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- W3021977980 abstract "Abstract 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 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 five-point 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; MPR Styloid : 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 fovea-centered ( 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." @default.
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- W3021977980 date "2020-05-07" @default.
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- W3021977980 title "The importance of radial multiplanar reconstructions for assessment of triangular fibrocartilage complex injury in CT arthrography of the wrist" @default.
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- W3021977980 doi "https://doi.org/10.1186/s12891-020-03321-2" @default.
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