目的:本协议的目的是通过专家组使用Delphi技术建立基于证据的关于远端尺尺关节(DRUJ)不稳定和三角纤维软骨复合体(TFCC)损伤成像的共识声明。
方法:19位手外科医师制定了关于DRUJ不稳定性和TFCC损伤的初步问题清单。放射科医师根据文献和作者的临床经验做出陈述。在三个迭代的Delphi回合中修改了问题和陈述。Delphi小组成员由27名肌肉骨骼放射科医生组成。小组成员以11项数字量表对每个陈述的一致程度进行评分。“0”,“5”和“10”的分数反映了完全的分歧,不确定的协议,并完全同意,分别。小组共识定义为80%或更多的小组成员的分数为“8”或更高。
结果:十四个陈述中的三个在第一轮Delphi中达成了小组共识,十个陈述在第二轮Delphi中达成了小组共识。德尔福第三轮也是最后一轮仅限于前几轮未达成小组共识的一个问题。
结论:基于Delphi的协议表明,在中性旋转中具有静态轴向切片的CT,内旋,旋后是治疗DRUJ不稳定性的最有用和最准确的成像技术。MRI是诊断TFCC病变最有价值的技术。MR关节造影和CT关节造影的主要适应症是TFCC的Palmer1B中央凹病变。
结论:MRI是评估TFCC病变的首选方法,与中心比周围异常更高的准确性。MR关节造影的主要适应症是评估TFCC中央凹插入病变和周围非Palmer损伤。
结论:•常规X线摄影应该是评估DRUJ不稳定性的初始成像技术。静态轴向切片处于中性旋转的CT,内旋,旋后是评估DRUJ不稳定性的最准确方法。•MRI是诊断引起DRUJ不稳定的软组织损伤的最有用的技术,尤其是TFCC病变。•MR关节造影和CT关节造影的主要适应症是TFCC的中央凹病变。
OBJECTIVE: The purpose of this agreement was to establish evidence-based
consensus statements on imaging of distal radioulnar joint (DRUJ) instability and triangular fibrocartilage complex (TFCC) injuries by an expert group using the Delphi technique.
METHODS: Nineteen hand surgeons developed a preliminary list of questions on DRUJ instability and TFCC injuries. Radiologists created statements based on the literature and the authors\' clinical experience. Questions and statements were revised during three iterative Delphi rounds. Delphi panelists consisted of twenty-seven musculoskeletal radiologists. The panelists scored their degree of agreement to each statement on an 11-item numeric scale. Scores of \"0,\" \"5,\" and \"10\" reflected complete disagreement, indeterminate agreement, and complete agreement, respectively. Group
consensus was defined as a score of \"8\" or higher for 80% or more of the panelists.
RESULTS: Three of fourteen statements achieved group
consensus in the first Delphi round and ten statements achieved group
consensus in the second Delphi round. The third and final Delphi round was limited to the one question that did not achieve group
consensus in the previous rounds.
CONCLUSIONS: Delphi-based agreements suggest that CT with static axial slices in neutral rotation, pronation, and supination is the most useful and accurate imaging technique for the work-up of DRUJ instability. MRI is the most valuable technique in the diagnosis of TFCC lesions. The main indication for MR arthrography and CT arthrography are Palmer 1B foveal lesions of the TFCC.
CONCLUSIONS: MRI is the method of choice for assessing TFCC lesions, with higher accuracy for central than peripheral abnormalities. The main indication for MR arthrography is the evaluation of TFCC foveal insertion lesions and peripheral non-Palmer injuries.
CONCLUSIONS: • Conventional radiography should be the initial imaging technique in the assessment of DRUJ instability. CT with static axial slices in neutral rotation, pronation, and supination is the most accurate method for evaluating DRUJ instability. • MRI is the most useful technique in diagnosing soft-tissue injuries causing DRUJ instability, especially TFCC lesions. • The main indications for MR arthrography and CT arthrography are foveal lesions of the TFCC.