title: Comparison of conventional MRI and MR arthrography in the evaluation wrist ligament tears: A preliminary experience.
abstract: OBJECTIVE
  To compare conventional magnetic resonance imaging (MRI) and direct magnetic resonance (MR) arthrography in the evaluation of triangular fibrocartilage complex (TFCC) and intrinsic wrist ligament tears.
  
  
  METHODS
  T1-weighted, fat suppressed (FS) proton density plus T2-weighted (FS PD/T2), 3D multiple-echo data image combination (MEDIC) sequences and direct MR arthrography were performed in 53 patients with wrist pain. Images were evaluated for the presence and location of TFCC, scapholunate ligament (SLL) and lunatotriquetral ligament (LTL) tears, and imaging findings were compared with operative findings in 16 patients who underwent arthroscopy or open surgery (gold standard).
  
  
  RESULTS
  SIXTEEN PATIENTS UNDERWENT ARTHROSCOPY/OPEN SURGERY: 12 TFCC tears were detected arthroscopically out of which 9 were detected on FS PD/T2 sequence, 10 on MEDIC sequence, and all 12 were detected on MR arthrography. The sensitivities of FS PD/T2, MEDIC sequences, and MR arthrography in the detection of TFCC tears were 75%, 83.3%, and 100%, respectively. Out of the eight arthroscopically confirmed SLL tears, three tears were detected on FS PD/T2 sequence, five on MEDIC sequence, and all eight were visualized on MR arthrography. The sensitivities of FS PD/T2, MEDIC sequences, and MR arthrography in detecting SLL tears were 37.5%, 62.5%, and 100%, respectively. One arthroscopically confirmed LTL tear was diagnosed on FS PD/T2 sequence, three on MEDIC sequence, and all five arthroscopically confirmed LTL tears were detected with MR arthrography. The sensitivities of PD, MEDIC sequences, and MR arthrography in detecting LTL tears were 20%, 40%, and 100%, respectively.
  
  
  CONCLUSIONS
  MR arthrography is the most sensitive and specific imaging modality for the evaluation of wrist ligament tears.
authors.affiliation: Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Shivani
authors.initials: S
authors.lastname: Pahwa
authors.affiliation: Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Deep N
authors.initials: DN
authors.lastname: Srivastava
authors.affiliation: Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Raju
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Shivanand
authors.initials: S
authors.lastname: Gamanagatti
authors.affiliation: Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Prakash P
authors.initials: PP
authors.lastname: Kotwal
authors.affiliation: Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Vijay
authors.initials: V
authors.lastname: Sharma
keywords: MR arthrography; TFCC; TFCC tear; lunatotriquetral ligament; scapholunate ligament; wrist arthroscopy; wrist ligament tear
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