ÖZET

Amaç:

Amacımız, kıkırdağa özgün manyetik rezonans görüntüleme (MRG) sekansları kullanarak değişik lunat morfolojilerinin triangüler fibrokartilaj (TFK) üzerindeki etkilerini araştırmaktı. İkincil olarak MRG ve posteroanterior el bilek grafilerinde lunat tiplerini ayırmada daha iyi parametreler tanımlamayı amaçladık.

Gereç ve Yöntem:

Koronal 3B dual echo steady state ve 2D multi-echo data image combination MR görüntüleri kullanılarak 118 nötral varyanslı el bileği MR incelemesinde lunat ve hamat kemiklerin karşılıklı temas eden kıkırdak yüzeyi olup olmamasına göre lunat tiplendirmesi yapıldı. Ayrı bir seansta posteroanterior el bilek grafilerinde lunat tipleri değerlendirildi. MRG’de TFK, hamat ve lunat eklem kıkırdak lezyonları değerlendirildi. Koronal MRG ve grafilerden lunat-hamat (L-H) ve kapitat-trikuetrum (K-T) mesafeleri ölçüldü. Lunat tipleri ile kıkırdak lezyonları arasındaki ilişkinin değerlendirilmesinde X2, Fisher’s exact test, t-test veya Mann-Whitney U testleri kullanıldı. İki lunat tipini ayırmada en iyi eşik değeri tespit etmede ROC eğrisi analizi kullanıldı.

Bulgular:

Ortalama yaş 38,5±13,4 (E:K=33:85) idi. TFC ve lunat kıkırdak lezyonları ile lunat tipleri arasında ilişki saptanmadı. MR’de L-H/K-T MR için 0,907, direct grafilerde 0,75 lunat tiplerini ayırmada en yüksek duyarlılık ve özgüllüğü gösterdi. Tip 2 morfoloji hamatta kıkırdak dejenerasyonu ile korele bulundu (p=0,003). Yaş, hamat, lunat ve TFC kıkırdak lezyonları ile ilişkili bulundu (sırasıyla p=0,008, p=0,003, p<0,001).

Sonuç:

Nötral varyanslı el bileklerinde lunat tiplerinin TFC ve lunat kıkırdak üzerinde etkisi gözlenmezken tip 2 lunat morfolojisi hamat kıkırdak dejenerasyonu ile korele bulundu. Yaş, her üç kıkıdak yüzeydeki dejeneratif değişiklikler ile koreleydi.

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Kıkırdağa Özgün MR Sekansları ile Lunat Tipleri ve Bunların Triangüler Fibrokartilaja Etkisinin Değerlendirilmesi

ÖZET

References