Triangular Ligament Research Articles

Laparoscopic Left Liver Sectoriectomy of Caroli's Disease Limited to Segment II and III

Caroli's disease is defined as a abnormal dilatation of the intra-hepatica bile ducts: Its incidence is extremely low (1 in 1,000,000 population) and in most of the cases the whole liver is interested and liver transplantation is the treatment of choice. In case of dilatation limited to the left or right lobe, liver resection can be performed. For many year the standard approach for liver resection has been a formal laparotomy by means of a large incision of abdomen that is characterized by significant post-operatie morbidity. More recently, minimally invasive, laparoscopic approach has been proposed as possible surgical technique for liver resection both for benign and malignant diseases. The main benefits of the minimally invasive approach is represented by a significant reduction of the surgical trauma that allows a faster recovery a less post-operative complications. This video shows a case of Caroli s disease occured in a 58 years old male admitted at the gastroenterology department for sudden onset of abdominal pain associated with fever (>38C° ), nausea and shivering. Abdominal ultrasound demonstrated a significant dilatation of intra-hepatic left sited bile ducts with no evidences of gallbladder or common bile duct stones. Such findings were confirmed abdominal high resolution computer tomography. Laparoscopic left sectoriectomy was planned. Five trocars and 30° optic was used, exploration of the abdominal cavity showed no adhesions or evidences of other diseases. In order to control blood inflow to the liver, vascular clamp was placed on the hepatic pedicle (Pringle s manouvre), Parenchymal division is carried out with a combined use of 5 mm bipolar forceps and 5 mm ultrasonic dissector. A severely dilated left hepatic duct was isolated and divided using a 45mm endoscopic vascular stapler. Liver dissection was continued up to isolation of the main left portal branch that was then divided with a further cartridge of 45 mm vascular stapler. At his point the left liver remains attached only by the left hepatic vein: division of the triangular ligament was performed using monopolar hook and the hepatic vein isolated and the divided using vascular stapler. Haemostatis was refined by application of argon beam coagulation and no bleeding was revealed even after removal of the vascular clamp (total Pringle s time 27 minutes). Postoperative course was uneventful, minimal elevation of the liver function tests was recorded in post-operative day 1 but returned to normal at discharged on post-operative day 3.

Laparoscopic left liver sectoriectomy of Caroli's disease limited to segment II and III.

Caroli's disease is defined as a abnormal dilatation of the intra-hepatica bile ducts: Its incidence is extremely low (1 in 1,000,000 population) and in most of the cases the whole liver is interested and liver transplantation is the treatment of choice. In case of dilatation limited to the left or right lobe, liver resection can be performed. For many year the standard approach for liver resection has been a formal laparotomy by means of a large incision of abdomen that is characterized by significant post-operatie morbidity. More recently, minimally invasive, laparoscopic approach has been proposed as possible surgical technique for liver resection both for benign and malignant diseases. The main benefits of the minimally invasive approach is represented by a significant reduction of the surgical trauma that allows a faster recovery a less post-operative complications.This video shows a case of Caroli s disease occured in a 58 years old male admitted at the gastroenterology department for sudden onset of abdominal pain associated with fever (>38C° ), nausea and shivering. Abdominal ultrasound demonstrated a significant dilatation of intra-hepatic left sited bile ducts with no evidences of gallbladder or common bile duct stones. Such findings were confirmed abdominal high resolution computer tomography. Laparoscopic left sectoriectomy was planned. Five trocars and 30° optic was used, exploration of the abdominal cavity showed no adhesions or evidences of other diseases.In order to control blood inflow to the liver, vascular clamp was placed on the hepatic pedicle (Pringle s manouvre), Parenchymal division is carried out with a combined use of 5 mm bipolar forceps and 5 mm ultrasonic dissector. A severely dilated left hepatic duct was isolated and divided using a 45mm endoscopic vascular stapler. Liver dissection was continued up to isolation of the main left portal branch that was then divided with a further cartridge of 45 mm vascular stapler.At his point the left liver remains attached only by the left hepatic vein: division of the triangular ligament was performed using monopolar hook and the hepatic vein isolated and the divided using vascular stapler.Haemostatis was refined by application of argon beam coagulation and no bleeding was revealed even after removal of the vascular clamp (total Pringle s time 27 minutes).Postoperative course was uneventful, minimal elevation of the liver function tests was recorded in post-operative day 1 but returned to normal at discharged on post-operative day 3.

Technique of Open Ivor Lewis Esophagectomy

Technique of Open Ivor Lewis Esophagectomy

A safe and fast technique for isolated hepatic perfusion

Herein we describe our modified technique of isolated hepatic perfusion that is simpler and faster compared to the initial ones reported in the literature. Previous techniques [7] of isolated hepatic perfusion included total vascular isolation of the liver with portal and systemic venous by pass. The venous by pass was performed either using a cut-down technique or by percutaneous cannulation of the femoral vein. Another important step of previous described techniques was the continuous intra-operative monitoring of complete vascular isolation of the liver by 131-I labeled serum albumin. The technique we describe herein does not include portal vein by pass but shunting of the blood is limited solely to the inferior vena cava. Complete vascular isolation of the liver is demonstrated by a steady volume of the reservoir during the entire procedure, without using labeled albumin. SURGICAL TECHNIQUE The patient is placed in the supine position and general anesthesia through orotracheal intubation is provided. The patient is invasively monitored by radial artery catheter and Swan-Ganz catheter in the pulmonary artery. An 18-French cannula is also placed in the right jugular vein (right if possible) for veno-venous by-pass (see below). The operation begins with a mini-laparotomy on the midline to asses the feasibility of the operation. Once peritoneal carcinomatosis or massive extra-hepatic neoplastic disease is ruled out, the midline incision is extended up to the xyphoid process and to a subcostal laparotomy. The quality of the liver is assessed, with special attention to the steato-hepatitis following chemotherapy. In case of severe steatosis the procedure is not indicated due to increased risk of liver failure after the perfusion. The liver is fully mobilized by division of the right and left triangular ligaments, the round ligament and all the retroperitoneal attachments. The vena cava is dissected off the retroperitoneum and attention is paid to ligate and divide all the collateral veins from the retro

Left-to-right approach facilitates total hepatectomy with caval flow preservation

Left-to-right approach facilitates total hepatectomy with caval flow preservation

Comments on “Electrical conductivity of open-cell metal foams” by K.P. Dharmasena and H.N.G. Wadley [J. Mater. Res. 17, 625 (2002)

Electrical conductivity of open-cell metallic foam calculated by Dharmasena and Wadley using the tetrakaidecahedral cell-based model with ligaments of constant or varying triangular cross sections along the cell edges was mistakenly concluded to strongly overestimate measured electrical conductivities of the open-cell aluminum foams (ERG Duocel). Accurate analysis shows that the model with triangular ligaments on the contrary underestimates the experimental results. A tetrakaidecahedral cell-based model that takes into account the particular ligament geometry, which is determined by constant mean curvature of ligament surfaces, is shown to explain the experimental data of electrical conductivity of the Duocel foams ranging in relative density from 4% to 12%.

The Use of Polymer Clips in Transperitoneal Laparoscopic Nephropexy

Here we report a patient with symptomatic mobile kidney (nephroptosis) who was treated successfully with transperitoneal laparoscopic nephropexy with the use of nonabsorbable polymer clips. In this procedure, clips were used on Gerota's fascia to fix the kidney to the transversus abdominis fascia and the triangular ligament. This method is easier and requires less time than previously reported techniques.

Clinical study of reconstructing the medial malleolus with free grafting of fibular head composite tendon bone flap

Objective To explore new surgical procedure for repairing and reconstructing medial malleolus and soft tissue defect. Methods According to the size of medial malleolus and composite soft tissue defect, vascular fibular head composite tendon bone flap free grafting using anterior tibial recurrent vessel as the perforating branch was designed to reconstruct the medial malleolar saddle and triangular ligament, and composite back broadest muscle flap free grafting was designed to repair the medical malleolar wound surface. From January 2000 to December 2006, the technique was used in 5 male patients who were injured by machine or in traffic accidents, causing bone and soft tissue defect. The size of wound surface ranged from 19 cm × 12 cm to 24 cm × 12 cm. Results The wound surface was healed at the first stage in 4 cases, and the other case had infection and was cured in 6 months with anti infection therapy. Postoperative follow-ups from 6 months to 6 years showed that grafted bones and free cutaneous flaps were healed well, malleolar joints were stable, joint movement was normal, and the appearance was satisfactory. The overall outcome was good. Conclusion Fibular head composite tendon bone flap free grafting is effective for repairing medical malleolar defect.

Simple bile duct cyst in the right triangular ligament

HistopathologyVolume 50, Issue 6 p. 807-808 Simple bile duct cyst in the right triangular ligament E A Husain, E A Husain Department of Pathology, The Royal London Hospital, London, UKSearch for more papers by this authorR M Feakins, R M Feakins Department of Pathology, The Royal London Hospital, London, UKSearch for more papers by this author E A Husain, E A Husain Department of Pathology, The Royal London Hospital, London, UKSearch for more papers by this authorR M Feakins, R M Feakins Department of Pathology, The Royal London Hospital, London, UKSearch for more papers by this author First published: 21 March 2007 https://doi.org/10.1111/j.1365-2559.2007.02651.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume50, Issue6May 2007Pages 807-808 RelatedInformation

Laparoscopy-assisted hepatic lobectomy using hilar Glissonean pedicle transection

Although many reports have described laparoscopic minor liver resections, major hepatic resection, including right or left lobectomy, has not been widely developed because of technical difficulties. This article describes a new technique for performing laparoscopy-assisted right or left hepatic lobectomy using hilar Glissonean pedicle transection. Laparoscopic mobilization of the right or left hepatic lobe is performed, including dissection of the round, faliciform, triangular, and coronary ligaments. The right or left Glissonean pedicle is encircled and divided laparoscopically. A parenchymal dissection is then performed though the upper median or right subcostal incision, through which the resected liver is removed. We successfully performed this procedure in 6 patients without blood transfusion or serious complications. Laparoscopy-assisted hepatic lobectomy using hilar Glissonean pedicle transection can be feasible and safe in highly selected patients.

Role of MR imaging in chronic wrist pain

Magnetic resonance (MR) imaging for chronic wrist pain is challenging. Correct assessment of the triangular fibrocartilage, hyaline cartilage, ligaments, and tendons has become mandatory for comprehensive decision making in wrist surgery. The MR technique, potential and limits of MR imaging in patients with chronic wrist pain will be discussed. MR arthrography with injection of gadolinium-containing contrast material into the distal radioulnar joint is suggested for evaluation of the triangular fibrocartilage. The clinically meaningful ulnar-sided peripheral tears are otherwise hard to diagnose. The diagnostic performance of MR imaging for interosseous ligament tears varies considerably. The sensitivity for scapholunate ligament tears is consistently better than for lunotriquetral ligament tears. Gadolinium-enhanced MR imaging is considered to be the best technique for detecting established avascularity of bone, but the assessment of the MR results remains challenging. Most cases of ulnar impaction syndrome have characteristic focal signal intensity changes in the ulnar aspect of the lunate. Avascular necrosis of the lunate (Kienböck's disease) is characterized by signal changes starting in the proximal radial aspect of the lunate. MR imaging is extremely sensitive for occult fractures. Questions arise if occult posttraumatic bone lesions seen on MR images only necessarily require the same treatment as fractures evident on plain films or computed tomography (CT) images. MR imaging and ultrasound are equally effective for detecting occult carpal ganglia. Carpe bossu (carpal boss) is a bony protuberance of a carpometacarpal joint II and III which may be associated with pain.

Invited commentary

Multiple arterial grafts improve outcomes in patients with obstructive coronary artery disease, particularly after 10 years, and they reduce the need for reintervention in patients when compared with bypassing with a single internal thoracic artery and saphenous vein grafts (SVGs). Total coronary artery revascularization has become possible in many patients by using bilateral internal thoracic artery grafts (ITA), “T” or “Y” grafts, the radial artery (RA), the gastroepiploic artery (GEA), and the construction of composite arterial grafts. Dr Takahashi and associates [1Takahashi K. Daitoku K. Nakata S. Oikawa S. Minakawa M. Kondo N. Early and mid-term outcome of anastomosis of gastroepiploic artery to left coronary artery.Ann Thorac Surg. 2004; 78: 2033-2036Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar, 2Takahashi K. Minakawa M. Kondo N. Oikawa S. Hatakeyama M. Coronary artery bypass surgery by the transdiaphragmatic approach.Ann Thorac Surg. 2002; 74: 700-703Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar] are well versed in the utilization of GEA as a bypass graft for coronary revascularization with the aorta no-touch technique. The current report [3Takahashi K. Daitoku K. Minakawa M. et al.Coronary artery bypass grafting using an abdominal artery as an inflow.Ann Thorac Surg. 2006; 82: 69-73Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar] is an expansion of their vast experience with utilization of abdominal arteries as composite bypass conduits focusing on a difficult subset of patients with porcelain aortas. The techniques of utilizing abdominal visceral arteries as inflow conduits and the mobilization of the triangular ligament of the left lobe of the liver to maximize conduit length and eliminate kinking are well thought out and clearly described. This information can be beneficial to the surgeon when reoperating patients with extensive and diffuse vascular disease involving the aorta. However, it should be noted that in many of the cases presented, alternative strategies could have been easily used. Although the authors avoid the usage of “T” grafts because they state there is a high incidence of string sign bilateral ITA grafting and “T” or “Y” grafts have clearly demonstrated an acceptable early and late mortality [4Tector A.J. McDonald M.L. Kress D.C. Downey F.X. Schmahl T.M. Purely internal thoracic artery grafts outcomes.Ann Thorac Surg. 2001; 72: 450-455Abstract Full Text Full Text PDF PubMed Scopus (70) Google Scholar, 5Wendler O. Hennen B. Demertzis S. et al.Circulation. 2000; 102: III-79-III-83Crossref Google Scholar]. Moreover in 6 of the cases presented, SVGs were utilized as part of the composite graft. In 8 other patients who underwent primary coronary artery bypass grafting with abdominal visceral arteries as inflow grafts, 2 had SVG aortic proximal anastomoses and 3 had composite SVG grafts. It should be noted that in each of these cases that if the aorta was truly “porcelain,” then there are other inflow options for the construction of composite arterial or SVG grafts. These include the innominate artery, descending aorta, and the construction of an ITA “T” or “Y” graft. Even though Takahashi and associates [1Takahashi K. Daitoku K. Nakata S. Oikawa S. Minakawa M. Kondo N. Early and mid-term outcome of anastomosis of gastroepiploic artery to left coronary artery.Ann Thorac Surg. 2004; 78: 2033-2036Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar, 2Takahashi K. Minakawa M. Kondo N. Oikawa S. Hatakeyama M. Coronary artery bypass surgery by the transdiaphragmatic approach.Ann Thorac Surg. 2002; 74: 700-703Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar] have vast experience in the utilization and creation of abdominal visceral grafts, most cardiothoracic surgeons are much more comfortable with avoidance of entering the abdominal cavity. They would rather create inflow anastomoses within the mediastinum or left chest. Moreover, the abdominal visceral grafts could be threatened if a later abdominal operation was required for cancer, inflammatory process, or rupture of a hallow viscus. The author’s conclusions are based on a small number of patients and sufficient data on graft quality is not available. The authors have shown that in experienced hands the use of abdominal visceral arteries for inflow conduits is safe and should be part of the thoracic surgeon’s armamentarium with limited graft inflow options. Coronary Artery Bypass Grafting Using an Abdominal Artery as an InflowThe Annals of Thoracic SurgeryVol. 82Issue 1PreviewIn multiple bypass surgery, when the ascending aorta cannot be used as an inflow, it is sometimes necessary to use an abdominal artery. This technique is useful when a re-median sternotomy might damage a patent graft in patients undergoing reoperations or when the gastroepiploic artery is unsuitable for use as a graft. Full-Text PDF

Laparoscopy-assisted right hepatic lobectomy using a wall-lifting procedure

This article describes a new technique for performing a laparoscopy-assisted right hepatic lobectomy using a hanger wall-lifting procedure. The patient is placed in the left semi-lateral position. A cholecystectomy and hemi-hepatic vascular inflow control are then performed through a midline incision, through which the resected liver can be removed. Next, the right lower chest and right upper abdominal wall are lifted by two wires vertical to the abdominal wall. Two ports, a 5-mm port in right lateral abdomen for forceps and a 12-mm port just right of the umbilicus for the laparoscope, are inserted. The obtained view of the operative field in the right upper abdominal cavity is thus excellent. The laparoscopy-assisted mobilization of the right hepatic lobe is done with the assistance of a hand inserted through the midline incision, including a dissection of the hepato-renal ligament, the right triangular ligament, and the right coronary ligament. A parenchymal dissection is then performed using the Cavitron Ultrasonic Surgical Aspirator (CUSA) and the resected specimen is passed through the midline incision without any morcellation of the liver. This procedure can minimize the length of the wound, while avoiding the lethal complications associated with pneumoperitoneum.

Hepatocellular carcinoma with mesothelioma‐like dissemination

Reported herein is a case of hepatocellular carcinoma (HCC) with unusual peritoneal dissemination masquerading as peritoneal mesothelioma. A 61-year-old man was clinically found to have multiple tumors in his abdominal cavity; peritonitis carcinomatosa was suspected. An autopsy revealed numerous tumors of various sizes in the abdominal serosa, omentum, and diaphragm. No signs of tumor, fibrosis, or cirrhosis were found in the liver, except for a small nodule in the hepatic triangular ligament. Histologically, the tumor cells proliferated in thick trabeculae or in sheets and formed a few canaliculi and tubules with homogenously brown contents in their lumina, which stained positively with Hall stain. Immunohistochemically, these tumors were positive for hepatocyte, alpha-fetoprotein (AFP) and low-molecular-weight cytokeratin; were focally positive for pan-cytokeratin and epithelial membrane antigen (EMA); and were negative for high-molecular-weight cytokeratin, vimentin, and calretinin. Carcinoembryonic antigen (CEA) produced a bile canalicular immunohistochemical staining pattern. Thus, the tumor was diagnosed as an HCC (Edmondson II type) of the triangular ligament with massive peritoneal dissemination. The origin of this tumor and its differential diagnosis (malignant mesothelioma, hepatoid adenocarcinoma, and hepatoid yolk sac tumor) are discussed.

Doppler assessment after right hepatectomy confirms the need to fix the remnant left liver in the anatomical position

The remnant left liver after right hepatectomy tends to rotate spontaneously into the right subphrenic space. This rotation might induce venous outflow impairment. The aim of this study was to assess immediate venous outflow in the left hepatic vein by intraoperative Doppler ultrasound (US) according to the position of the remnant liver. From August 2003 to February 2004, assessment of left hepatic venous outflow was systematically performed in 44 consecutive right hepatic resections by Doppler US in spontaneous and anatomical positions. The anatomical position was defined as the position in which the falciform ligament was in its strict median position. The placement of the left liver from the spontaneous position to the anatomical position resulted in a significant increase in left hepatic venous outflow (20.1 +/- 5.7 versus 8.5 +/- 4.4 cm/s; P < 0.0001). In the spontaneous position, the decrease in left hepatic venous outflow persisted even without division of the left triangular ligament (10.2 +/- 5.4 versus 21.7 +/- 5.3 cm/s in the anatomical position) or removal of the middle hepatic vein (8.4 +/- 3.4 versus 21.3 +/- 5.8 cm/s). : Results of this study strongly suggest that after right hepatectomy the remnant left liver should always be fixed in the anatomical position.

A Canine Model of Laparoscopic Segmental Liver Resection

Laparoscopic hepatectomy has been recently proposed for the treatment of liver tumors, however there is a lack of experimental models to study surgical technique and the metabolic reactions after this procedure. The dog is an important animal for research but the laparoscopic hepatectomy model is not well established in this animal. We describe the surgical laparoscopic technique of left liver segmentectomy in the dog and the preliminary results of this procedure. Female dogs weighting more then 15 kg were used. Four transversal abdominal incisions (two of 1 cm and two of 0.5 cm) were made for the introduction of the video camera and the other laparoscopic instruments. The liver was inspected and the left lobe was mobilized through incision of the left triangular hepatic ligament. The vascular pedicle corresponding to the left medial lobe (corresponding to segment II) was identified, dissected, and clamped, delimiting a correspondent ischemic area. The hepatic parenchyma was divided according to the previous delimitation with minimum bleeding. The segment of the liver was then removed through an enlarged abdominal incision. The incisions were closed by continuous suture. The mean time of the procedure was forty minutes. We observed normal clinical evolution without any sign of complications due to the hepatic resection, and normal augmentation of body weight on follow-up of more than 3 months. Left hepatectomy in the dog is a viable procedure and may serve for surgical training and development of research projects in this field.

Les lésions ligamentaires intracarpiennes associées aux fractures du poignet: Étude prospective radio-clinique sur 40 cas

Purpose of the study We performed a prospective study to search for arthrographic signs in favor of intracarpal ligament lesions occurring concomitantly with wrist fractures. We looked for a relationship between type of fracture and displacement and examined their impact on early functional outcome. Material and methods The series included 40 patients treated over a 1-year period. All 40 patients had a displaced wrist fracture requiring surgical treatment. A three-phase arthrography was performed during the initial operation in order to search for injuries involving the scapho-lunate, luno-pyramidal or triangular complex ligaments. A second arthrography was performed at the time the osteosynthesis material was removed. All patients were followed one year postperatively. Functional outcome was recorded at one year. Results Abnormal images were found in 57% of the patients at the first arthrography. Injury to the triangular complex predominated, followed by combined injuries. There was no statistical correlation between type of fracture, degree of displacement, and presence of ligament lesions (p > 0.05). Lesions of the triangular fibrocartilaginous complex (TFCC) were significantly increased (p = 0.04) in the event of intra-articular fracture. Age and gender did not influence ligament injury. At one year, the functional outcome was statistically comparable between patients with and without ligament injury. At the second arthrography, we observed only five cases where cure of the luno-pyramidal ligament had been achieved. Discussion Intracarpal ligament injuries associated with wrist fractures are frequent. Age had no effect on occurrence of ligament injury in our series, similar to findings reported by others. Likewise, the type of fracture had no effect. Data in the literature show that intra-articular fractures and highly-displaced fractures aggravate ligament injury. Our functional results at one year did not demonstrate any significant difference in patients with and without ligament injury. A 3 or 5-year follow-up might provide further insight. Nevertheless, neglected scapho-lunate lesions still have a bad reputation in the literature, leading us to search for such lesions and to provide adapted treatment in all patients aged less than 50 years presenting a displaced fracture of the wrist.

The terminal tendon of the digital extensor mechanism: Part I, anatomic study

The purpose of this study was to examine the anatomy of the terminal tendon (TT) and its relationship to adjacent structures. The extensor tendons of 56 cadaveric digits (52 fresh-frozen and 4 formalin-preserved) underwent anatomic dissection. The TT is a segment between the convergence of the lateral bands proximally and the bony insertion in the phalanx distally. The ulnar lateral bands were thicker than the radial bands. The average distance from the TT insertion to the germinal matrix of the nail bed was 1.4 mm. The triangular ligament (TL) is a thin layer of transverse fibers between the lateral bands proximal to the TT. The dimensions of the TT and the TL vary relative to the size of the digit with the largest often occurring in the middle, followed by the ring, index, and small finger. The transverse retinacular ligament (TRL) had a dorsal attachment to the lateral bands and was much more defined and distinct than the oblique retinacular ligament. The ulnar TRL often was thicker than the radial TRL. The TT is the primary structure responsible for extending the distal interphalangeal (DIP) joint. The function of the adjacent retinacular structures is to provide stability to the TT. The thin nature and proximity of the TT to the nail matrix must be kept in mind during surgery. Knowledge of the TT anatomy is necessary for further study of its kinematics and pathology and for diagnosis and management of its disorders.

Urgent inferior vena cava replacement with an autologous pericardium tube graft

Urgent inferior vena cava replacement with an autologous pericardium tube graft

High-resolution MR imaging of triangular fibrocartilage complex (TFCC): comparison of microscopy coils and a conventional small surface coil

To compare MR images of the triangular fibrocartilage complex (TFCC) using microscopy coils with those using a conventional surface coil qualitatively and quantitatively. Proton density-weighted images and T2*-weighted images of the TFCC from ten normal volunteers were obtained with a conventional surface coil (C4 coil; 80 mm in diameter), a 47-mm microscopy surface coil and a 23-mm microscopy surface coil) at 1.5 T. Qualitative image analysis of MR images with three coils was performed by two radiologists who assigned one of five numerical scores (0, nonvisualization; 1, poor; 2, average; 3, good; 4, excellent) for five TFCC components, which were disc proper, triangular ligament, meniscus homologue, ulnotriquetral and ulnolunate ligament. Quantitative analysis included the signal-to-noise ratio (S/N) of the disc proper of TFCC, the lunate cartilage, the lunate bone and the contrast-noise-ratio (C/N) between articular cartilage and disc proper or bone marrow were measured. All structures show higher scores qualitatively on MR with microscopy coils than those with a C4 coil, and the difference was significant with the exception of the ulnolunate ligament. MR with microscopy coils showed significantly higher S/N values than those with a conventional surface coil (P<0.05 to P<0.001). T2*-weighted images using microscopy coils showed significantly higher cartilage-disc proper C/N and cartilage-bone marrow C/N (P<0.01 to P<0.001). On proton density-weighted images, the C/N between cartilage and disc proper with two microscopy coils was significantly higher (P<0.01) than that with a conventional coil. High-resolution MR images of the normal wrist using microscopy coils were superior to those using a conventional surface coil qualitatively and quantitatively. High-resolution MR imaging with a microscopy coil would be a promising method to diagnose TFCC lesions.