In this prospective study a total of 47 patients, 25 men and 22 women, who showed clinical signs of wrist instability (chronic or acute) underwent both direct MRI artrography and native high-resolution MRI using 47mm microscopic coil. The average age of the patients was 30,7 years, within the range of 21 - 43 years.

All of patients had pain in the wrist joint and during clinical examination and positive signs of instability were detected. Patients were examinated with the MR device Philips Achieva with field strength 1.5 Tesla using a microscopy coil (micro 47 grant coil); the examination was performed without contrast agent. The patients were examined in gantry with the limb along the body with palm facing the pad. The examination was performed on the coronal plane with T1 TSE and 3D SPIR sequence, on the sagittal plane with the PD SPAIR sequence and on the transversal plane with mFFE WATS sequence (Tab.1).

Table 1. Protocol of examination with a microscopy coil

Subsequently, the patients were examined with direct MR arthrography. In the magnetic resonance preparating room, mixture of contrast agent was applied into their radiocarpal joint area in aseptic conditions; the puncture was performed at the level of the joint cavity between the running of the tendons of the extensor policis longus muscle and extensor indicis muscle. Patients were examined in the identical position, with their hand along the body, but with the help of a 8-channel dedicated wrist coil (wrist coil 8). The examinations were performed sagittally with T1 TSE, coronally with T1 TSE, T1 TSE SPIR and PD sequence and transversally with 3D WATSf sequence (Tab.2).

Table 2. Protocol of examination -direct MR arthrography

 Examinations were evaluated independently by two radiologist specialized in musculosceletal radiology and for evaluating ligament damage was used classification system based on Geissler arthroscopic classification of scapholunate lesions. IV-grade scale was used in the classification; grade I ligament was considered as undamaged, grade II with the changes of ligament signal but without its clear tear, grade III in partial ligament tear, with evaluation of localisation of tear - in the volar and/or dorsal portion of  the scapholunate ligament; grade IV corresponds with complete ligament tear.   The processing was performed in the software IBM SPSS Statistics, Version 21. For the summarization of classification correspondence, contingency tables were used.  To assess the statistical significance of the relationship in the contingency table, Fisher’s exact test was used; to evaluate the strength of the association, Cohen’s kappa coefficient and Cramer’s V coefficient were used.