Comprehensive Assessment of Ankle Syndesmosis Injury Using 3D Isotropic Turbo Spin-Echo Sequences: Diagnostic Performance Compared With That of Conventional and Oblique 3-T MRI

Kim, Min‐Chul; Choi, Yun Sun; Jeong, Min Chang; Park, Soo‐Jin; Chun, Tong Jin; Kim, Jin Su; Young, Ki Won

doi:10.2214/ajr.16.16985

Cited by 16 publications

(27 citation statements)

References 24 publications

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“…En caso de dudas, es recomendable solicitar proyección de mortaja bilateral ya que, si se objetiva una diferencia mayor de 2 mm en el espacio tibiofibular claro, es sugerente de lesión sindesmal (1) . Las radiografías en estrés, si bien están indicadas cuando hay alto índice de sospecha con radiografías estáticas normales, son difíciles de realizar debido al dolor que provocan en el paciente (1,(4)(5)(6) . Los parámetros radiológicos normales más usados son: 1) el espacio tibiofibular < 6 mm en la proyección AP y de mortaja; y 2) la superposición tibiofibular > 6 mm en la proyección AP y > 1 mm en la de mortaja.…”

Section: Tratamiento De Las Lesiones Agudas Ligamentosasunclassified

Tratamiento de las lesiones agudas ligamentosas

Villa¹,

Serrano²,

Cañada³

et al. 2019

MACT

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Este es un artículo Open Access bajo la licencia CC BY-NC-ND (www.creativecommons.org/licenses/by-nc-nd/4.0/). FS Introducción La sindesmosis es una estructura anatómica compleja muy importante para la estabilidad y la transmisión de cargas a través del tobillo (1). Las lesiones agudas son muy comunes, estando asociadas en un 5-10% a esguinces y en un 23% a fracturas del tobillo (2). Debemos tener un alto índice de sospecha, ya que la identificación de estas lesiones es de gran importancia para evitar la morbilidad a largo plazo. Son complejas de diagnosticar e, incluso cuando se identifican, un tratamiento incorrecto puede provocar una degeneración articular precoz con malos resultados funcionales (1) .

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Section: Tratamiento De Las Lesiones Agudas Ligamentosasunclassified

Tratamiento de las lesiones agudas ligamentosas

Villa¹,

Serrano²,

Cañada³

et al. 2019

MACT

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“…Most syndesmosis injuries arise from external rotation of the ankle; among the four ligaments, it is most important to evaluate the AiTFL 6,7 . There have been many attempts to accurately evaluate the pathology of AiTFL and ATFL using MRI 4,8‐12 . There is still a question about the usefulness of the routine ankle MRI protocol for diagnosis of AiTFL and ATFL injury because of the variable diagnostic accuracy.…”

Section: Introductionmentioning

confidence: 99%

“…There is still a question about the usefulness of the routine ankle MRI protocol for diagnosis of AiTFL and ATFL injury because of the variable diagnostic accuracy. MRI sensitivity is about 40–95% and its specificity is 70–97%, which is a wide range 4,9‐11,13‐16 . The reason for this variable diagnostic accuracy may be associated with anatomical features of lateral ankle ligaments.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, assessment of lateral ligament injury using the axial plane may result in false‐positive findings 14,15 . Recently, a three‐dimensional (3D) isotropic sequence has been developed to overcome this problem, 10,13,19‐21 which can be used to evaluate the AiTFL or ATFL with an accurate anatomical plane. However, this sequence requires a longer scan time and suffers from imaging blurring, 22 which may limit the wider use of 3D isotropic imaging 23,24 .…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the anterior inferior tibiofibular and anterior talofibular ligaments using 2D oblique coronal imaging and 3D isotropic resolution T2‐weighted fast spin‐echo sequences at 3.0 T: Is there additional diagnostic value?

et al. 2020

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Introduction To compare diagnostic performance of additional two‐dimensional (2D) oblique coronal view and three‐dimensional (3D) T2‐weighted fast spin‐echo(FSE) images for diagnosing injury of the anterior inferior tibiofibular (AiTFL) and anterior talofibular ligaments (ATFL). Methods This study included 48 patients with ankle sprain who had undergone MRI using standard protocol and two additional sequences with 2D oblique coronal and 3D isotropic images, followed by arthroscopic surgery. Ligament injuries was subdivided by intact tendon, partial or complete tear. Retrospectively, two musculoskeletal radiologists respectively reviewed three image sets of MR including 2D axial image only (set 1), 2D axial and oblique coronal images (set 2), and 2D axial with 3D‐isotropic images (set 3). Using arthroscopic findings as reference standard, diagnostic performances of both methods were analysed by the area under the curve (AUC). Results Arthroscopy confirmed 13 AiTFL and 41 ATFL injuries. For AiTFL, when set 1 and set 3 were compared, AUC value was significantly higher for set 3 (P < 0.05). However, there was no significant difference between AUC values for set 2 and set 3 sequences by either reader for either type of tear (P > 0.05). For ATFL, both readers found there was no significant difference in AUC values between set 1 and set 3 and between set 2 and set 3. Conclusion Additional oblique coronal sequence demonstrated better diagnostic performance for AiTFL injury than conventional and isotropic imaging did. This sequence showed as much diagnostic accuracy as isotropic sequence for evaluation of ATFL injury.

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“…Lateral sprain is the commonest, accounting for about 85% of all ankle sprains. Post-sprained ankles may sustain one or more intra-articular injuries as ligamentous tear, chondral defect, and osteochondral lesions (OCL) [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

CT arthrography for demonstration of various articular injuries in post-sprained ankle pain

El-Sherif

Mohamed

El-Ameen

et al. 2019

Egypt J Radiol Nucl Med

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Background: Post-sprained ankles may sustain ligamentous tear, chondral defect, or osteochondral lesions (OCL). Being widely available and does not depend on high-end machine, the aim of this study was to assess the value of high resolution multi-detector CT arthrography (CTA) in detection of various ligamentous tears, chondral defects, and osteochondral lesions in case of sprain-related persistent ankle pain. Results: There were 34 (68%) cases of ligamentous injury, most of which had single ligament affection whereas some cases demonstrated multi-ligamentous injury, and the total number of individual injured ligaments was 42 ligaments. There were 36 cases (72%) which had either chondral or osteochondral defects; the total number of OCL was 21 lesions and the total number of segmental cartilage defects was 20. Conclusion: This study emphasized the diagnostic importance of multi-detector CTA in sprain-related ankle pain. In persistent post-sprained ankle pain, multi-detector CTA is a helpful imaging modality which could be utilized for detection of OCL, chondral defects, and various ligamentous tears.

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Comprehensive Assessment of Ankle Syndesmosis Injury Using 3D Isotropic Turbo Spin-Echo Sequences: Diagnostic Performance Compared With That of Conventional and Oblique 3-T MRI

Abstract: The performance of 3D SPACE sequences is comparable to that of 2D proton density-weighted MR images for the diagnosis of acute and chronic syndesmosis injuries.

Cited by 16 publications

References 24 publications

Tratamiento de las lesiones agudas ligamentosas

Tratamiento de las lesiones agudas ligamentosas

Evaluation of the anterior inferior tibiofibular and anterior talofibular ligaments using 2D oblique coronal imaging and 3D isotropic resolution T2‐weighted fast spin‐echo sequences at 3.0 T: Is there additional diagnostic value?

CT arthrography for demonstration of various articular injuries in post-sprained ankle pain

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