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Article

MRI of Finger Pulleys at 7T—Direct Characterization of Pulley Ruptures in an Ex Vivo Model

1
Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Maximiliansplatz 3, 91054 Erlangen, Germany
2
Department of Orthopedics, University Medical Center, 18055 Rostock, Germany
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Institute of Neuroanatomy, Medical Faculty, University of Bonn, 53115 Bonn, Germany
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Institute of Anatomy and Cell Biology, FAU Erlangen-Nürnberg, Krankenhausstraße 9, 91054 Erlangen, Germany
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Department of Radiology, Boston University School of Medicine, Boston, MA 02118, USA
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Division of Medical Physics in Radiology, German Cancer Research Centre (DKFZ), 69120 Heidelberg, Germany
7
Institute of Neuroradiology and Radiology, Klinikum Fürth, Jakob-Henle-Str. 1, 90766 Fürth, Germany
*
Author to whom correspondence should be addressed.
Academic Editor: Sven Nebelung
Diagnostics 2021, 11(7), 1206; https://doi.org/10.3390/diagnostics11071206
Received: 8 June 2021 / Revised: 29 June 2021 / Accepted: 30 June 2021 / Published: 3 July 2021
(This article belongs to the Special Issue Advanced MRI Techniques for Musculoskeletal Imaging)
The aim of this study was to evaluate 7 Tesla (7T) magnetic resonance imaging (MRI) for direct visualization and specific characterization of the finger flexor pulleys A2, A3, and A4 before and after ex vivo pulley rupture. Thirty fingers of human cadavers were examined before and after pulley disruption with a 26 min clinical 7T pulse sequence protocol. Images were assessed by two experienced radiologists for the presence of pulley rupture. Injury characterization included definition of rupture location, morphology, and complications. Image quality was evaluated according to a 4-point Likert-type scale from “not evaluable” to “excellent”. Macroscopic preparations were used as the reference standard. Direct characterization of intact A2, A3, and A4 pulleys and the corresponding pulley lesions was possible in all cases. The rupture location was distributed equally at the radial, ulnar, and central parts of the pulleys. A dislocation and intercalation of the pulley stump between the flexor tendon and finger phalanges was observed as a complication in 62.5% of cases. The average Likert score for direct visualization of pulleys was 2.67 before rupture and 2.79 after rupture creation, demonstrating adequate image quality for routine application. 7T MRI enables a direct characterization of A2, A3, and A4 pulleys before and after artificial disruption, including the definition of rupture morphology and location as well as the detection of rupture complications. This promises a precise presurgical evaluation of pulley injuries and complicated pulley stump dislocations. View Full-Text
Keywords: finger flexor pulleys; ultra-high-field MRI; imaging; injury classification; climbing finger flexor pulleys; ultra-high-field MRI; imaging; injury classification; climbing
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MDPI and ACS Style

Heiss, R.; Librimir, A.; Lutter, C.; Janka, R.; Kuerten, S.; Roemer, F.W.; Nagel, A.M.; Uder, M.; Bayer, T. MRI of Finger Pulleys at 7T—Direct Characterization of Pulley Ruptures in an Ex Vivo Model. Diagnostics 2021, 11, 1206. https://doi.org/10.3390/diagnostics11071206

AMA Style

Heiss R, Librimir A, Lutter C, Janka R, Kuerten S, Roemer FW, Nagel AM, Uder M, Bayer T. MRI of Finger Pulleys at 7T—Direct Characterization of Pulley Ruptures in an Ex Vivo Model. Diagnostics. 2021; 11(7):1206. https://doi.org/10.3390/diagnostics11071206

Chicago/Turabian Style

Heiss, Rafael, Alexander Librimir, Christoph Lutter, Rolf Janka, Stefanie Kuerten, Frank W. Roemer, Armin M. Nagel, Michael Uder, and Thomas Bayer. 2021. "MRI of Finger Pulleys at 7T—Direct Characterization of Pulley Ruptures in an Ex Vivo Model" Diagnostics 11, no. 7: 1206. https://doi.org/10.3390/diagnostics11071206

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