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J Korean Radiol Soc. 1996 May;34(5):657-662. Korean. Original Article.
Byun KH , Suh KJ , Oh HH , Kim TG , Lee SK , Ryeom HK , Kim YJ , Kang DS , Cheong HY .
Department of Diagnostic Radiology, Kyungpook National University Hospital, Korea.

PURPOSE: To evaluate the MRI appearance of Kienbock's disease and correlate this with radiographic findings. MATERIALS AND METHODS: Thirteen clinically confirmed cases of 12 patients with kienbock's disease wereretrospectively reviewed. The significance of signal intensity and pattern of Kienbock's disease on MR images was evaluated and the findings on MR images were compared with radiographic stages classified by Lichtman. Enhanced MR images were abtained in four cases. RESULTS: Lichtman's stage I accounted for one case; stage II, two; stage III, eight; stage IV, two. On T1-weighted MR images, the lunate showed focal low signal intensity in the stage I caseand in one of the two stage II case. Eleven wrists demonstrated a generalized loss of lunate signal. On T2-weighted images, the stage I case showed focal high signal intensity. In stage II, one showed focal low signal intensity and the other exhibited generalized low signal intensity with a high spot area. In stage III, five ofeight cases showed generalized low signal intensity, and one demonstrated high signal intensity. Two showed a high spot area within the generalized low signal intensity. In stage IV, one showed generalized low signal intensity and the other exhibited high signal intensity. No enhancement was seen in the three lesions with focal orgeneralized low signal intensity both on T1 and T2-weighted images. Conversely, one lesion with low signalintensity on T1-weighted imaes and high signal intensity on T2-weighted images showed contrast enhancement. CONCLUSION: Low signal intensity of the lunate on T1-weighted images is a consistent findings of Kienbock's disease. However, further studies such as follow-up MRIs, or pathologic correlation studies and MR contrast enhancement studies will be necessary to evaluate the sighificance of high signal intensity on T2-weighted images.

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