[MRI or arthroscopy in the diagnosis of scapholunate ligament tears in fractures of the distal radius?].
In a prospective study, 45 patients with fractures of the distal radius and radiologically suspected tears of the scapholunate interosseous ligament were examined. Magnetic resonance imaging was performed prior to wrist arthroscopy. The latter examination gave the definite diagnosis. MRI was performed in conventional technique (without contrast medium) in 25 cases and after additional intravenous injection of contrast medium in the remaining 20 patients. The images were obtained with a 1.0-T clinical imager using a T(2)-weighted turbo spin echo sequence (slice 3 mm, transversal) and a FLASH 2D sequence (slice 2 mm, oblique/coronal). Three independent observers assessed the MRI scans before arthroscopy was performed. The correct diagnosis was made by MRI in 76 %. Overall sensitivity and specificity came to 71 % and 86 %, respectively. The use of intravenously applied contrast medium did not improve MRI accuracy. In conclusion, MRI is not recommended for the diagnosis of scapholunate ligament tears. Presumably, the results of MRI could be improved by a more sophisticated technique.
Schädel-Höpfner
M
M
Klinik für Unfallchirurgie, Philipps-Universität Marburg. schaedel@mailer.uni-marburg.de
Iwinska-Zelder
J
J
Böhringer
G
G
Braus
T
T
Klose
K J
KJ
Gotzen
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement; D008023:Ligaments, Articular / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D012667:Lunate Bone / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D021361:Scaphoid Bone / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D014954:Wrist Injuries / Q000175:diagnosis* / Q000601:surgery
D003287:Contrast Media; D019786:Gadolinium DTPA
Magnetresonanztomographie oder Arthroskopie in der Diagnostik skapholunärer Bandschäden bei distalen Radiusfrakturen?