Abstract
Amaç: Özellikle el-ayak bileği olmak üzere omuz ve kalça eklemlerinde Magnetik Rezonans Artrografi (MRArt) tetkikinin eklem içi patolojiler ile eklem yüzeyine bakan tendon-ligaman patolojilerinde tanıda Magnetik Rezonans Görüntüleme (MRG) tetkikine ne kadar ek yarar sağladığı ortaya konulmaya çalışılacaktır. Yöntem: Ocak 2018 ile Haziran 2019 tarihleri arasında Ortopedi ve Travmatoloji Ana bilim dalına başvuran farklı şikayet ve ön tanıları olan 25 olguda el bileğine, 12 olguda ayak bileğine, beş olguda omuz eklemine, yedi olguda kalça eklemine MRG ve MRArt tetkiki yapıldı. Konvansiyonel MRG ve MRArt görüntüleri ayrı ayrı hem hasta bazında hem de toplu olarak değerlendirildi. Yöntemler arası uyum değerlendirilmesinde Kappa hesaplaması kullanıldı. Bulgular: MRArt tetkiki; el bileği ekleminde %68, ayak bileği ekleminde %50, omuz ekleminde %80, kalça ekleminde %28 oranında MRG tetkikine ek bulgu vermiştir. Tüm eklemler beraber değerlendirildiğinde %57 oranında MRArt tetkiki ek bulgu sağlamıştır. Sonuç: Omuz ekleminde özellikle labral patolojilerde ve ligaman yırtıklarında, kalça ekleminde labral patolojilerde, el bileği ekleminde özellikle ligaman yırtıklarında, ayak bileği ekleminde osteokondral defekt (OCD) kontrolünde ve ligaman yırtıklarında MRArt tetkikinin MRG tetkiki ile birlikte değerlendirildiğinde anlamlı katkısı bulunmaktadır.
Supporting Institution
Yoktur
Thanks
Mersin Üniversitesi Radyoloji ve Ortopedi Ana Bilim Dalları öğretim üyelerine ve Bioistatistik Ana Bilim Dalından Doç. Gülhan Örekici Temel’e teşekkür ederim.
References
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- 7. Oneson SR, Timins ME, Scales LM, et al. MR imaging diagnosis of triangular fibrocartilage pathology with arthroscopic correlation. Am J Roentgenol. 1997; 168: 1513-1518.
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- 9. Rosenberg ZS, Beltran J, Bencardino JT. MR imaging of the ankle and foot. Radiographics. 2000; 20:153-179.
- 10. Stoller DW, Ferkel RD. The ankle and foot. In: Stoller DW, ED. Magnetic resonance imaging in orthopaedics and sports medicine. 3rd ed. Baltimore: Lippincott Williams&Wilkins. 2007.P.733-1050.
- 11.Cerezal L, Abascal F, Canga A, et al. Magnetic resonance artrography of the ankle: indications and technique (II). Lower limp. RADIOLOGIA 2006;48(6):357-368.
- 12.Schmid MR, Pfirrmann CW, Hodler J, et al. Cartilage lesions in the ankle joint: comparison of MR arthrography and CT artrography. Skeletal Radiol 2003; 32:259-265.
- 13. Farmer KD, Hughes PM: MR artrography of the shoulder: fluoroscopyically guided technique using a posterior approach. AJR AM J Roentgenol 2002; 178:433-434.
- 14. Catalano OA, Manfredi R, Vanzulli A, et al.: MR Artrography of the glenohumeral joint: modified posterior approach without imaging guidance. Radiology 2007; 242:550-554.
- 15. Morag Y, Jacopson JA, Shields G, et al. MR artrography of rotator inerval, long head of the biceps brachii, and biceps pulley of the shoulder. Radiology 2005; 235: 21-30.
- 16. Robinson G, Ho Y, Finlay K, et al. Normal anatomy ana common labral lesions an MR arthrography of the shoulder. Clin Radiol 2006; 61(10): 805-821.
- 17. Palmer WE, Caslowitz PL. Anterior shoulder instabilty: diagnostic criteria determined from prospective analysis of 121 MR artrograms. Radiology 1995, 197: 819-825.
- 18. Guntern DV, Pfirmann CW, Schmid MR, et al. Articular cartilage lesions of the glenohumeral joint: diagnostic effectiveness of MR arthrography and prevalence in patients with subacromial impingement syndrome. Radiology. 2003; 226(1): 165-170.
- 19. Keeney JA, Peelle MW, Jackson J, et al. Magnetc resonance arthrography versus arthroscopy in the evaluation of articular hip pathology. Clin Orthop Relat Res 2004; 429:163-169.
- 20. Pfirmann CW, Megiardi B, Dora C, et al. Cam and pincer femoroacetabular impingement: characteristic MR arthrographic findings in 50 patients. Radiology 2006; 240(3): 778-785.
Abstract
Aim: It was tried to reveal the additional benefit of Magnetic Resonance Arthrography (MRArt) examination in the shoulder and hip joints, especially the hand-ankle, to the Magnetic Resonance Imaging (MRI) examination in the diagnosis of intra-articular pathologies and tendon-ligament pathologies facing the joint surface. Method: Between January 2018 and June 2019, MRI and MRArt were performed on the wrist in 25 cases, ankle in 12 cases, shoulder in 5 cases, and hip joint in 7 cases with different clinical complaints and pre-diagnoses who applied to the Department of Orthopedics and Traumatology. Conventional MRI and MRArt images were evaluated separately on patient basis and collectively. Kappa calculation was used to calculate agreement between methods. Results: MRArt examination provided additional findings to MRI examination in 68% of the wrist joint, 50% of the ankle joint, 80% of the shoulder joint and 28% of the hip joint. When all joints were evaluated together, 57% of the MRArt examination provided additional findings. Conclusion: Especially in labral pathologies and ligament tears in the shoulder joint, especially ligament tears in the wrist joint, labral pathologies in the hip joint, osteochondral defect (OCD) control in the ankle joint, MRArt examination has a significant contribution when evaluated together with MRI.
References
- 1. Erden İ. Kas-iskelet manyetik rezonans uygulamaları. Ankara: Türk manyetik rezonans derneği, 2007.
- 2. Kaya T. Kas iskelet yumuşak doku radyolojisi. Bursa: Nobel&Güneş Tıp Kitapevi, 2008.
- 3. Maizlin ZV, Brown JA, Clement JJ, et al. MR arthrography of the wrist: Controversies and Concepts. Hand (N Y). 2009; 4(1): 66-73.
- 4. Hobby JL, Tom BD, Bearcroft PW, et al. AK. Magnetic resonance imaging of the wrist: diagnostic performance statistics. Clin Radiol. 2001; 56: 50-57. 5. Khoury V, Harris PG, Cardinal E. Cross-sectional imaging of internal derangement of the wrist with arthroscopic correlation. Semin Musculoskelet Radiol. 2007; 11: 36-47.
- 6. Braun H, Kenn W, Schneider S, et al. Direct MR arthrography of the wrist: value in detecting complete and partial defects of intrinsic ligaments and the TFCC in comparison with arthroscopy. Rofo. 2003; 175: 1515-1524.
- 7. Oneson SR, Timins ME, Scales LM, et al. MR imaging diagnosis of triangular fibrocartilage pathology with arthroscopic correlation. Am J Roentgenol. 1997; 168: 1513-1518.
- 8. Naraan KN, Zoga AC. Osteochondral lesions about the ankle. Radiol clin N am. 2008; 46:995-1002.
- 9. Rosenberg ZS, Beltran J, Bencardino JT. MR imaging of the ankle and foot. Radiographics. 2000; 20:153-179.
- 10. Stoller DW, Ferkel RD. The ankle and foot. In: Stoller DW, ED. Magnetic resonance imaging in orthopaedics and sports medicine. 3rd ed. Baltimore: Lippincott Williams&Wilkins. 2007.P.733-1050.
- 11.Cerezal L, Abascal F, Canga A, et al. Magnetic resonance artrography of the ankle: indications and technique (II). Lower limp. RADIOLOGIA 2006;48(6):357-368.
- 12.Schmid MR, Pfirrmann CW, Hodler J, et al. Cartilage lesions in the ankle joint: comparison of MR arthrography and CT artrography. Skeletal Radiol 2003; 32:259-265.
- 13. Farmer KD, Hughes PM: MR artrography of the shoulder: fluoroscopyically guided technique using a posterior approach. AJR AM J Roentgenol 2002; 178:433-434.
- 14. Catalano OA, Manfredi R, Vanzulli A, et al.: MR Artrography of the glenohumeral joint: modified posterior approach without imaging guidance. Radiology 2007; 242:550-554.
- 15. Morag Y, Jacopson JA, Shields G, et al. MR artrography of rotator inerval, long head of the biceps brachii, and biceps pulley of the shoulder. Radiology 2005; 235: 21-30.
- 16. Robinson G, Ho Y, Finlay K, et al. Normal anatomy ana common labral lesions an MR arthrography of the shoulder. Clin Radiol 2006; 61(10): 805-821.
- 17. Palmer WE, Caslowitz PL. Anterior shoulder instabilty: diagnostic criteria determined from prospective analysis of 121 MR artrograms. Radiology 1995, 197: 819-825.
- 18. Guntern DV, Pfirmann CW, Schmid MR, et al. Articular cartilage lesions of the glenohumeral joint: diagnostic effectiveness of MR arthrography and prevalence in patients with subacromial impingement syndrome. Radiology. 2003; 226(1): 165-170.
- 19. Keeney JA, Peelle MW, Jackson J, et al. Magnetc resonance arthrography versus arthroscopy in the evaluation of articular hip pathology. Clin Orthop Relat Res 2004; 429:163-169.
- 20. Pfirmann CW, Megiardi B, Dora C, et al. Cam and pincer femoroacetabular impingement: characteristic MR arthrographic findings in 50 patients. Radiology 2006; 240(3): 778-785.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Publication Date | December 15, 2021 |
| Submission Date | September 22, 2020 |
| Acceptance Date | February 26, 2021 |
| Published in Issue | Year 2021 Volume: 14 Issue: 3 |
Cite
MEU Journal of Health Sciences Assoc was began to the publishing process in 2008 under the supervision of Assoc. Prof. Gönül Aslan, Editor-in-Chief, and affiliated to Mersin University Institute of Health Sciences. In March 2015, Prof. Dr. Caferi Tayyar Şaşmaz undertook the Editor-in Chief position and since then he has been in charge.
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