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(Radiology. 2001;218:118-125.)
© RSNA, 2001

Experimental Studies

Lateral Ulnar Collateral Ligament of the Elbow: Optimization of Evaluation with Two-dimensional MR Imaging1

John A. Carrino, MD, William B. Morrison, MD, Kelly H. Zou, PhD, Richard T. Steffen, MD, William N. Snearly, MD and Peter M. Murray, MD

1 From the Department of Radiology, Harvard Medical School, Brigham and Women’s Hospital, Boston, Mass (J.A.C., K.H.Z.); the Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (W.B.M.); the Department of Orthopedic Surgery, Wilford Hall Medical Center, Lackland Air Force Base, Tex (R.T.S.); TMC Advanced Imaging, Glendale, Ariz (W.N.S.); and the Department of Orthopedic Surgery, University of Kentucky School of Medicine, Lexington (P.M.M.). Received March 9, 2000; revision requested April 11; revision received May 17; accepted June 28. Address correspondence to J.A.C., Department of Radiology, Thomas Jefferson University Hospital, 11 S 11th St, Suite 3390, Philadelphia, PA 19107-5091 (e-mail: john.carrino@mail.tju.edu).

PURPOSE: To compare, in a cadaveric model, magnetic resonance (MR) imaging techniques with differing contrast and spatial resolution properties in the evaluation of disruption of the lateral ulnar collateral ligament (LUCL) at the elbow.

MATERIALS AND METHODS: LUCL tears were surgically created in eight of 28 cadaveric elbow specimens. All specimens underwent 1.5-T MR imaging with the following pulse sequences: T1-weighted spin echo (SE), intermediate-weighted fast SE, fat-suppressed T2-weighted fast SE, gradient-recalled echo (GRE) with high spatial resolution, intermediate-weighted fast SE with high spatial resolution, and fat-suppressed T1-weighted SE with intraarticular administration of gadopentetate dimeglumine (MR arthrography). All images were obtained in the oblique coronal plane. Two radiologists independently graded the LUCL with separate and side-by-side assessment.

RESULTS: Areas under the receiver operating characteristic curve were as follows for readers A and B, respectively: T1-weighted SE imaging, 0.64 and 0.62; intermediate-weighted fast SE imaging, 0.87 and 0.67; T2-weighted fast SE imaging, 0.68 and 0.69; GRE imaging, 0.56 and 0.68; MR arthrography, 0.84 and 0.85; and intermediate-weighted imaging with high spatial resolution, 0.92 and 0.88. Interobserver reliability was poor with T1-weighted SE imaging ({kappa} = 0.13) and GRE imaging ({kappa} = 0.18), fair with T2-weighted fast SE imaging ({kappa} = 0.36), and moderate with MR arthrography ({kappa} = 0.46), intermediate-weighted fast SE imaging ({kappa} = 0.55), and intermediate-weighted imaging with high spatial resolution ({kappa} = 0.59).

CONCLUSION: Intermediate-weighted imaging with high spatial resolution and MR arthrography showed the greatest overall ability to enable the diagnosis of LUCL tears.

Index terms: Elbow, injuries, 42.482 • Elbow, MR, 42.121411, 42.121412, 42.121415, 42.121419 • Magnetic resonance (MR), arthrography, 42.121419 • Magnetic resonance (MR), comparative studies, 42.121411, 42.121412, 42.121415, 42.121419 • Magnetic resonance (MR), pulse sequences, 42.121411, 42.121412, 42.121415, 42.121419




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