University of Wisconsin–Madison

Comparison of CUBE versus MRA and Conventional MRI in the Detection of Ligament Tears and Cartilage Defects in the Wrist

June 2010 to November 2010

The purpose of the study is to prospectively compare the diagnostic performance of different magnetic resonance imaging sequences in evaluating the joint cartilage and ligaments of the wrist in cadavers. Accurate assessment of either cartilage damage or ligament injuries of the wrist is imperative in determining the etiology of persistent wrist pain and guiding treatment. Previous studies have shown rather low sensitivity and specificity in detecting these injuries (range of 50-70% and 65-86%, respectively), which is likely due to the small size of these structures in the wrist and the use of low field strength magnetic resonance imaging (weaker magnet strength – 1.5 Tesla). The use of high field strength magnetic resonance imaging (stronger magnet strength – 3 Tesla) however, can produce images with increased resolution and thinner section thickness potentially improving the accuracy of diagnosing wrist injuries in a noninvasive manner. In this study, we will compare CUBE, which is a new magnetic resonance imaging pulse sequence that allows three dimensional acquisition in a short time period and reconstructions in any plane, with our current routine magnetic resonance imaging protocol and routine magnetic resonance arthrogram protocol (images obtained following injection of dilute gadolinium contrast into the radiocarpal (wrist) joint). In addition, comparison between imaging performed on a 1.5T scanner versus a 3.0T scanner will be evaluated. Twenty-thirty fresh frozen cadaver wrists will be imaged and will subsequently undergo arthroscopy (surgical visualization) – the current gold standard – performed by an Orthopedic Surgeon. The images will be analyzed by three musculoskeletal radiologists and compared to findings at the time of arthroscopy (reference standard) to determine accuracy, sensitivity and specificity of each of the imaging protocols.

This project led by: Humberto Rosas, MD