Scapholunate ligament: normal MR appearance on three-dimensional gradient-recalled-echo images

Abstract

Purpose: To evaluate the (a) capability of coronal three-dimensional (3D) gradient-recalled-echo (GRE) images in the demonstration of the volar, middle, and dorsal portions of the scapholunate ligament (SLL); (b) normal magnetic resonance (MR) appearance of these portions and of their attachment to the lunate and scaphoid; and (c) normal appearance of the ligament-cartilage interface for various portions of the SLL.

Materials and methods: Coronal 3D GRE imaging was used to study the volar, middle, and dorsal portions of the SLL in 14 patients with an arthroscopically normal SLL and in five cadaveric wrists that had a normal SLL proved with dissection.

Results: The trapezoidal volar portion of the SLL was seen with inhomogeneous high intermediate signal intensity and attached directly to the lunate and scaphoid cortex. The triangular middle portion was seen with inhomogeneous intermediate signal intensity and in most cases attached to the hyaline cartilage of the lunate and scaphoid. The low-signal-intensity bandlike dorsal portion attached either to the cartilage, cartilage and cortex, or cortex alone of the lunate and scaphoid.

Conclusion: The volar, middle, and dorsal portions of the SLL can be differentiated on the basis of MR appearance on 3D GRE images. The various portions attach to cartilage and/or to cortex, and the appearance of the ligament-cartilage interface follows a specific pattern.