Eklem patolojilerinde MR artrografinin tanıya katkısı

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.

Anahtar Kelimeler:

magnetik rezonans görüntüleme, labrum, ligaman, magnetik rezonans artrografi

The contrıbutıon of MRI arthrography to dıagnosıs ın joınt pathologıes

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.

Keywords:

Magnetic Resonance Imaging, Magnetik Resonance Arthrography, labrum, ligament,

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