title: Correlation of histopathology with magnetic resonance imaging in Kienböck disease.
abstract: OBJECTIVE
  Diagnosis and treatment remain controversial for Kienböck disease. A few reports have correlated magnetic resonance imaging (MRI), which is essential for early diagnosis, and histopathology of Kienböck biopsy specimens, but histopathological correlations of whole lunate bones or histological slices compared with MRI images are lacking. The purpose of this study was to compare presurgical MRI scans with corresponding histological slices of Kienböck-diseased lunates.
  
  
  METHODS
  We excised whole lunates at the time of surgery from 6 patients with Kienböck disease (stage IIIB) undergoing tendon-ball replacement or a Graner procedure. We stained paraffin-embedded, coronally sectioned specimens with hematoxylin-eosin and compared them with presurgical coronal scans using MRI with a 47-mm microscopy surface coil.
  
  
  RESULTS
  Toward the center of the lunates, the signal intensity in the proton density-weighted images was reduced, whereas the dorsal and palmar sides of the lunates exhibited no changes in intensity. In correlation, histopathological findings revealed strongly disrupted trabeculae toward the center of the lunates and intact trabeculae in the dorsal side of the lunates. Likewise, the necrotic and vitalized bone exhibited low and high signal intensities, respectively, in the proton density-weighted images; however, in the fast-field echo images, there were no correlations with histopathological observations.
  
  
  CONCLUSIONS
  Proton density-weighted MRIs but not fast-field echo images using a 47-mm microscopy coil reflected the extent and localization of the necrotic area in Kienböck-diseased lunates, as evidenced by comparison with histological analyses of the lunate specimens.
  
  
  CONCLUSIONS
  Proton density-weighted MRIs accurately reflect the vascular status of the lunate and may help plan treatment on a case-by-case basis.
authors: Department of Orthopaedic Surgery, Kikkoman General Hospital, Noda, Chiba, Japan. oga-take@pg7.so-net.ne.jp
authors: Takeshi
authors: T
authors: Ogawa
authors: Yasumasa
authors: Y
authors: Nishiura
authors: Yuki
authors: Y
authors: Hara
authors: Yoshikazu
authors: Y
authors: Okamoto
authors: Naoyuki
authors: N
authors: Ochiai
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D012667:Lunate Bone / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000175:diagnosis* / Q000601:surgery*; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D055815:Young Adult