Diagnostic Performance of Flat-Panel CT Arthrography for Cartilage Defect Detection in the Ankle Joint: Comparison With MDCT Arthrography With Gross Anatomy as the Reference Standard

Chemouni, D.; Champsaur, Pierre; Guenoun, Daphné; Desrousseaux, Julie; Pauly, Vanessa; Corroller, Thomas Le

doi:10.2214/ajr.13.12163

Cited by 10 publications

(15 citation statements)

References 29 publications

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“…In most patients, clinical symptoms are nonspecific; and standard radiographs are known to be inaccurate for the evaluation of the articular cartilage status [2]. Because detection of cartilage defects in the ankle joint is crucial for surgical decision-making, many investigators have explored a variety of imaging techniques for assessing the integrity of hyaline cartilage [3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…Current detector designs in multidetector CT (MDCT) can reach a maximal z-resolution of 0.4-0.5 mm, enabling the detection of small cartilage and bone lesions that could be overlooked in MR arthrography [10,11]. Thus, MDCT arthrography is considered the method of choice in the assessment of articular cartilage, especially in the ankle joint where hyaline cartilage is particularly thin [3,6,7,12].…”

Section: Introductionmentioning

confidence: 99%

“…Other advantages of FPCT include its large volumetric coverage and reduced metal and beam-hardening artifacts [15,16]. FPCT arthrography has recently been shown to be as feasible as MDCT arthrography with similar image quality in vitro and ex vivo [7,13,14,17]. In clinical practice, FPCT arthrography can now be performed immediately after arthrography, without relocating the patient, which avoids resorption of contrast material and improves workflow [18,19].…”

Section: Introductionmentioning

confidence: 99%

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Flat-panel CT arthrography for cartilage defect detection in the ankle joint: first results in vivo

et al. 2020

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Objectives The purpose of this study was to compare the diagnostic performance of flat-panel computed tomography (FPCT) arthrography for cartilage defect detection in the ankle joint to direct magnetic resonance (MR) arthrography using multidetector computed tomography (MDCT) arthrography as the reference standard. Methods Twenty-seven patients with specific suspicion of articular cartilage lesion underwent ankle arthrography with injection of a mixture of diluted gadolinium and iobitridol and were examined consecutively with the use of FPCT, MDCT, and 1.5 T MR imaging. FPCT, MDCT, and MR arthrography examinations were blinded and randomly evaluated by two musculoskeletal radiologists in consensus. In each ankle, eight articular cartilage areas were assessed separately: medial talar surface, medial talar trochlea, lateral talar trochlea, lateral talar surface, tibial malleolus, medial tibial plafond, lateral tibial plafond, and fibular malleolus. Findings at FPCT and MR were compared with MDCT assessments in 216 cartilage areas. Results For the detection of cartilage defects, FPCT demonstrated a sensitivity of 97%, specificity of 95%, and accuracy of 96%; and MR arthrography showed a sensitivity of 69%, specificity of 94%, and accuracy of 87%. FPCT and MR arthrography presented almost perfect agreement (κ = 0.87) and moderate agreement (κ = 0.60), respectively, with MDCT arthrography. Mean diagnostic confidence was higher for FPCT (2.9/3) than for MR (2.3/3) and MDCT (2.7/3) arthrography. Conclusions FPCT demonstrated better accuracy than did 1.5 T MR arthrography for cartilage defect detection in the ankle joint. Therefore, FPCT should be considered in patients scheduled for dedicated imaging of ankle articular cartilage.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Flat-panel CT arthrography for cartilage defect detection in the ankle joint: first results in vivo

et al. 2020

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“…In the past 25 years, CT and MR imaging have come to play a greater role in the diagnosis and grading of osteochondral lesions and conventional radiographs are now generally considered to be insensitive for the evaluation of suspected chondral injury, unless there is a significant subjacent osseous component. With the development of slip ring technology and numerous sequential detector rows in CT or multidetector CT, the ability to evaluate subtle osseous injuries with multi-planar reconstructions has improved dramatically 8, 9, 10, 11, 12. We believe that high-resolution MDCT plays a valuable role in the delineation of subchondral lesions that may present with instability of osteochondral fragments at the articular surface by detecting the presence of detachment, fragmentation, and displacement; we recommend MDCT arthrography in the setting of such lesions visible on MR imaging but equivocal for instability.…”

Section: Discussionmentioning

confidence: 99%

The comparison of direct magnetic resonance arthrography with volumetric interpolated breath-hold examination sequence and multidetector computed tomography arthrography techniques in detection of talar osteochondral lesions

Pirimoğlu¹,

Oğul²,

Polat³

et al. 2019

Acta Orthopaedica et Traumatologica Turcica

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Objective The aim of this study was to compare additive diagnostic values of magnetic resonance (MR) arthrography with volumetric interpolated breath-hold examination (VIBE) sequence and multidetector computed tomography (MDCT) arthrography for diagnosis and grading of talar osteochondral lesions. Methods MDCT arthrography and MR arthrography with three dimensional VIBE sequence were performed in 27 patients. Findings of MR arthrography and MDCT arthrography images were compared with arthroscopic findings. Sensitivity, specificity, and accuracy rates were calculated for both MR arthrography and MDCT arthrography imaging findings. Results For grade I osteochondral lesions; sensitivity, specificity and accuracy rates of MR arthrography were 95%, 73%, 90%, respectively; For grade I osteochondral lesions; sensitivity, specificity and accuracy rates of MDCT arthrography were 96%, 79%, 81%. For grade IV osteochondral lesions; sensitivity, specificity and accuracy rates of MDCT arthrography and MR arthrography were 100%. For grade II lesions, the sensitivity, specificity and accuracy rates of the MR arthrography were 80%, 76%, 77%, respectively; for grade III lesions, the sensitivity, specificity and accuracy rates of the MR arthrography were 78%, 68%, 75%. For grade II osteochondral lesions; the sensitivity, specificity and accuracy rates of the MDCT arthrography were 91%, 81%, 86%; for grade III osteochondral lesions; the sensitivity, specificity and accuracy rates of the MDCT arthrography were 90%, 83%, 89%; For grade II and III osteochondral lesions, MDCT arthrography had higher sensitivity, specificity and accuracy rates than MR arthrography. MDCT arthrography had higher diagnostic performance than MR arthrography for detection of grade II and III lesions (p = 0.041 and p = 0.038, respectively). Conclusion MDCT arthrography appears to be more reliable than MR arthrography with three dimensional VIBE sequence for accurate detection and grading of osteochondral lesions. Level of evidence Level III, Diagnostic Study.

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“…Kraniotis et al described that CTA detects radiographically silent osteochondral lesions in patients with fractures of the ankle joint but did not compare CTA to other imaging techniques [16]. In the study by Chemouni et al CT arthrography showed an accuracy of 88% [31]. For detection of retropatellar osteochondral lesions, CTA performed superior compared with conventional MRI in several studies [1, 28].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of CT Arthrography for Evaluation of Osteochondral Lesions at the Ankle

Kirschke

Braun

Baum

et al. 2016

BioMed Research International

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Background. To retrospectively determine the diagnostic value of computed tomography arthrography (CTA) of the ankle in the evaluation of (osteo)chondral lesions in comparison to conventional magnetic resonance imaging (MRI) and intraoperative findings. Methods. A total of N = 79 patients had CTAs and MRI of the ankle; in 17/79 cases surgical reports with statements on cartilage integrity were available. Cartilage lesions and bony defects at talus and tibia were scored according to defect depth and size by two radiologists. Statistical analysis included sensitivity analyses and Cohen's kappa calculations. Results. On CTA, 41/79 and 31/79 patients had full thickness cartilage defects at the talus and at the tibia, respectively. MRI was able to detect 54% of these defects. For the detection of full thickness cartilage lesions, interobserver agreement was substantial (0.72 ± 0.05) for CTA and moderate (0.55 ± 0.07) for MRI. In surgical reports, 88–92% and 46–62% of full thickness defects detected by CTA and MRI were described. CTA findings changed the further clinical management in 15.4% of cases. Conclusions. As compared to conventional MRI, CTA improves detection and visualization of cartilage defects at the ankle and is a relevant tool for treatment decisions in unclear cases.

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Diagnostic Performance of Flat-Panel CT Arthrography for Cartilage Defect Detection in the Ankle Joint: Comparison With MDCT Arthrography With Gross Anatomy as the Reference Standard

Abstract: Flat-panel CT arthrography is accurate for detecting cartilage defects in the ankle joint and is an alternative to MDCT arthrography that may have better diagnostic performance and may permit the use of a lower radiation dose.

Cited by 10 publications

References 29 publications

Flat-panel CT arthrography for cartilage defect detection in the ankle joint: first results in vivo

Flat-panel CT arthrography for cartilage defect detection in the ankle joint: first results in vivo

The comparison of direct magnetic resonance arthrography with volumetric interpolated breath-hold examination sequence and multidetector computed tomography arthrography techniques in detection of talar osteochondral lesions

Diagnostic Value of CT Arthrography for Evaluation of Osteochondral Lesions at the Ankle

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