The classification and MR imaging of scapholunate ligament injuries

Abstract

Objective: To explore the MRI characteristics of injuries of scapholunate ligament (SLL), and provide imaging basis for the early diagnosis and treatment of the injuries. Methods: A total of 20 healthy volunteers without wrist injuries and 30 patients who complained dorsoradial-sided wrist pain and were highly suspected as the injury of SLL underwent the wrist magnetic resonance examination and X-ray examination in Beijing Jishuitan Hospital from January 2013 to September 2017.All subjects underwent anterior and lateral radiographs of the wrist joint and examination on coronal T(1)WI scan and PD-FS on 3 planes respectively in a prone position.Then the MRI characteristics of 20 healthy volunteers and 30 patients with SLL injuries that confirmed by operation were analyzed.According to the comparative analysis of normal anatomy and Geissler grades, the injuries were graded and MRI features of different types of injuries were analyzed.At last, imaging findings were compared with surgical results. Results: Twenty healthy volunteers without injuries showed mainly in low signal intensity on T(1)WI and PD-FS images.According to Geissler grades, there were 11 GradeⅠ injuries (5 had triangular fibrocartilage complex (TFCC) and SLL injuries and 1 had fracture of scaphoid and SLL injuries simultaneously), 8 GradeⅡ injuries (2 had TFCC and SLL injuries, 1 had TFCC, lunotriquetral ligament (LTL) and SLL injuries and 1 had distal radius fracture, TFCC and SLL injuries simultaneously), 7 Grade Ⅲ injuries (3 had TFCC and SLL injuries, 2 had fracture of scaphoid and SLL injuries and 1 had TFCC, LTL and SLL injuries simultaneously) and 4 Grade Ⅳ injuries (2 had TFCC and SLL injuries and 1 had fracture of scaphoid and SLL injuries simultaneously) among 30 patients.A tear can be confidently diagnosed when the ligament segment was absent or there was a fluidfilled discontinuity.A tear that involves 1 or 2 of the 3 segments (volar, proximal, or dorsal) of either the SLL was considered a partial tear, whereas a tear of all 3 segments was a complete tear. Conclusion: MRI can demonstrate the anatomy of interosseous ligaments accurately, evaluate and make the general grades of injuries.It is of significance for the early diagnosis and treatment protocols of the interosseous ligaments injuries.