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. 2025 May 8.
doi: 10.1007/s00330-025-11656-4. Online ahead of print.

MRI of wrist ligament trauma was similar at 7 T and 3 T with arthroscopy as a reference standard

Simon Götestrand  1   2 , Magnus Flondell  3   4 , Björn Lundin  5   6 , Elena Aksyuk  6 , Rami Abu Shalhoub  6 , Pawel Szaro  7   8 , Erik Hedström  5   6   9   10 , Anders Björkman  4   11   12 , Mats Geijer  5   7   8
Affiliations

MRI of wrist ligament trauma was similar at 7 T and 3 T with arthroscopy as a reference standard

Simon Götestrand et al. Eur Radiol. .

Abstract

Objectives: The aim was to compare the diagnostic accuracy of magnetic resonance imaging (MRI) at 7 Tesla (T) and 3 T in patients with clinically suspected injury of the triangular fibrocartilage complex (TFCC) or the scapholunate ligament (SLL) using wrist arthroscopy as a reference standard.

Methods: Twenty-four patients scheduled for wrist arthroscopy due to suspected TFCC or SLL injury were examined with 7-T and 3-T MRI before arthroscopy. Four musculoskeletal radiologists independently evaluated the MR examinations in randomized order, and the findings were compared to those at wrist arthroscopy.

Results: Sensitivity, specificity, and accuracy for TFCC injuries were 0.85, 0.68, and 0.82 for 7 T and 0.75, 0.73, and 0.77 for 3 T, respectively. For SLL injuries, the corresponding values were 0.70, 0.65, and 0.74 for 7 T and 0.69, 0.55, and 0.70 for 3 T, respectively. For both TFCC and SLL injuries, no statistically significant difference between 7 T and 3 T was found, and the confidence intervals for accuracy overlapped (0.67-0.94 vs 0.63-0.88 for TFCC injuries and 0.59-0.89 vs 0.52-0.86 for SLL injuries). In 14 of 24 patients (58%), MRI contributed findings of additional types of injuries, e.g., tendon injuries and ganglia, vital for a complete diagnosis.

Conclusions: The diagnostic accuracy of MRI at 7 T was similar to 3 T for detecting injury to the TFCC and the SLL. A majority of injuries were correctly diagnosed by MRI, but some injuries found using arthroscopy were missed.

Key points: Question Previous studies have found that MRI cannot reliably diagnose or rule out TFCC or SLL injury, compared to the current reference standard wrist arthroscopy. Findings The diagnostic accuracy for MRI at 7 T was similar to 3 T for detecting injuries to the TFCC and the SLL. Clinical relevance Although MRI cannot replace wrist arthroscopy, it is an important complementary tool in the diagnostic workup of suspected wrist ligament injuries, with the ability to diagnose additional types of pathologies not accessible by arthroscopy.

Keywords: Arthroscopies; Articular Ligaments; Imaging (Magnetic Resonance); Injuries (Wrist); Triangular Fibrocartilage Complex.

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Conflict of interest statement

Compliance with ethical standards. Guarantor: Mats Geijer. Conflict of interest: The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. Statistics and biometry: No complex statistical methods were necessary for this paper. Informed consent: Written informed consent was obtained from all subjects (patients) in this study. Ethical approval: Institutional Review Board approval was obtained. Study subjects or cohorts overlap: The MR exams of two of the participants were also assessed/graded in a previous study. However, the analyses/data from that previous study were not reused, and had a different focus. For the present study, the MR exams were assessed/graded again, with different clinical questions, so the data is new. The previous study (also included as a PDF): Götestrand et al [9]. Methodology: Prospective/retrospective Diagnostic or prognostic study Performed at one institution

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