3D MRI of the Wrist: Anatomy and Clinical Applications With Comparison to 2D MRI

Abstract

The wrist joint has complex anatomy and is commonly involved in traumatic injuries. Magnetic resonance imaging (MRI) is routinely used to evaluate various wrist structures including the ligaments, triangular fibrocartilage complex (TFCC), tendons, and articular cartilage. While the 2D (2-dimensional) MR imaging offers high spatial resolution, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), it has some limitations due to relatively thick slices, limited fluid contrast, and the need for image acquisition in multiple planes. Isotropic 3D MR imaging can overcome these limitations by acquiring a volumetric dataset with thin contiguous slices enabling multiplanar reconstructions in arbitrary, though structure-specific planes. Recent advances have reduced the acquisition duration of 3D imaging datasets making them more time efficient than 2D MRI thus enabling clinical implementation. In this article, we will review the main concepts on wrist anatomy and imaging, present illustrative cases using recent technical advances of 3D MRI and compare 2D vs. 3D benefits for various wrist structures and their pathologies.