Reliability and validity of different ankle MRI scanning planes for the anterior talofibular ligament injury diagnosis: a cadaveric study

Abstract

Background The objective of the current study is to compare reliability, accuracy, sensitivity, and specificity in magnetic resonance imaging (MRI) evaluation of anterior talofibular ligament (ATFL) among the routine axial scanning plane, oblique axial-coronal scanning plane, and oblique axial-sagittal scanning plane. Methods Twenty cadaveric feet were studied. ATFL was exposed before scanning. Routine axial, oblique axial-coronal, and oblique axial-sagittal MRI scanning of 20 ATFL-intact cadaveric feet were acquired utilizing a 1.5-T MRI unit. The scans were repeated on the 20 cadaveric feet after the ATFL was artificially injured. In total, 120 sets of MR images were obtained and were randomly numbered. Three independent observers who were blinded to the experiment evaluated the images. Interobserver agreement, sensitivity, specificity, and accuracy were calculated and compared between different scanning planes utilizing the McNemar test. Results The interobserver agreement was fair to good (kappa, 0.55 to 0.65) in the routine axial plane, fair to good (kappa, 0.557 to 0.75) in the oblique axial-sagittal plane, and excellent (kappa, 0.85 to 0.95) in the oblique axial-coronal plane. The accuracy was significantly higher when utilizing oblique axial-coronal MRI scanning than routine axial MRI scanning (reader 1: p = .018; reader 2: p = .005). Conclusions The diagnostic accuracy of oblique axial-coronal plane MRI was higher than the routine axial plane concerning ATFL injury, and the interobserver agreement was excellent. The oblique axial-coronal plane could be added to the MRI scanning protocol during clinical practices to improve the diagnostic accuracy of ATFL injury.

The Role of Mri in the Diagnosis of Ankle Ligaments Injury

“…Our result reported main causes of ankle pain was during stumping 45%, 17. 5% accidents, l0% during sport activity and 27.5% during football, it agreement with other study [18]. Nawroz et al recorded the cause of ankle sprains, the greatest patients were because accidents in 40%, 26% by sport, 18% by stumping and 16% by football [12].…”

Evaluation of 3-Dimensional Magnetic Resonance Imaging (3D MRI) in Diagnosing Anterior Talofibular Ligament Injury

“…MRI has the ability to display soft tissues and the advantages of noninvasiveness, rapid evaluation, multiplanar display, and no radiation damage. Numerous studies have reported that MRI examination has a high diagnostic value [ 7 – 9 ]. Kumar et al reported a sensitivity of ATFL tears of 60%, accuracy of 72%, and specificity of 87% [ 10 ].…”

Approach to Ankle Instability in Patients With a Negative Ankle MRI: A Case Series

“…The initial management of ankle injuries is the RICE protocol, which consists of rest, ice, compression, elevation, and analgesia [ 7 ]. Surgical treatment is rare and includes arthroscopy and reconstructive surgeries such as the modified Brostrom technique which is a well-recognized surgical technique used for the treatment of lateral ligamentous complex injuries for ankle instability and is now regarded as the reference standard technique [ 7 , 8 ]. The use of surgical treatment is typically limited to patients who fail conservative management [ 7 , 8 ].…”

“…Surgical treatment is rare and includes arthroscopy and reconstructive surgeries such as the modified Brostrom technique which is a well-recognized surgical technique used for the treatment of lateral ligamentous complex injuries for ankle instability and is now regarded as the reference standard technique [ 7 , 8 ]. The use of surgical treatment is typically limited to patients who fail conservative management [ 7 , 8 ]. The aim of this study was to explore the approach to patients with negative ankle MRI who continue to have symptoms of ankle instability despite conservative therapy in our institute.…”