METHODS: Both wrists of ten patients with unilateral SLL tears (six partial, four complete tears) as diagnosed by clinical-standard MRI were imaged during continuous active radioulnar motion using a 1.5-T MRI scanner in combination with a custom-made motion device. Following automatic segmentation of the wrist, the scapholunate and lunotriquetral joint widths were analyzed across the entire range of motion (ROM). Mixed-effects model analysis of variance (ANOVA) followed by Tukey\'s posthoc test and two-way ANOVA were used for statistical analysis.
RESULTS: With the increasing extent of SLL tear, the scapholunate joint widths in injured wrists were significantly larger over the entire ROM compared to those of the contralateral healthy wrists (p<0.001). Differences between partial and complete tears were most pronounced at 5°-15° ulnar abduction (p<0.001). Motion patterns and trajectories were altered. Complete SLL deficiency resulted in complex alterations of the lunotriquetral joint widths.
CONCLUSIONS: Real-time MRI may improve the functional diagnosis of SLL insufficiency and aid therapeutic decision-making by revealing dynamic forms of dissociative instability within the proximal carpus. Static MRI best differentiates SLL-injured wrists at 5°-15° of ulnar abduction.
方法:10例单侧SLL撕裂患者的两个手腕(6例,使用1.5-TMRI扫描仪结合定制的运动装置,在连续活动的径向臂运动过程中对临床标准MRI诊断出的四次完全撕裂)进行成像。在自动分割手腕之后,在整个运动范围(ROM)内分析了肩胛骨和颈肌关节宽度.使用混合效应模型方差分析(ANOVA),然后进行Tukeyposthoc检验和双向ANOVA进行统计分析。
结果:随着SLL撕裂程度的增加,与对侧健康手腕相比,受伤手腕的肩胛骨关节宽度在整个ROM上明显更大(p<0.001)。部分撕裂和完全撕裂之间的差异在5°-15°尺骨外展时最为明显(p<0.001)。运动模式和轨迹被改变。完全的SLL缺乏导致了腔三足关节宽度的复杂改变。
结论:实时MRI可改善SLL功能不全的功能诊断,并通过揭示近端腕骨内分离不稳定的动态形式来辅助治疗决策。静态MRI最好区分尺骨外展5°-15°SLL损伤的手腕。