Cargando…
Can the Diagnostics of Triangular Fibrocartilage Complex Lesions Be Improved by MRI-Based Soft-Tissue Reconstruction? An Imaging-Based Workup and Case Presentation
Introduction. The triangular fibrocartilage complex (TFCC) provides both mobility and stability of the radiocarpal joint. TFCC lesions are difficult to diagnose due to the complex anatomy. The standard treatment for TFCC lesions is arthroscopy, posing surgery-related risks onto the patients. This fe...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi Publishing Corporation
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5303600/ https://www.ncbi.nlm.nih.gov/pubmed/28246600 http://dx.doi.org/10.1155/2017/5870875 |
_version_ | 1782506736630890496 |
---|---|
author | Hammer, Niels Hirschfeld, Ulrich Strunz, Hendrik Werner, Michael Wolfskämpf, Thomas Löffler, Sabine |
author_facet | Hammer, Niels Hirschfeld, Ulrich Strunz, Hendrik Werner, Michael Wolfskämpf, Thomas Löffler, Sabine |
author_sort | Hammer, Niels |
collection | PubMed |
description | Introduction. The triangular fibrocartilage complex (TFCC) provides both mobility and stability of the radiocarpal joint. TFCC lesions are difficult to diagnose due to the complex anatomy. The standard treatment for TFCC lesions is arthroscopy, posing surgery-related risks onto the patients. This feasibility study aimed at developing a workup for soft-tissue reconstruction using clinical imaging, to verify these results in retrospective patient data. Methods. Microcomputed tomography (μ-CT), 3 T magnetic resonance imaging (MRI), and plastination were used to visualize the TFCC in cadaveric specimens applying segmentation-based 3D reconstruction. This approach further trialed the MRI dataset of a patient with minor radiological TFCC alterations but persistent pain. Results. TFCC reconstruction was impossible using μ-CT only but feasible using MRI, resulting in an appreciation of its substructures, as seen in the plastinates. Applying this approach allowed for visualizing a Palmer 2C lesion in a patient, confirming ex postum the arthroscopy findings, being markedly different from MRI (Palmer 1B). Discussion. This preliminary study showed that image-based TFCC reconstruction may help to identify pathologies invisible in standard MRI. The combined approach of μ-CT, MRI, and plastination allowed for a three-dimensional appreciation of the TFCC. Image quality and time expenditure limit the approach's usefulness as a diagnostic tool. |
format | Online Article Text |
id | pubmed-5303600 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Hindawi Publishing Corporation |
record_format | MEDLINE/PubMed |
spelling | pubmed-53036002017-02-28 Can the Diagnostics of Triangular Fibrocartilage Complex Lesions Be Improved by MRI-Based Soft-Tissue Reconstruction? An Imaging-Based Workup and Case Presentation Hammer, Niels Hirschfeld, Ulrich Strunz, Hendrik Werner, Michael Wolfskämpf, Thomas Löffler, Sabine Biomed Res Int Research Article Introduction. The triangular fibrocartilage complex (TFCC) provides both mobility and stability of the radiocarpal joint. TFCC lesions are difficult to diagnose due to the complex anatomy. The standard treatment for TFCC lesions is arthroscopy, posing surgery-related risks onto the patients. This feasibility study aimed at developing a workup for soft-tissue reconstruction using clinical imaging, to verify these results in retrospective patient data. Methods. Microcomputed tomography (μ-CT), 3 T magnetic resonance imaging (MRI), and plastination were used to visualize the TFCC in cadaveric specimens applying segmentation-based 3D reconstruction. This approach further trialed the MRI dataset of a patient with minor radiological TFCC alterations but persistent pain. Results. TFCC reconstruction was impossible using μ-CT only but feasible using MRI, resulting in an appreciation of its substructures, as seen in the plastinates. Applying this approach allowed for visualizing a Palmer 2C lesion in a patient, confirming ex postum the arthroscopy findings, being markedly different from MRI (Palmer 1B). Discussion. This preliminary study showed that image-based TFCC reconstruction may help to identify pathologies invisible in standard MRI. The combined approach of μ-CT, MRI, and plastination allowed for a three-dimensional appreciation of the TFCC. Image quality and time expenditure limit the approach's usefulness as a diagnostic tool. Hindawi Publishing Corporation 2017 2017-01-29 /pmc/articles/PMC5303600/ /pubmed/28246600 http://dx.doi.org/10.1155/2017/5870875 Text en Copyright © 2017 Niels Hammer et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Hammer, Niels Hirschfeld, Ulrich Strunz, Hendrik Werner, Michael Wolfskämpf, Thomas Löffler, Sabine Can the Diagnostics of Triangular Fibrocartilage Complex Lesions Be Improved by MRI-Based Soft-Tissue Reconstruction? An Imaging-Based Workup and Case Presentation |
title | Can the Diagnostics of Triangular Fibrocartilage Complex Lesions Be Improved by MRI-Based Soft-Tissue Reconstruction? An Imaging-Based Workup and Case Presentation |
title_full | Can the Diagnostics of Triangular Fibrocartilage Complex Lesions Be Improved by MRI-Based Soft-Tissue Reconstruction? An Imaging-Based Workup and Case Presentation |
title_fullStr | Can the Diagnostics of Triangular Fibrocartilage Complex Lesions Be Improved by MRI-Based Soft-Tissue Reconstruction? An Imaging-Based Workup and Case Presentation |
title_full_unstemmed | Can the Diagnostics of Triangular Fibrocartilage Complex Lesions Be Improved by MRI-Based Soft-Tissue Reconstruction? An Imaging-Based Workup and Case Presentation |
title_short | Can the Diagnostics of Triangular Fibrocartilage Complex Lesions Be Improved by MRI-Based Soft-Tissue Reconstruction? An Imaging-Based Workup and Case Presentation |
title_sort | can the diagnostics of triangular fibrocartilage complex lesions be improved by mri-based soft-tissue reconstruction? an imaging-based workup and case presentation |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5303600/ https://www.ncbi.nlm.nih.gov/pubmed/28246600 http://dx.doi.org/10.1155/2017/5870875 |
work_keys_str_mv | AT hammerniels canthediagnosticsoftriangularfibrocartilagecomplexlesionsbeimprovedbymribasedsofttissuereconstructionanimagingbasedworkupandcasepresentation AT hirschfeldulrich canthediagnosticsoftriangularfibrocartilagecomplexlesionsbeimprovedbymribasedsofttissuereconstructionanimagingbasedworkupandcasepresentation AT strunzhendrik canthediagnosticsoftriangularfibrocartilagecomplexlesionsbeimprovedbymribasedsofttissuereconstructionanimagingbasedworkupandcasepresentation AT wernermichael canthediagnosticsoftriangularfibrocartilagecomplexlesionsbeimprovedbymribasedsofttissuereconstructionanimagingbasedworkupandcasepresentation AT wolfskampfthomas canthediagnosticsoftriangularfibrocartilagecomplexlesionsbeimprovedbymribasedsofttissuereconstructionanimagingbasedworkupandcasepresentation AT lofflersabine canthediagnosticsoftriangularfibrocartilagecomplexlesionsbeimprovedbymribasedsofttissuereconstructionanimagingbasedworkupandcasepresentation |