The scapholunate interosseous ligament in MR arthrography of the wrist: correlation with non-enhanced MRI and wrist arthroscopy.
OBJECTIVE
To compare three-compartment MR wrist arthrography with non-enhanced MRI in correlation with wrist arthroscopy, and to evaluate the potential of MR arthrography for consistently visualizing all parts of the scapholunate interosseous ligament of the wrist (SLIL) and exactly diagnosing the site and extent of SLIL defects.


METHODS
In 41 patients with wrist pain (34 patients with wrist pain for more than 6 months) plain radiographs, stress views, non-enhanced MRI and three-compartment MR arthrography were done within 2 h of each other, using three-dimensional volume acquisition (0.6-1.0 mm effective slice thickness) with a gradient-recalled echo sequence and a 1.5-T magnet. The MR arthrography findings were compared with the findings from non-enhanced MRI and correlated with the arthroscopic findings in all patients.


RESULTS
The dorsal, central and palmar segments of the SLIL could be delineated exactly by MR arthrography in 95% of the patients; with non-enhanced MRI only 28% of SLIL segments were seen consistently. Demonstration of SLIL defects was possible with high diagnostic confidence in 42% of SLIL segments by non-enhanced MRI and in 94% by MR arthrography. With wrist arthroscopy as the standard of reference, sensitivity and specificity values for SLIL perforations were 52%/34% for non-enhanced MRI and 90%/87% for MR arthrography.


CONCLUSIONS
MR arthrography, using three-dimensional volume acquisition with thin slices (0.6-1.0 mm), combines the advantages of three-compartment arthrography and non-enhanced MRI. It shows the precise location and magnitude of ligamentous defects of all parts of the SLIL, correlates well with wrist arthroscopy and has potential implications for diagnosis and treatment planning.
Scheck
R J
RJ
Department of Radiology, Klinikum Innenstadt, Ludwig-Maximilian-University Munich, Germany.
Kubitzek
C
C
Hierner
R
R
Szeimies
U
U
Pfluger
T
T
Wilhelm
K
K
Hahn
K
K
D000328:Adult; D018771:Arthralgia / Q000175:diagnosis; D001175:Arthrography / Q000379:methods*; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D014953:Wrist / Q000000981:diagnostic imaging / Q000473:pathology*