The search result changed since you submitted your search request. Documents might be displayed in a different sort order.
  • search hit 4 of 13
Back to Result List

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

Please always quote using this URN: urn:nbn:de:bvb:20-opus-236075
  • Background: Triangular fibrocartilage complex (TFCC) lesions commonly cause ulnar-sided wrist pain and instability of the distal radioulnar joint. Due to its triangular shape, discontinuity of the TFCC is oftentimes difficult to visualize in radiological standard planes. Radial multiplanar reconstructions (MPR) may have the potential to simplify diagnosis in CT wrist arthrography. The objective of this study was to assess diagnostic advantages provided by radial MPR over standard planes for TFCC lesions in CT arthrography. Methods: OneBackground: Triangular fibrocartilage complex (TFCC) lesions commonly cause ulnar-sided wrist pain and instability of the distal radioulnar joint. Due to its triangular shape, discontinuity of the TFCC is oftentimes difficult to visualize in radiological standard planes. Radial multiplanar reconstructions (MPR) may have the potential to simplify diagnosis in CT wrist arthrography. The objective of this study was to assess diagnostic advantages provided by radial MPR over standard planes for TFCC lesions in CT arthrography. Methods: One hundred six patients (49 women, 57 men; mean age 44.2 ± 15.8 years) underwent CT imaging after wrist arthrography. Two radiologists (R1, R2) retrospectively analyzed three randomized datasets for each CT arthrography. One set contained axial, coronal and sagittal planes (MPR\(_{Standard}\)), while the other two included an additional radial reconstruction with the rotating center either atop the ulnar styloid (MPR\(_{Styloid}\)) or in the ulnar fovea (MPR\(_{Fovea}\)). Readers evaluated TFCC differentiability and condition. Suspected lesions were categorized using Palmer’s and Atzei’s classification and diagnostic confidence was stated on a fivepoint Likert scale. Results: Compared to standard planes, differentiability of the superficial and deep TFCC layer was superior in radial reconstructions (R1/R2; MPR\(_{Fovea}\): p < 0.001; MPRStyloid: p ≤ 0.007). Palmer and Atzei lesions were present in 86.8% (92/106) and 52.8% (56/106) of patients, respectively. Specificity, sensitivity and accuracy for central Palmer lesions did not differ in radial and standard MPR. For peripheral Atzei lesions, sensitivity (MPR\(_{Standard}\) 78.6%/80.4%, MPR\(_{Styloid}\) 94.6%/94.6%, MPR\(_{Fovea}\) 91.1%/89.3%) and accuracy (MPR\(_{Standard}\) 86.8%/86.8%, MPR\(_{Styloid}\) 96.2%/96.2%, MPR\(_{Fovea}\) 94.3%/93.4%) improved with additional styloid-centered (p = 0.004/0.008) and foveacentered (p = 0.039/0.125) reconstructions. No substantial difference was observed between both radial MPR (p = 0.688/0.250). Interrater agreement was almost perfect for each dataset (κ\(_{Standard}\) = 0.876, κ\(_{Styloid}\) = 0.894, κ\(_{Fovea}\) = 0.949). Diagnostic confidence increased with addition of either radial MPR (p < 0.001). Conclusions: Ancillary radial planes improve accuracy and diagnostic confidence for detection of peripheral TFCC lesions in CT arthrography of the wrist.show moreshow less

Download full text files

Export metadata

Additional Services

Share in Twitter Search Google Scholar Statistics
Metadaten
Author: Jan-Peter GrunzORCiD, Carsten Herbert Gietzen, Karsten Luetkens, Matthias Wagner, Karlheinz Kalb, Thorsten Alexander Bley, Luka Lehmkul, Jörg van Schoonhoven, Tobias Gassenmaier, Rainer Schmitt
URN:urn:nbn:de:bvb:20-opus-236075
Document Type:Journal article
Faculties:Medizinische Fakultät / Institut für diagnostische und interventionelle Radiologie (Institut für Röntgendiagnostik)
Language:English
Parent Title (English):BMC Musculoskeletal Disorders
Year of Completion:2020
Volume:21
Article Number:286
Source:BMC Musculoskeletal Disorders (2020) 21:286 https://doi.org/10.1186/s12891-020-03321-2
DOI:https://doi.org/10.1186/s12891-020-03321-2
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:Arthrography; Tomography; Triangular fibrocartilage; Wrist; X-ray computed
Release Date:2021/05/10
Collections:Open-Access-Publikationsfonds / Förderzeitraum 2020
Licence (German):License LogoCC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International