• DOI:10.1148/RADIOL.2373041450
• Corpus ID: 23720934

Interosseous ligament tears of the wrist: comparison of multi-detector row CT arthrography and MR imaging.

@article{Schmid2005InterosseousLT,
  title={Interosseous ligament tears of the wrist: comparison of multi-detector row CT arthrography and MR imaging.},
  author={Marius R. Schmid and Thomas Schertler and Christian W A Pfirrmann and Nadja Saupe and Mirjana Manestar and Simon Wildermuth and Dominik Weishaupt},
  journal={Radiology},
  year={2005},
  volume={237 3},
  pages={
          1008-13
        }
}

• M. Schmid, T. Schertler, +4 authors D. Weishaupt
• Published 1 December 2005
• Medicine, Physics
• Radiology

PURPOSE
To compare the accuracy of multi-detector row computed tomographic (CT) arthrography and magnetic resonance (MR) imaging in depicting tears of dorsal, central, and palmar segments of scapholunate (SL) and lunotriquetral (LT) ligaments in cadavers.

MATERIALS AND METHODS
Cadaver wrists were obtained and used according to institutional guidelines and with informed consent of donors prior to death. Nine cadaver wrists of eight subjects were evaluated. MR images were obtained with a 1.5-T MR unit. Imaging protocol included intermediate-weighted coronal and transverse fast spin-echo and coronal three-dimensional gradient-echo sequences. Multi-detector row CT arthrography was performed after tricompartmental injection of 3-6 mL of contrast material with a concentration of 160 mg per milliliter of iodine. Palmar, dorsal, and central segments of both ligaments were analyzed on transverse and coronal MR images and multiplanar multi-detector row CT reconstructions by two musculoskeletal radiologists working independently. Open inspection of the wrists was the reference standard. Sensitivity, specificity, accuracy, and positive and negative predictive values were calculated from the imaging and gross pathologic readings. Statistical significance was calculated with the McNemar test. Weighted kappa values for interobserver agreement were calculated for both imaging modalities.

RESULTS
All ligament segments could be visualized in all cases with both imaging modalities. CT arthrography was more sensitive (100%) than MR imaging (60%) in detection of palmar segment tears (P = .62); specificity of both imaging modalities was 77%. Sensitivity (CT arthrography, 86%; MR imaging, 79%) and specificity (CT arthrography, 50%; MR imaging, 25%) for detection of the central segment tears were determined. Dorsal segment tears were detected only with CT arthrography, while all tears were missed with MR imaging (P = .02). Interobserver agreement was better for multi-detector row CT arthrography (kappa = 0.37-0.78) than for MR imaging (kappa = -0.33 to -0.10).

CONCLUSION
Performance in depiction of palmar and central segment tears of SL and LT ligaments is almost equal for multi-detector row CT arthrography and MR imaging, with much higher interobserver reliability for CT arthrography. CT arthrography is significantly superior to MR imaging in the detection of dorsal segment tears of SL and LT ligaments.