Extrinsic Carpal Ligaments: Normal MR Arthrographic Appearance in Cadavers

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Abstract
To describe the normal magnetic resonance (MR) arthrographic anatomy of the major carpal ligaments (excluding scapholunate and lunotriquetral ligaments) and their osseous attachments by using standard imaging planes. MR images of 22 wrists derived from fresh human cadaveric hands were obtained after tricompartmental arthrography. The MR arthrographic appearance of the carpal ligaments and their bone attachments were analyzed and correlated to those seen on anatomic sections. Two readers determined in consensus which was the best plane to observe the course and attachment sites for each ligament. They further analyzed the size and sites of attachment of these ligaments in two orthogonal planes chosen for optimal viewing. Each ligament was well seen as a hypointense linear structure with MR arthrography. The radioscaphocapitate, radiolunotriquetral, radioscapholunate, dorsal radiotriquetral, palmar scaphotriquetral, and dorsal scaphotriquetral ligaments were best evaluated in the transverse plane. The palmar and dorsal ulnotriquetral and ulnolunate ligaments were best visualized in the sagittal plane. The radial collateral ligament was best analyzed in the coronal plane. The attachment sites of all ligaments were best analyzed either in the transverse or sagittal planes. MR arthrography allows visualization of the carpal ligaments. Detailed knowledge of the normal appearance of these ligaments can serve as a baseline for future studies in which MR arthrography is used to characterize wrist instability.

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