High-resolution MRI of the ulnar and radial collateral ligaments of the wrist

• Published in: Acta radiologica (1987) Vol. 58; no. 12; p. 1493
• Main Authors: Nozaki, Taiki, Wu, Wei Der, Kaneko, Yasuhito, Rafijah, Gregory, Yang, Lily, Hitt, Dave, Yoshioka, Hiroshi
• Format: Journal Article
• Language: English
• Published: England 01.12.2017
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Collateral Ligament, Ulnar - diagnostic imaging; Collateral Ligaments - diagnostic imaging; Female; Humans; Image Processing, Computer-Assisted - methods; Imaging, Three-Dimensional - methods; Magnetic Resonance Imaging - methods; Male; Middle Aged; Reproducibility of Results; Wrist Injuries - diagnostic imaging; Wrist Joint - diagnostic imaging; Young Adult; isotropic 3D MRI; Magnetic resonance imaging (MRI); high-resolution wrist MRI; multiplanar reconstruction; radial collateral ligament; ulnar collateral ligament
• ISSN: 1600-0455
• DOI: 10.1177/0284185117698862

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.