Ankle Traction During MRI of Talar Dome Osteochondral Lesions

Lee, Ryan Ka Lok; Griffith, James F.; Law, Eric K. C.; Ng, Alex Wing Hung; Yeung, D.

doi:10.2214/ajr.17.17873

Cited by 8 publications

(9 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Traction force also enabled the dispersion of fluid to the space between the cartilage and subchondral bone, so that articular cartilage separation from bone could be depicted on MRI. 16 In the present study, articular cartilage separation from bone or instability of the osteochondral fragment could be depicted on CT with traction. Moreover, the requisite duration of traction is much shorter than that of MRI, which is important since patients may feel discomfort due to the traction force during MRI.…”

Section: Discussionmentioning

confidence: 70%

“…As a means of increasing the separation between the articular surfaces of the tibial and talar cartilage for quantitative MRI, MRI combined with axial traction has been attempted. 1,13,16 In these reports, axial traction allowed assessment of articular cartilage delineation without affecting image quality. It has been shown that computed tomography (CT) with axial traction could depict articular cartilage separation from bone, 16 while subchondral bone evaluation was not significantly different with or without traction.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of Articular Cartilage Injury Using Computed Tomography With Axial Traction in the Ankle Joint

et al. 2018

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 70%

mentioning

confidence: 99%

Evaluation of Articular Cartilage Injury Using Computed Tomography With Axial Traction in the Ankle Joint

et al. 2018

View full text Add to dashboard Cite

show abstract

“…This makes MRI evaluation more challenging, especially in distinguishing be- tween MR grade I and grade IIA ( Figure 3). Small FOV imaging helps optimize resolution of the talar dome articular cartilage, providing a better signal-to-noise ratio even at 1.5T MRI than standard MRI at 3T (15,16).…”

Section: Discussionmentioning

confidence: 99%

“…In a study conducted by Lee et al, they could increase the joint space width with traction in small FOV coil. Although this method can improve the cartilage surface visibility of talar dome, the risk is still potential (15). The results of some published studies show that MRI has the ability to display osteochondral lesions of the talus with accuracies ranging from 65.9% to 83.0% (18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging of Osteochondral Lesions of the Talus: Comparison Between Small FOV Surface Coil with BLADE and Boot-Shape Coil Without BLADE

Sun

Hao

et al. 2019

Iran J Radiol

View full text Add to dashboard Cite

Background: It is common for osteochondral lesions of the talus (OLT) to be associated with ankle injury, residual ankle stiffness and pain after osteochondral injuries, and OLTs are most common in the dome of the talus. Before choosing the appropriate therapy based on diagnosis, it is necessary to determine if the OLT is a stabile lesion or not. More accurate diagnosis and classifications could be conducted to guide the clinical treatment. Objectives: To compare the accuracy rate and diagnostic indices of proton-density fat-saturation BLADE (proprietary name for periodically rotated overlapping parallel lines with enhanced reconstruction in magnetic resonance systems from Siemens Healthcare) sequences from a small field of view (FOV) surface coil and proton-density fat-saturation sequences without BLADE in a routine FOV using a boot-shaped coil on the magnetic resonance imaging (MRI) of OLT. Patients and Methods: One hundred and one patients with ankle pain for greater than 6 weeks and normal X-ray participated in this study. They were ready for diagnosis by arthroscopy and treatment following MR examination. All patients were scanned by two different methods: (a) a coronal proton-density fat-saturated sequence with BLADE using a small FOV surface coil and (b) a coronal proton-density fat-saturated sequence without BLADE using a routine FOV boot coil. In this study, the arthroscopic results were regarded as the gold standard for assessing OLTs and were used to directly compare the ability of the two different scanning methods to produce accurate findings with regard to MR imaging of OLTs. Results: Of the 101 patients, 57 patients with cartilaginous injury were confirmed by the results of arthroscopy, and 44 patients were without cartilaginous injury. Forty-eight lesions had the same grade with the small FOV BLADE sequence MRI and arthroscopy, while 37 lesions had the same grade on routine FOV MRI and arthroscopy among 57 patients with cartilaginous injury. Among MR findings of 101 patients, the results of weighted Kappa, accuracy, sensitivity and specificity were 0.803, 90.10%, 84.21%, and 97.73%, respectively between small FOV and arthroscopy; 0.515, 75.25%, 64.91%, and 88.64%, respectively between routine FOV and arthroscopy. The accuracy rate, sensitivity and specificity of small FOV with BLADE were higher than routine FOV. Mc Nemar's test confirmed that the accuracy, sensitivity and specificity of small FOV BLADE were significantly better than routine FOV (P < 0.001). Greater values of small FOV compared to routine FOV appeared in sensitivity of 0.94 vs. 0.81 (MR normal and grade I), 0.89 vs. 0.77 (MR normal and grade I-IIA), 0.90 vs. 0.74 (MR normal and grade I-IIB), 0.91 vs. 0.75 (MR normal and grade I-III) and specificity of 0.98 vs. 0.92 (MR normal and grade I), the same in specificity of 0.91 vs. 0.91 (MR normal and grade I-IIA), 0.80 vs. 0.80 (MR normal and grade I-III), only smaller in specificity of 0.60 vs. 0.80 (MR normal and grade I-IIB). Conclusion: Small FOV surface coil with BLADE sequence grad...

show abstract

“…23,36,51,56 Most frequently, their location is described as the middle third of the medial or lateral talar dome, but also the anterior or posterior third may be affected. 5,8,28,56,62 As talar OCDs have a strong influence on the quality of life of patients, 5 successful treatment is important. Meanwhile, ankle arthroscopy has been defined as the gold standard for visualization, and treatment of talar OCDs is performed most frequently with debridement of the lesion and bone marrow stimulation by microfracture.…”

Section: Introductionmentioning

confidence: 99%

Accessibility to Talar Dome in Neutral Position, Dorsiflexion, or Noninvasive Distraction in Posterior Ankle Arthroscopy

2019

View full text Add to dashboard Cite

Background: Osteochondral lesions of the talus are frequent pathologies of the ankle joint. Especially through arthroscopy, the treatment is kept as minimally invasive as possible. However, there are some drawbacks as to the reachability because of the high congruency of the ankle joint. Here, either noninvasive distraction or maximal dorsiflexion may be an option for better access to the lesion. The purpose of this study was to evaluate maximal dorsiflexion compared to neutral position or noninvasive distraction of the ankle joint in the arthroscopic reachability of the talar dome. The hypothesis of this study was that maximal dorsiflexion would allow for greater accessibility of the talar dome compared to neutral position or noninvasive distraction of the joint. Methods: Twenty matched pairs (n=40) of anatomical ankle specimens were used. The effects of neutral position, maximal dorsiflexion, and noninvasive distraction of the ankle joint on arthroscopic accessibility of the ankle joint were tested. After disarticulation of the talus, reach was measured and compared between the 3 positions. Results: In neutral position, 13.7±1.2 mm of the talar dome was reached laterally and 14.0±1.0 mm medially. In maximal dorsiflexion, the distance was 19.0±1.1mm laterally and 19.8±1.4 mm medially, and in noninvasive distraction it was 16.1±1.5 mm laterally and 15.7±1.0 mm medially. The statistical comparison showed a significantly better reach in dorsiflexion laterally ( P = .003) and medially ( P = .026). Conclusion: Accessibility of the talar dome in maximal dorsiflexion was superior to that in neutral position or noninvasive distraction. Clinical Relevance: Results of this study may allow for better planning in arthroscopic treatment of osteochondral lesions of the talus.

show abstract

Ankle Traction During MRI of Talar Dome Osteochondral Lesions

Abstract: Traction MRI of the ankle is safe and technically feasible. This study is the first to date to investigate the effect of ankle traction on the MRI assessment of talar dome osteochondral lesions. Traction improves cartilage surface visibility of talar dome osteochondral lesions.

Cited by 8 publications

References 37 publications

Evaluation of Articular Cartilage Injury Using Computed Tomography With Axial Traction in the Ankle Joint

Evaluation of Articular Cartilage Injury Using Computed Tomography With Axial Traction in the Ankle Joint

Magnetic Resonance Imaging of Osteochondral Lesions of the Talus: Comparison Between Small FOV Surface Coil with BLADE and Boot-Shape Coil Without BLADE

Accessibility to Talar Dome in Neutral Position, Dorsiflexion, or Noninvasive Distraction in Posterior Ankle Arthroscopy

Contact Info

Product

Resources

About