Magnetic resonance imaging of triangular fibrocartilage

Due to their small size and complex structure, diagnosing injury of the proximal wrist ligamentous structures can be challenging. The triangular fibrocartilage complex (TFCC) is an example of one such structure, for which lesions may be missed unless high-resolution magnetic resonance imaging (MRI) obtained via a standard matrix with a small field of view or high-resolution imaging matrix (small spatial scale matrix elements/large matrix size) is utilized. While there have been recent advances in increasing MRI spatial resolution, attempts at improved visualization by isolated increase in the spatial resolution will be ineffective if the signal-to-noise ratio (SNR) of the images obtained is low. Additionally, high contrast resolution is important to facilitate a more precise visualization of these structures and their pathology. Thus, a balance of the three important imaging factor qualifications of high spatial resolution, high SNR, and high contrast resolution must be struck for optimized TFCC and wrist imaging. The goal of this article, then, is to elucidate the theory and techniques of effective high-resolution imaging of the proximal ligamentous structures of the wrist, balancing SNR and high contrast resolution constraints, and focusing on imaging of the TFCC as a prototypical example.