MDCT Arthrography Research Articles

MDCT Arthrography Features of Ulnocarpal Impaction Syndrome

The aim of this article is to present the imaging patterns of ulnocarpal impaction syndrome (Palmer class II lesions) on MDCT arthrography. MDCT arthrography is an excellent tool for imaging patients with clinically suspected ulnocarpal impaction syndrome, allowing identification of the spectrum of findings and proper classification according to Palmer class II (degenerative) lesions, which directly affects management.

MDCT arthrography of the wrist: Diagnostic accuracy and indications

Purpose To evaluate the diagnostic accuracy and indications of arthrography with Multidetector Computed Tomography (arthro-MDCT) of the wrist in patients with absolute or relative contraindications to magnetic resonance imaging (MRI) studies and in patients with periarticular metal implants using diagnostic arthroscopy as the gold standard. Materials and methods After intra-articular injection of iodixanol and volumetric acquisition, 43 wrists in patients of both genders (18 females, 25 males, age range 32–60 years) were examined with a 16-detector-row CT scanner. Fifteen patients had prior wrist surgery. The patients had arthralgia, degenerative and traumatic arthropathies as well as limited range of motion, but no radiologically detected fractures. All examinations were interpreted by two experienced musculoskeletal radiologists. The findings were compared with arthroscopic findings carried out within 28 days of the CT study. Results In non-operated and operated wrists the comparison between arthro-MDCT and arthroscopy showed sensitivity, specificity and accuracy ranging between 92% and 94% for triangular fibrocartilage complex (TFCC), between 80% and 100% for intrinsic ligaments located within the proximal carpal compartment, and between 94% and 100% for articular cartilage. Inter-observer agreement between two radiologists, in the evaluation of all types of lesions, was almost perfect ( k = 0.96) and statistically significant ( p < 0.05). Conclusions Arthro-MDCT of the wrist provides an accurate diagnosis to identify chondral, fibrocartilaginous and intra-articular ligament lesions in patients who cannot be evaluated by MRI, and in post-surgical patients.

肩関節疾患におけるMD-CT arthrographyの有用性について

肩関節疾患におけるMD-CT arthrographyの有用性について

Wrist Ligament Tears: Evaluation of MRI and Combined MDCT and MR Arthrography

Wrist Ligament Tears: Evaluation of MRI and Combined MDCT and MR Arthrography

Wrist Ligament Tears: Evaluation of MRI and Combined MDCT and MR Arthrography

The purpose of this study was to evaluate the performance of MRI and a combination of MDCT arthrography and MR arthrography in the diagnosis of tears and cartilage abnormalities of the wrist ligaments. The feasibility of combining MDCT arthrography and MR arthrography and performing them with an optimized contrast solution was evaluated in vitro and in vivo. Forty-five consecutively enrolled subjects with suspected wrist ligament tears underwent MRI and a combined MDCT and MR arthrographic procedure. Two observers reviewed the images for evidence of tears and cartilage abnormalities of the scapholunate and lunotriquetral ligaments and triangular fibrocartilaginous complex. Interobserver agreement was determined with kappa statistics, and the diagnostic accuracy of each technique was calculated. A 1:1 solution of 2.5 mmol/L tetraazacyclododecanetetraacetic acid (DOTA)-gadolinium and 300 mg I/mL iopamidol provided adequate contrast enhancement for both in vitro and in vivo MDCT arthrographic and MR arthrographic images. Interobserver agreement was substantial for MRI (kappa = 0.61) and MR arthrography (kappa = 0.71) and almost perfect for MDCT arthrography (kappa = 0.93). The sensitivity and specificity of MRI, MDCT arthrography, and MR arthrography for tears of the scapholunate ligament were 59% and 70%, 95% and 96%, and 68% and 87% for the first observer and 77% and 83%, 95% and 100%, and 77% and 87% for the second observer. For tears of the lunotriquetral ligament, these values were 30% and 94%, 100% and 94%, and 60% and 97% for the first observer and 50% and 97%, 90% and 100%, and 50% and 94% for the second observer. The three techniques appeared equivalent for complete tears of the scapholunate and lunotriquetral ligaments, but partial tears were significantly better visualized with MDCT arthrography. The sensitivity and specificity of MRI, MDCT arthrography, and MR arthrography for triangular fibrocartilaginous complex tears were 27% and 100%, 100% and 100%, and 82% and 100% for the first observer and 45% and 100%, 100% and 100%, and 82% and 100% for the second observer. For cartilage abnormalities, these values were 30% and 100%, 100% and 100%, and 30% and 100% for the first observer and 10% and 100%, 100% and 100%, and 40% and 100% for the second observer. MDCT arthrography appears more accurate than MRI and MR arthrography, particularly for discerning partial tears of the scapholunate and lunotriquetral ligaments that do not necessitate surgical therapy.

16-Slice MDCT Arthrography of the Shoulder: Accuracy for Detection of Glenoid Labral and Rotator Cuff Tears

Purpose: We wanted to determine the diagnostic accuracy of 16-slice MDCT arthrography (CTA) for glenoid labral and rotator cuff tears of the shoulder. Materials and Methods: We enrolled forty-five patients who underwent arthroscopy after CTA for pain or instability of the shoulder joint. The CTA images were analyzed for the existence, sites and types of glenoid labral tears and the presence and severity of rotator cuff tears. We determined the sensitivity, specificity and accuracy of CTA for detecting glenoid labral and rotator cuff tears on the basis of the arthroscopy findings. Results: At arthroscopy, there were 33 SLAP lesions (9 type I, 23 type II and 1 type III), 6 Bankart lesions and 31 rotator cuff lesions (21 supraspinatus, 9 infraspinatus and 1 subscapularis). On CTA, the sensitivity, specificity and accuracy for detecting 24 SLAP lesions, excluding the type I lesions, were 83%, 100% and 91%, the total rotator cuff tears were 90%, 100% and 98%, the full thickness supraspinatus tendon tears were 100%, 94% and 96%, and the partial thickness supraspinatus tendon tears were 29%, 100% and 89%, respectively. Conclusion: 16-slice MDCT arthrography has high accuracy for the diagnosis of abnormality of the glenoid labrum or rotator cuff tears and it can be a useful alternative to MRI or US.

Fat-Suppressed 3D Spoiled Gradient-Echo MRI and MDCT Arthrography of Articular Cartilage in Patients with Hip Dysplasia

Our objective was to assess the diagnostic ability of MDCT arthrography for acetabular and femoral cartilage lesions in patients with hip dysplasia. A disorder of the articular cartilage was evaluated in 20 hips of 18 patients with acetabular dysplasia who did not have osteoarthritis or who had early stage osteoarthritis before undergoing pelvic osteotomy surgery. The findings on fat-suppressed 3D fast spoiled gradient-echo MRI and MDCT arthrography of the hip were evaluated by two independent observers, and sensitivity, specificity, and accuracy were determined using arthroscopic findings as the standard of reference. Kappa values were calculated to quantify the level of interobserver agreement. The sensitivity and specificity for the detection of any cartilage disorder (grade 1 or higher) were (observer 1/observer 2) 49%/67% and 89%/76%, respectively, on MRI, and 67%/67% and 89%/82%, respectively, on CT arthrography. The sensitivity and specificity for the detection of cartilage lesions with substance loss (grade 2 or higher) were (observer 1/observer 2) 47%/53% and 92%/87%, respectively, on MRI, and 70%/79% and 93%/94%, respectively, on CT arthrography. CT arthrography provided significantly higher sensitivity in the detection of grade 2 or higher lesions than MRI for both observers. Interobserver agreement in the detection of grade 2 or higher cartilage lesions was moderate (kappa = 0.53) on MRI and substantial (kappa = 0.78) on CT. MDCT arthrography is a sensitive and reproducible method for assessing articular cartilage lesions with substance loss in patients with hip dysplasia.