Magnetic resonance imaging of injury to the medial collateral ligament of the elbow: A cadaver model

The purposes of this study were to evaluate the usefulness of thin-section 3-dimensional Fourier Transform (3DFT) gradient echo imaging of the medial collateral ligament and to evaluate the usefulness of intraarticular gadolinium for the detection of tears of the ligament. Magnetic resonance imaging was performed on 5 fresh-frozen cadaveric elbows through use of T1-weighted and 3DFT gradient echo T2-weighted sequences. The elbows were then arthroscoped, and lesions were created in the medial collateral ligaments. Magnetic resonance imaging was then repeated with the T1 and 3DFT sequences. In addition, dilute gadolinium was then injected intraarticularly, and fat-suppressed T1-weighted images and 3DFT images were obtained. Magnetic resonance imaging findings were correlated with the appearance of the dissected ligament. We found that in the prearthroscopy specimens, the ligament was best seen on the 3DFT images reformatted into a slightly posteriorly obliqued coronal plane. In the postarthroscopy elbows, 4 full-thickness perforations were detected with the 3DFT sequence; fat-suppressed T1-weighted images with intraarticular gadolinium detected these 4 as well as 1 partial inner surface tear. In conclusion, fat-suppressed T1-weighted magnetic resonance arthrography with gadolinium can provide information regarding inner surface partial tears and small full-thickness perforations. (J Shoulder Elbow Surg 2000;9:418-22.)