title: High-resolution MRI of the ulnar and radial collateral ligaments of the wrist.
abstract: Background Accurate diagnosis of injuries to the collateral ligaments of the wrist is technically challenging on MRI. Purpose To investigate usefulness of high-resolution two-dimensional (2D) and isotropic three-dimensional (3D) magnetic resonance imaging (MRI) for identifying and classifying the morphology of the ulnar and radial collateral ligaments (UCL and RCL) of the wrist. Material and Methods Thirty-seven participants were evaluated using 3T coronal 2D and isotropic 3D images by two radiologists independently. The UCL was classified into four types: 1a, narrow attachment to the tip of the ulnar styloid (Tip); 1b, broad attachment to the Tip; 2a, narrow attachment to the medial base of the ulnar styloid (Base); and 2b, broad attachment to the Base. The RCL was also classified into four types: 1a, separate radioscaphoid and scaphotrapezial ligaments (RS + ST) with narrow scaphoid attachment; 1b, RS + ST with broad scaphoid attachment; 2a, continuous radio-scapho-trapezial ligaments (RST) with narrow scaphoid attachment; and 2b, RST with broad scaphoid attachment. The inter-observer reliability of these classifications was calculated. Results Type 1a was the most common of both collateral ligaments. Of UCL classifications, 31.4% were revised after additional review of multiplanar reconstruction (MPR) images from isotropic data. The inter-observer reliability of UCL classification was substantial (k = 0.62) without MPR, and almost perfect (k = 0.84) with MPR. The inter-observer reliability of RCL classification was almost perfect (k = 0.89). Anatomic delineation between the two sequences was not statistically different. Conclusion The UCL and RCL were each identified on high-resolution 2D and isotropic 3D MRI equally well. MPR allows accurate identification of the UCL attachment to the ulnar styloid.
authors.affiliation: 1 Department of Radiological Sciences, University of California, Irvine, CA, USA.
authors.forename: Taiki
authors.initials: T
authors.lastname: Nozaki
authors.affiliation: 2 School of Medicine, University of California, Irvine, CA, USA.
authors.forename: Wei Der
authors.initials: W
authors.lastname: Wu
authors.affiliation: 1 Department of Radiological Sciences, University of California, Irvine, CA, USA.
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Kaneko
authors.affiliation: 3 Department of Orthopaedic Surgery, University of California, Irvine, CA, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Rafijah
authors.affiliation: 1 Department of Radiological Sciences, University of California, Irvine, CA, USA.
authors.forename: Lily
authors.initials: L
authors.lastname: Yang
authors.affiliation: 4 Philips Medical Systems, Cleveland, OH, USA.
authors.forename: Dave
authors.initials: D
authors.lastname: Hitt
authors.affiliation: 1 Department of Radiological Sciences, University of California, Irvine, CA, USA.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshioka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000070637:Collateral Ligament, Ulnar / Q000000981:diagnostic imaging; D017885:Collateral Ligaments / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D014954:Wrist Injuries / Q000000981:diagnostic imaging*; D014955:Wrist Joint / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: Magnetic resonance imaging (MRI); high-resolution wrist MRI; isotropic 3D MRI; multiplanar reconstruction; radial collateral ligament; ulnar collateral ligament