Young Han Lee MD, Presenter: Nothing to Disclose

Ho-Taek Song MD, Abstract Co-Author: Nothing to Disclose

Sungjun Kim, Abstract Co-Author: Nothing to Disclose

Yong Min Huh, Abstract Co-Author: Nothing to Disclose

Jin-Suck Suh MD, Abstract Co-Author: Nothing to Disclose

To evaluate the diagnostic performance of 3D-THRIVE(T1 High Resolution Isotropic Volume Examination) MR Arthrography(MRA) for the wrist intrinsic ligaments and triangular fibrocartilage complex(TFCC) tears of the wrist, as compared to the routine wrist MR Imaging(MRI).

One hundred and thirty two wrist MRAs were performed between March 2009 and February 2010 on patients with wrist pain. All patients underwent both pre-arthrography PD/T2-weighted MRI and 3D-THRIVE MR Arthrography on a 3-T MR system with dedicated wrist coil. Multiplanar reformation(MPR) of the 3D-THRIVE was performed according to sagittal plane images and axial plane images. Forty three of 132 patients who underwent arthroscopy were enrolled. Two radiologists reviewed the two sets of images in random order without knowledge of arthroscopic findings by consensus: scapholunate ligament(SLL)/lunotriquetral ligament(LTL) or TFCC tears. Arthroscopy results were compared with MR interpretations. Diagnostic performance, including accuracy, sensitivity, specificity, positive predictive value, and negative predictive value, was calculated. Using areas(Az) under the receiver operating characteristic curve(ROC), we compared the diagnostic performance.

Of the 43 patients, 36 had TFCC tears, 19 had SLL tears, and 16 had LTL tears(Total 71 tears at arthroscopy). MRI and MRA sensitivities for detection of TFCC tears were 47.2% and 86.1%, respectively, for SLL tears was 47.4% and 94.7%, and for LTL tears was 25.0% and 75.0%. MRI and MRA specificities for detection of ligament and TFCC tears were 100%. The overall diagnostic performance for lesion characterization was significantly higher(p < 0.05) using the 3D-THRIVE MRA(Az = 0.974, 0.875, and 0.931 for SL ligament, LT ligament, and TFCC, respectively) than using the routine MRI(Az = 0.737, 0.625, and 0.736, respectively).

The use of 3D THRIVE Gradient echo sequence wrist MR Arthrography at 3-T enabled accurate assessment of intrinsic ligament and TFCC tears. The MPR images of the 3D-THRIVE allows optimal resolution and SNR for qualitative diagnosis of wrist injury with no additional scan time.

3D-THRIVE-Gradient-echo images of Wrist MR Arthrography can be used to optimize visualization of ligaments and TFCC, permitting the MPR images.

Lee, Y, Song, H, Kim, S, Huh, Y, Suh, J, Isovolumetric Wrist MR Arthrography Using 3D-THRIVE Sequence Correlated with Operative Arthroscopy.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9012457.html