The importance of radial multiplanar reconstructions for assessment of triangular fibrocartilage complex injury in CT arthrography of the wrist

Grunz, Jan-Peter; Gietzen, Carsten Herbert; Luetkens, Karsten Sebastian; Wagner, Matthias; Kalb, K.; Bley, Thorsten Alexander; Lehmkuhl, Lukas; Schoonhoven, Jörg van; Gassenmaier, Tobias; Schmitt, Rainer

doi:10.1186/s12891-020-03321-2

Cited by 22 publications

(15 citation statements)

References 42 publications

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“…Concordant with previous studies on CT wrist arthrography, diagnostic accuracy for central and peripheral lesions converged with additional radial reformatting [ 15 , 16 ]. The deep peripheral layer of the TFCC includes the insertion of the triangular ligament into the ulnar fovea and functions as the main stabilizer between the ulnar head and sigmoid notch.…”

Section: Discussionsupporting

confidence: 88%

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Improved diagnostic accuracy for ulnar-sided TFCC lesions with radial reformation of 3D sequences in wrist MR arthrography

et al. 2021

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Objectives Triangular fibrocartilage complex (TFCC) injuries frequently cause ulnar-sided wrist pain and can induce distal radioulnar joint instability. With its complex three-dimensional structure, diagnosis of TFCC lesions remains a challenging task even in MR arthrograms. The aim of this study was to assess the added diagnostic value of radial reformatting of isotropic 3D MRI datasets compared to standard planes after direct arthrography of the wrist. Methods Ninety-three patients underwent wrist MRI after fluoroscopy-guided multi-compartment arthrography. Two radiologists collectively analyzed two datasets of each MR arthrogram for TFCC injuries, with one set containing standard reconstructions of a 3D thin-slice sequence in axial, coronal and sagittal orientation, while the other set comprised an additional radial plane view with the rotating center positioned at the ulnar styloid. Surgical reports (whenever available) or radiological reports combined with clinical follow-up served as a standard of reference. In addition, diagnostic confidence and assessability of the central disc and ulnar-sided insertions were subjectively evaluated. Results Injuries of the articular disc, styloid and foveal ulnar attachment were present in 20 (23.7%), 10 (10.8%) and 9 (9.7%) patients. Additional radial planes increased diagnostic accuracy for lesions of the styloid (0.83 vs. 0.90; p = 0.016) and foveal (0.86 vs. 0.94; p = 0.039) insertion, whereas no improvement was identified for alterations of the central cartilage disc. Readers’ confidence (p < 0.001) and assessability of the ulnar-sided insertions (p < 0.001) were superior with ancillary radial reformatting. Conclusions Access to the radial plane view of isotropic 3D sequences in MR arthrography improves diagnostic accuracy and confidence for ulnar-sided TFCC lesions. Key Points • In multi-compartment arthrography of the wrist, ancillary radial plane view aids assessability of the foveal and styloid ulnar-sided insertions of the triangular fibrocartilage complex. • Assessment of peripheral TFCC injuries is more accurate with access to radial multiplanar reconstructions. • Additional radial planes provide greater diagnostic confidence.

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Section: Discussionsupporting

confidence: 88%

“…Besides, isotropic 3D MRI can be used for multiplanar reformations with arbitrary orientation [ 12 , 13 ]. Similar to angulated planes for the intrinsic carpal ligaments [ 14 ], radial reformatting has been suggested as a reasonable tool to assess TFCC lesions following CT arthrography in previous studies [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Improved diagnostic accuracy for ulnar-sided TFCC lesions with radial reformation of 3D sequences in wrist MR arthrography

et al. 2021

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“…Using multiplanar reformatting of raw data not only in the coronal and sagittal plane, but also with respect to the particular anatomy of the scaphoid bone (parasagittal, paracoronal reconstruction) and TFCC (radial reconstruction), can provide additional information about the potential cause of an unstable wrist. 24 Despite its advantages, CT arthrography of the wrist remains a special application that is not routinely performed at many institutions.…”

Section: Computed Tomographymentioning

confidence: 99%

Osteoarthritis of the Wrist: Pathology, Radiology, and Treatment

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Gietzen

Christopoulos

et al. 2021

Semin Musculoskelet Radiol

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Osteoarthritis (OA) is a degenerative disease that can manifest in any synovial joint under certain conditions. It leads to destruction of articular cartilage and adjacent bone, as well as formation of osteophytes at the edges of afflicted joint surfaces. Regarding the wrist, typical degenerative arthritis affects particular joints at a specific patient age, due to asymmetric load distribution and repetitive microtrauma. However, in the presence of instability or systemic diseases, early-onset degeneration can also impair the range of motion and grip strength in younger patients. Although advanced stages of OA display characteristic signs in radiography, the detection of early manifestations frequently requires computed tomography or magnetic resonance imaging (in some cases with additional arthrography). If a wrist becomes unstable, timely diagnosis and precise treatment are essential to prevent rapid disease progression. Therefore, close collaboration between radiologists and hand surgeons is obligatory to preserve the carpal function of patients.

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“…Qualitätskriterium einer gut durchgeführten MRT-Untersuchung ist die Visualisierung der fovealen TFCC-Lamina. In der MRT-und CT-Arthrografie ist ein 3-D-Datensatz vorteilhaft, mit dem sich die anatomischen TFCC-Strukturen im Rahmen einer Bildnachverarbeitung besser darstellen lassen [53,54]. Die Zentrierung des Ellenkopfs in der Inzisur des Radius wird in der axialen Schichtebene überprüft.…”

Section: Ulnokarpaler Komplexunclassified