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7 T MRI Matches 3 T for Diagnosing Wrist Ligament Injuries

MRI at 7 tesla (T) and 3 T field strengths showed similar accuracy in detecting triangular fibrocartilage complex (TFCC) and scapholunate ligament (SLL) injuries, according to a new study. Although some injuries were missed, MRI identified additional pathologies not seen on arthroscopy, supporting its complementary role in diagnosis. METHODOLOGY: This prospective study (May 2020 to April 2024) included 24 patients with a suspected TFCC or SLL injury (median age, 34 years; 29.2% women) who underwent both 7 T and 3 T MRI examinations followed by arthroscopy. Four musculoskeletal radiologists independently evaluated MRI examinations in a randomised order, comparing findings to wrist arthroscopy results. Sensitivity, specificity, area under the curve (AUC), and other parameters were estimated for each MRI field strength. TAKEAWAY: For TFCC injuries, 7 T MRI had a sensitivity of 0.85, specificity of 0.68, and AUC of 0.82, whereas 3 T MRI had a sensitivity of 0.75, specificity of 0.73, and AUC of 0.77. For SLL injuries, 7 T MRI had a sensitivity of 0.70, specificity of 0.65, and AUC of 0.74, whereas 3 T MRI had a sensitivity of 0.69, specificity of 0.55, and AUC of 0.70. For both TFCC and SLL injuries, no statistically significant difference was found between 7 T and 3 T MRI compared with arthroscopy. In 58% of patients, MRI identified additional pathologies including tendon injuries and ganglia, which were essential for a complete diagnosis. IN PRACTICE: "Neither MRI at 7 T nor 3 T can replace wrist arthroscopy, but MRI is an important complementary tool in the diagnostic workup of suspected wrist ligament injuries, with the ability to diagnose additional types of pathologies not accessible with arthroscopy," the authors wrote. SOURCE: This study was led by Simon Götestrand, Lund University, Lund, Sweden. It was published online on May 08, 2025, in European Radiology . LIMITATIONS: This study was limited by a likely selection bias as all patients were scheduled for arthroscopy, increasing the probability of injury. The small sample size also limited the statistical power. DISCLOSURES: Open access funding was provided by Lund University. The authors reported having no conflicts of interest.