MRI of the Wrist

Marcos Loreto Sampaio, MD; Nicholas M. Kolanko, MD


Appl Radiol. 2014;43(10) 

In This Article

MRI Protocol

While varying among institutions, a typical wrist MRI protocol is shown in Table 1. It employs a small field of view (8 to 10 cm), and section thickness varies from 2mm to 3mm. A thinner section sequence (up to 1mm) is normally added (2D or 3D GRE T2* or more recent volumetric3D turbo spin echo proton density fat saturation sequences), which allows for multiplanar reconstruction in isotropic acquisitions. 3T MRI is preferable to 1.5T, given the better signal-to-noise ratio, contrast, and resolution of the images, all of which increase diagnostic accuracy.[2] Direct or indirect MR arthrography (for both 1.5T and 3T) is employed as the standard of care in many institutions for assessing internal derangement, as multiple studies demonstrate the accuracy advantage of these techniques, particularly of 3T MR arthrography. However, whether arthrography is necessary for all cases remains unclear. Given the technological advances in MRI systems, dedicated coils and new sequences, the authors perform 3T MRI as a default at our institution, and reserve arthrography for selected postoperative cases, or for cases of clinical-radiological mismatch in which surgery is being considered.[3–8]