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The Value of Three-Dimensional MR Imaging in Displaying Triangular Fibrocartilage Complex

Muhebullah Alizada, Boyu Chen, Guoguang Fan, Mirwais Alizada

Introduction: Triangular fibrocartilage complex (TFCC) plays a vital role in stabilizing the ulnar side of the wrist, whose injury potentially causes ulnar sided wrist pain. Conventional 2D-MR sequences have limitations in exhibiting the fine anatomy of TFCC. A three-dimensional fast spin-echo pulse sequence with parallel imaging and extended echo train acquisition (3D-FSE-CUBE) sequence is a sensitive imaging technique for ligaments and articular cartilage. It can completely replace 2D FSE in clinical application to complex joint examination, which helps improve the accuracy of diagnosis. The number of researches on the wrist joint is minimal. Therefore, we applied the 3D cube sequence to estimate its diagnostic significance in the wrist joint.

Materials and Methods: Seventeen adult healthy volunteers (11 males and six females) were enrolled, which in total makes thirty-four wrist joints, aged 22-42 years old (mean ± SD; 29.00 ± 4.42). We utilized conventional MRI and 3D cube sequences to examine all of these volunteers’ wrist joints, measure the signal-to-noise ratio (SNR) of each sequence, and record the display rate of TFCC structures in each sequence. We compared SNR among the various sequences by using a paired t-test, and the difference was statistically significant with P ≤ 0.05.

Results: The 3D Cube-T2 sequence has a higher display rate compared to the 2D-FSE-T2 for displaying ulnolunate (UL), ulnotriquetral (UT), and Ulnar collateral ligaments. The 3D-Cube-T1 sequence has a higher display rate compared to the 2D-FSE-T1 sequence for UL, UT, and Ulnar collateral ligaments. The SNR of 3D-Cube-T1 is significantly higher when compared with 2D-FSE-T1 (p = 0.00). A significant difference between the SNR of 3D Cube-T2 and 2D-FSE-T2 was not noticed (p = 0.56).

Conclusion: Coronal 3D cube sequence has better SNR and a higher TFCC display rate, which can be used as a routine sequence to observe TFCC and its surrounding ligaments.