl Med Mol Imaging. 2012;39(12):1975–6.

    Article  CAS  PubMed  Google Scholar 

  11. Koskinen SK, Haapamaki VV, Salo J, Lindfors NC, Kortesniemi M, Seppala L, et al. CT arthrography of the wrist using a novel, mobile, dedicated extremity cone-beam CT (CBCT). Skeletal Radiol. 2013;42(5):649–57.

    Article  PubMed  Google Scholar 

  12. Buck FM, Hoffmann A, Hofer B, Pfirrmann CW, Allgayer B. Chronic medial knee pain without history of prior trauma: correlation of pain at rest and during exercise using bone scintigraphy and MR imaging. Skeletal Radiol. 2009;38(4):339–47.

    Article  PubMed  Google Scholar 

  13. Theumann N, Favarger N, Schnyder P, Meuli R. Wrist ligament injuries: value of post-arthrography computed tomography. Skeletal Radiol. 2001;30(2):88–93.

    Article  CAS  PubMed  Google Scholar 

  14. Moser T, Dosch JC, Moussaoui A, Dietemann JL. Wrist ligament tears: evaluation of MRI and combined MDCT and MR arthrography. AJR Am J Roentgenol. 2007;188(5):1278–86.

    Article  PubMed  Google Scholar 

  15. Braun H, Kenn W, Schneider S, Graf M, Sandstede J, Hahn D. Direct MR arthrography of the wrist – value in detecting complete and partial defects of intrinsic ligaments and the TFCC in comparison with arthroscopy. Rofo. 2003;175(11):1515–24.

    Article  CAS  PubMed  Google Scholar 

  16. Schmitt R, Christopoulos G, Meier R, Coblenz G, Frohner S, Lanz U, et al. Direct MR arthrography of the wrist in comparison with arthroscopy: a prospective study on 125 patients. Rofo. 2003;175(7):911–9.

    Article  CAS  PubMed  Google Scholar 

  17. Biswal S, Resnick DL, Hoffman JM, Gambhir SS. Molecular imaging: integration of molecular imaging into the musculoskeletal imaging practice. Radiology. 2007;244(3):651–71.

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank the team of the chief technician Savo Matijasevic for their great support and performance of the MR and SPECT/CT investigations. This study was supported financially by Philips Healthcare.

Conflicts of Interest

Angela da Silva is a medical physicist and an employee of Philips Healthcare. She supported the study with her technical and linguistic knowledge.

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Authors and Affiliations

  1. Department of Nuclear Medicine and Radiology, Lucerne Cantonal Hospital, Lucerne, Switzerland

    Klaus Strobel, Isabelle Steurer-Dober, Martin W. Huellner, Maria del Sol Pérez Lago, Patrick Veit-Haibach & Katharina Tornquist

  2. Advanced Molecular Imaging, Philips Healthcare, San Jose, CA, USA

    Angela J. Da Silva

  3. Division of Hand and Plastic Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland

    Elvira Bodmer, Urs von Wartburg & Urs Hug

  4. Röntgeninstitut/Nuklearmedizin, Kantonsspital Luzern, 16 Spitalstrasse, 6000, Luzern, Schweiz

    Klaus Strobel

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  1. Klaus Strobel
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  2. Isabelle Steurer-Dober
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  3. Angela J. Da Silva
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  4. Martin W. Huellner
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  5. Maria del Sol Pérez Lago
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  6. Elvira Bodmer
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  7. Urs von Wartburg
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  8. Patrick Veit-Haibach
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  9. Katharina Tornquist
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  10. Urs Hug
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Corresponding author

Correspondence to Klaus Strobel.

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Strobel, K., Steurer-Dober, I., Da Silva, A.J. et al. Feasibility and preliminary results of SPECT/CT arthrography of the wrist in comparison with MR arthrography in patients with suspected ulnocarpal impaction. Eur J Nucl Med Mol Imaging 41, 548–555 (2014). https://doi.org/10.1007/s00259-013-2584-7

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  • DOI: https://doi.org/10.1007/s00259-013-2584-7

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