THE SCAPHOLUNATE INTEROSSEOUS LIGAMENT IN MR ARTHROGRAPHY OF THE WRIST - CORRELATION WITH NONENHANCED MRI AND WRIST ARTHROSCOPY

Objective. To compare three-compartment MR wrist arthrography with non -enhanced MRI in correlation with wrist arthroscopy, and to evaluate t he potential of MR arthrography for consistently visualizing all parts of the scapholunate interosseous ligament of the wrist (SLIL) and exa ctly diagnosing the site and extent of SLIL defects. Design and Patien ts. In 41 patients with wrist pain (34 patients with wrist pain for mo re than 6 months) plain radiographs, stress views, nonenhanced MRI and three-compart ment MR arthrography were done within 2 h of each other , using three-dimensional volume acquisition (0.6-1.0 mm effective sli ce thickness) with a gradient-recalled echo sequence and a 1.5-T magne t. The MR arthrography findings were compared with the findings from n on-enhanced MRI and correlated with the arthroscopic findings in all p atients. Results. The dorsal, central and palmar segments of the SLIL could be delineated exactly by MR arthrography in 95% of the patients; with non-enhanced MRI only 28% of SLIL segments were seen consistentl y. Demonstration of SLIL defects was possible with high diagnostic con fidence in 42% of SLIL segments by non-enhanced MRI and in 94% by MR a rthrography. With wrist arthroscopy as the standard of reference, sens itivity and specificity values for SLIL perforations were 52%/34% for non-enhanced MRI and 90%/87% for MR arthrography. Conclusions. MR arth rography, using three-dimensional volume acquisition with thin slices (0.6-1.0 mm), combines the advantages of three-compartment arthrograph y and nonenhanced MRI. It shows the precise location and magnitude of ligamentous defects of all parts of the SLIL, correlates well with wri st arthroscopy and has potential implications for diagnosis and treatm ent planning.