[The nutritive vascular canals. The magnetic resonance differential diagnosis of carpal cystic lesions?].
OBJECTIVE
To find and describe potential MRI criteria of nutrient vessel canals of carpal bones.


METHODS
16 wrists of 13 patients with pain and radiographic depiction of cystic changes within the lunate were examined. The MRI protocol included coronal and sagittal T1- and T2-weighted SE sequences (4 mm slices, 120 FOV, 256 x 256 matrix) as well as coronal STIR images. Final diagnosis was confirmed by surgery (n = 5) and follow up. 10 cadaveric ossa lunata were studied to describe size, number, location and shape of nutrient vessel canals.


RESULTS
Ganglion cysts (n = 6) showed characteristic signs. In ulnar impaction syndrome (n = 1) small cystic lesions in the lunate were surrounded by a sclerotic rim and located near the proximal ulnar surface. In Kienböck's disease (n = 3) cystic components were irregular and surrounded by bone marrow edema. Nutrient vessel canals (n = 7) imaged as 1 to 3 small cystic lesions within the palmar or dorsal subchondral region.


CONCLUSIONS
MRI can aid in differential diagnosis of cystic carpal lesions. Nutrient vessel canals may not be mistaken for pathologic cystic lesions. Carpal ganglion cysts show distinct diagnostic pattern.
Vahlensieck
M
M
Radiologische Universitätsklinik Bonn. m.Vahlensieck@uni-bonn.de
Brüser
P
P
Schmidt
H M
HM
Schild
H H
HH
D000293:Adolescent; D000328:Adult; D001845:Bone Cysts / Q000175:diagnosis*; D002348:Carpal Bones / Q000098:blood supply* / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D013581:Synovial Cyst / Q000175:diagnosis; D014953:Wrist / Q000473:pathology