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Diagnostic performance of high-resolution ultrasound in the evaluation of intrinsic and extrinsic wrist ligaments after trauma.
Ultraschall in der Medizin 2023 March 32
UNLABELLED: ENGLISH ABSTRACT Purpose. To investigate the role of ultrasound (US) in the evaluation of intrinsic and extrinsic ligaments of the wrist having magnetic resonance arthrography (MRA) as the reference standard.
MATERIALS AND METHODS: This prospective study included patients referred for MRA after wrist trauma. US examination was performed just before MRA. On the dorsal and palmar sides of the wrist, the intrinsic interosseus and midcarpal, extrinsic and collateral ligaments were evaluated. MRA was performed on a 1.5-T unit. In the first 20 patients included, ligament thickness was independently assessed using US and MRA and thickness reproducibility was calculated. Ligament integrity was evaluated in all patients.
RESULTS: Thirty-eight patients (22 men, 16 women; mean age: 38 years) were included. Ligament thickness reproducibility ranged between 44% of the palmar ulnocapitate ligament and 71% of the palmar scaphotriquetral ligament. US had 100% sensitivity, specificity, positive and negative predictive values, accuracy in identifying tears of the palmar (n=8) and dorsal (n=3) bands of the scapholunate ligament and the ulnar collateral ligament (n=3). It had 100% sensitivity, 97% specificity, 50% positive predictive value, 100% negative predictive value, 97% accuracy in identifying tears of the palmar ulnolunate ligament (n=1).
CONCLUSION: Compared to MRA, US showed good reproducibility in the assessment of wrist ligament thickness and similar accuracy in identifying tears of the scapholunate, palmar ulnolunate and ulnar collateral ligaments. GERMAN ABSTRACT N/A.
MATERIALS AND METHODS: This prospective study included patients referred for MRA after wrist trauma. US examination was performed just before MRA. On the dorsal and palmar sides of the wrist, the intrinsic interosseus and midcarpal, extrinsic and collateral ligaments were evaluated. MRA was performed on a 1.5-T unit. In the first 20 patients included, ligament thickness was independently assessed using US and MRA and thickness reproducibility was calculated. Ligament integrity was evaluated in all patients.
RESULTS: Thirty-eight patients (22 men, 16 women; mean age: 38 years) were included. Ligament thickness reproducibility ranged between 44% of the palmar ulnocapitate ligament and 71% of the palmar scaphotriquetral ligament. US had 100% sensitivity, specificity, positive and negative predictive values, accuracy in identifying tears of the palmar (n=8) and dorsal (n=3) bands of the scapholunate ligament and the ulnar collateral ligament (n=3). It had 100% sensitivity, 97% specificity, 50% positive predictive value, 100% negative predictive value, 97% accuracy in identifying tears of the palmar ulnolunate ligament (n=1).
CONCLUSION: Compared to MRA, US showed good reproducibility in the assessment of wrist ligament thickness and similar accuracy in identifying tears of the scapholunate, palmar ulnolunate and ulnar collateral ligaments. GERMAN ABSTRACT N/A.
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