Diane Bergin MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: Since, the dorsal and volar components of the scapholunate (SL) and lunotriquetral (LT) ligaments are most important mechanically we sought to evaluate axial MR images in assessing the integrity of these ligaments. Methods and Materials: Two musculoskeletal radiologists retrospectively evaluated MR wrist studies of 34 patients (23 females and 11 males, age 20 -60 years, mean age 33) that had MR of the wrist and arthroscopy at our institution over a 3 year period. Of these studies, 24 were indirect and 2 direct arthrograms while 8 were non-enhanced MR. Axial images only were reviewed in consensus by both readers. The readers separately reviewed the volar and dorsal bands of both the SL and LT as either intact or torn and correlated this data with surgical results. After reviewing the initial data, we performed an additional pilot study to reevaluate the axial images for the LT. We performed oblique axial images perpendicular to the LT joint and parallel to the ligament in 10 patients in order to visualize the LT ligament similar to the way the SL ligament is seen on axial images. Results: Sensitivity and specificity of axial images for detection of intact SL ligament was; volar band (75%, 77%) and dorsal band (66%, 87%). Specificity of MR for detection of complete tear of the SL ligament was 95%. Sensitivity and specificity of axial images for detection of intact LT ligament was; volar band (12.5%, 96%) and dorsal band (11%, 85%). Specificity for detection of complete tear of the LT ligament was 94%. Evaluation of the SL ligament on MR deemed volar band intact (n= 26), torn (n =8), with dorsal band intact (n =28) and torn (n= 6). Evaluation of the LT ligament on MR deemed volar band intact (n= 32), torn (n=2), and dorsal band intact (n=29), torn (n=5). Oblique axial images better demonstrated the LT, as compared to standard axial images. Both dorsal and volar bands of the LT ligament were well delineated with oblique axial images. Conclusion: Axial images have moderate sensitivity/specificity for detection of complete and partial tears of the SL ligament with poor sensitivity but high specificity for detection of LT ligament tears. One of the reasons the LT ligament was poorly seen on standard MR images is due to the obliquity of traditional axial images relative to the ligament. We propose modified axial oblique images to visualize the LT ligament better. We believe that this plane may provide additional information as to the precise location of these tears.       Questions about this event email: diane.bergin@mail.tju.edu

Bergin MD, D, Axial MR Imaging of the Scapholunate and Lunotriquetral Ligaments: Correlation with Arthroscopic Findings.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3103794.html