Added Diagnostic Value of CT Arthrography to MR Arthrography in Suspected Wrist Internal Derangement
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 60
- 主要终点
- Percentage of Patients With Additional Wrist Pathologies Detected by Adding CT Arthrography to MR Arthrography
研究概览
简要总结
The wrist is a complex joint made up of small bones, cartilage, and stabilizing ligaments, including the triangular fibrocartilage complex (TFCC) and intrinsic carpal ligaments. Because these structures are small and intricate, diagnosing internal joint damage (internal derangement) after trauma or chronic pain can be challenging.
Magnetic resonance arthrography (MRA), an imaging scan performed after injecting a contrast dye into the joint, is widely used because it shows soft tissues clearly. However, MRA can sometimes miss subtle bone fragments, cartilage defects, or partial ligament tears due to lower spatial resolution. Computed tomography arthrography (CTA) provides higher-detail spatial imaging and excels at identifying small bone injuries and ligament tears, though it offers less soft-tissue contrast than MRI.
The purpose of this study is to determine whether performing CT arthrography in addition to MR arthrography improves the detection and characterization of internal wrist pathologies compared with MR arthrography alone.
Participants enrolled in this study will:
- Undergo a clinical history taking and examination regarding their wrist symptoms.
- Receive an ultrasound-guided injection into the radiocarpal joint using a sterile mixture containing iodinated contrast, gadolinium contrast, saline, and a local numbing medication (xylocaine).
- Undergo a high-resolution CT scan of the wrist immediately following the injection.
- Undergo a 1.5T MR arthrography scan.
Researchers will compare the findings between the two imaging techniques to evaluate how often adding CT arthrography identifies additional lesions that were occult or inconclusive on MR arthrography.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Diagnostic
- 盲法
- None
入排标准
- 年龄范围
- 15 Years 至 60 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients aged 15 to 60 years.
- •Clinically suspected ligamentous, cartilage, tendon, or occult osseous wrist injury.
- •Patients scheduled for MR arthrography of the wrist.
排除标准
- •History of previous wrist surgery.
- •Acute fractures requiring emergency management.
- •Active wrist infection.
- •Contraindications to iodinated or gadolinium-based contrast agents.
- •Regional metallic implants causing significant imaging artifacts.
- •Pregnancy.
研究组 & 干预措施
Combined CT and MR Arthrography
Participants with clinically suspected wrist internal derangement receive an ultrasound-guided intra-articular injection into the radiocarpal joint using a combined mixture of iodinated contrast, gadolinium-based contrast, sterile saline, and xylocaine. Immediately following the injection, participants undergo high-resolution computed tomography arthrography (HRCT) of the affected wrist. This is followed by 1.5T magnetic resonance arthrography (MRA) with pre-contrast and post-contrast T1 SPIR sequences in axial, coronal, and sagittal planes to assess wrist internal derangement.
干预措施: Combined CT Arthrography and MR Arthrography (Diagnostic Test)
结局指标
主要结局
Percentage of Patients With Additional Wrist Pathologies Detected by Adding CT Arthrography to MR Arthrography
时间窗: Baseline
Assessed as the proportion of participants in whom CT arthrography identifies additional internal derangement lesions (including intrinsic scapholunate and lunotriquetral ligament tears, central triangular fibrocartilage complex tears, cartilage defects, and occult osseous abnormalities) that were missed, occult, or inconclusive on MR arthrography alone.
次要结局
未报告次要终点
研究者
Norhan Anwar Kamal El Dein Hussien
Resident of Diagnostic and Interventional Radiology
Assiut University