PMID- 35586350
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 14
IP  - 4
DP  - 2022 Apr
TI  - Analyzing Chronological Change in Postoperative Magnetic Resonance Imaging 
      Results in Patients With Kienbock's Disease by Using an Original Grading System.
PG  - e24178
LID - 10.7759/cureus.24178 [doi]
LID - e24178
AB  - Background and objective Signal changes in MRI for Kienbock's disease have only 
      been qualitatively assessed so far. In light of this, we proposed a new grading 
      system for quantitative analysis with an ordinal scale. Methods The study 
      included 31 patients (17 men, 14 women) with Kienbock's disease. By referring to 
      Nakamura's MRI grading system, we devised a grading system with five grades 
      (Grades 1-5) using proton density-weighted (PDW) coronal images with respect to 
      the signal intensity of the lunate. All cases were examined by using the MRI 
      grading system by three hand surgeons, both preoperatively and postoperatively. 
      We evaluated the inter-rater reliability of our grading system by using the 
      interclass correlation coefficient. After surgery, we implemented annual MRI 
      evaluation for as long as possible and quantitatively assessed changes in MRI 
      grades. We also investigated the correlation between postoperative MRI grades, 
      Mayo Wrist Scores (MWS), and age at the surgery by using Pearson's coefficient. 
      Results The MRI evaluation was performed 2-15 years after surgery. The 
      reliability of our grading system was high; inter-rater interclass correlation 
      coefficients were 0.783 (examiners 1-2), 0.780 (examiners 1-3), and 0.825 
      (examiners 2-3), representing a substantial agreement. The correlation 
      coefficient between the MRI grade and MWS was -0.31, suggesting a mild negative 
      correlation; postoperative MRI grade also correlated with age at surgery 
      (Pearson's coefficient: 0.447). Conclusions Our proposed MRI grading system has 
      high reliability and could be used to assess the regeneration of a necrotic 
      lunate for quantitative analysis on an ordinal scale. Improvements were observed 
      one to four years postoperatively, demonstrating a mild correlation with the 
      clinical results.
CI  - Copyright (c) 2022, Ogawa et al.
FAU - Ogawa, Takeshi
AU  - Ogawa T
AD  - Department of Orthopedic Surgery, National Hospital Organization, Mito Medical 
      Center, Ibaraki, JPN.
FAU - Ikumi, Akira
AU  - Ikumi A
AD  - Department of Orthopedic Surgery and Sports Medicine, Tsukuba University Hospital 
      Mito Clinical Education and Training Center, Mito, JPN.
FAU - Kohyama, Sho
AU  - Kohyama S
AD  - Department of Orthopedic Surgery, Kikkoman General Hospital, Noda, JPN.
FAU - Hara, Yuki
AU  - Hara Y
AD  - Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 
      Tsukuba, JPN.
FAU - Yoshii, Yuichi
AU  - Yoshii Y
AD  - Department of Orthopedic Surgery, Tokyo Medical University Ibaraki Medical 
      Center, Ibaraki, JPN.
FAU - Ochiai, Naoyuki
AU  - Ochiai N
AD  - Department of Orthopedic Surgery, Kikkoman General Hospital, Noda, JPN.
FAU - Yamazaki, Masashi
AU  - Yamazaki M
AD  - Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 
      Tsukuba, JPN.
LA  - eng
PT  - Journal Article
DEP - 20220416
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC9109422
OTO - NOTNLM
OT  - kienbock's disease
OT  - magnetic resonance imaging
OT  - necrotic lunate
OT  - ordinal scale
OT  - proton density weighted image
OT  - quantitative analysis
COIS- The authors have declared that no competing interests exist.
EDAT- 2022/05/20 06:00
MHDA- 2022/05/20 06:01
PMCR- 2022/04/16
CRDT- 2022/05/19 02:23
PHST- 2022/04/15 00:00 [accepted]
PHST- 2022/05/19 02:23 [entrez]
PHST- 2022/05/20 06:00 [pubmed]
PHST- 2022/05/20 06:01 [medline]
PHST- 2022/04/16 00:00 [pmc-release]
AID - 10.7759/cureus.24178 [doi]
PST - epublish
SO  - Cureus. 2022 Apr 16;14(4):e24178. doi: 10.7759/cureus.24178. eCollection 2022 
      Apr.