Scapholunate instability: improved detection with semi-automated kinematic CT analysis during stress maneuvers.

Autor: Abou Arab W; Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, 29 avenue du Maréchal de Lattre de Tassigny, 54035, Nancy cedex, France. waled.abouarab@gmail.com., Rauch A; Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, 29 avenue du Maréchal de Lattre de Tassigny, 54035, Nancy cedex, France., Chawki MB; Nuclear Medecine Department, Central Hospital, University Hospital Center of Nancy, 29 avenue du Maréchal de Lattre de Tassigny, 54035, Nancy cedex, France., Dap F; Centre Chirurgical Emile Gallé, Nancy, France., Dautel G; Centre Chirurgical Emile Gallé, Nancy, France., Blum A; Lorraine University, IADI laboratory, UMR S 947, rue du Morvan, 54511, Vandoeuvre-lès-Nancy, France., Gondim Teixeira PA; Lorraine University, IADI laboratory, UMR S 947, rue du Morvan, 54511, Vandoeuvre-lès-Nancy, France.
Jazyk: angličtina
Zdroj: European radiology [Eur Radiol] 2018 Oct; Vol. 28 (10), pp. 4397-4406. Date of Electronic Publication: 2018 Apr 30.
DOI: 10.1007/s00330-018-5430-2
Abstrakt: Objectives: To evaluate the diagnostic performance of radioulnar deviation (RUD) and clenching fist (CF) maneuvers for the evaluation of scapholunate dissociation (SLD) using quantitative kinematic CT.
Methods: Thirty-seven patients with suspected scapholunate instability were prospectively evaluated with kinematic CT. Two radiologists independently evaluated the SLD during RUD and CF maneuvers. Various dynamic parameters describing SLD were compared (maximal value, variation coefficient and range) in patients with and without scapholunate ligament ruptures confirmed by CT arthrography.
Results: SLD in CF varied from 3.17 ± 0.38 to 3.24 ± 0.80 mm in controls and from 4.11 ± 0.77 and 4.01 ± 0.85 mm in patients with scapholunate ligament ruptures for reader 1 and 2 (p < 0.009). SLD in RUD varied from 3.35 ± 0.51 and 3.01 ± 0.78 mm in controls and from 4.51 ± 1.26 to 4.42 ± 1.75 mm in patients with scapholunate ligament ruptures for reader 1 and 2 (p varied from 0.001 to 0.002). The inter-observer variability was better for RUD (ICC = 0.85 versus 0.6 for RUD and CF respectively).
Conclusion: Analysis of SLD using kinematic CT has shown significant measurement differences between the groups with or without scapholunate instability with good diagnostic performance.
Key Points: • Kinematic CT can quantitatively assess scapholunate dissociation. • SLD analysis on kinematic CT has excellent reproducibility with radioulnar deviation maneuver. • Scapholunate dissociation was significantly different in patients with and without instability. • Diagnostic performance for scapholunate instability identification was better with radioulnar deviation.
Databáze: MEDLINE
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