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Ankle MRI for anterolateral soft tissue impingement: increased accuracy with the use of contrast-enhanced fat-suppressed 3D-FSPGR MRI.

Choo HJ, Suh JS, Kim SJ, Huh YM, Kim MI, Lee JW - Korean J Radiol (2008 Sep-Oct)

Bottom Line: The overall accuracy for lesion characterization was significantly higher (p < 0.05) using the CE fat-suppressed 3D-FSPGR MR images (Az = 0.892 and 0.881 for reader 1 and 2, respectively) than using the routine MR images (Az = 0.763 and 0.745).The use of CE fat-suppressed 3D-FSPGR MRI enhanced impingement depiction in most cases.However, in cases with a thickened non-enhancing scar or joint effusion, the routine images better depicted a soft tissue mass that intruded into anterolateral gutter than the CE images.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, College of Medicine, Inje University, Busan, Korea.

ABSTRACT

Objective: To validate the use of contrast-enhanced (CE) fat-suppressed three-dimensional (3D) fast gradient-recalled acquisition in the steady state with radiofrequency spoiling (FSPGR) magnetic resonance imaging (MRI) for the diagnosis of anterolateral soft tissue impingement of the ankle, as compared to the use of routine ankle MRI.

Materials and methods: Contrast-enhanced fat-suppressed 3D-FSPGR MRI and routine MRI scans were retrospectively reviewed for 45 patients with arthroscopically proven anterolateral impingement. In addition, scans were reviewed in 45 control subjects with diagnoses other than impingement. Two radiologists independently reviewed the two sets of images in random order. Using areas (Az) under the receiver operating characteristic curve (ROC), we compared the depiction of anterolateral soft tissue impingement in the two sets of images.

Results: The overall accuracy for lesion characterization was significantly higher (p < 0.05) using the CE fat-suppressed 3D-FSPGR MR images (Az = 0.892 and 0.881 for reader 1 and 2, respectively) than using the routine MR images (Az = 0.763 and 0.745). The use of CE fat-suppressed 3D-FSPGR MRI enhanced impingement depiction in most cases. However, in cases with a thickened non-enhancing scar or joint effusion, the routine images better depicted a soft tissue mass that intruded into anterolateral gutter than the CE images.

Conclusion: The use of CE fat-suppressed 3D-FSPGR MRI of the ankle allows a more accurate assessment of anterolateral soft tissue impingement of the ankle, as compared to the use of routine MRI.

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Related in: MedlinePlus

Imaging findings of normal anterolateral recess of ankle and soft tissue impingement at anterolateral recess of ankle by use of 3D-FSPGR MR. Images are reformatted-axial contrast-enhanced fat-suppressed 3D-FSPGR images (TR/TE of 20.9/2.2 msec, flip angle of 15°, 256 × 192 matrix, 1 number of excitatid, field of view of 12 cm) using coronal contrast enhanced 3D-FSPGR imaging.A. Normal image shows no enhancing lesion at anterolateral recess of ankle.B. Anterolateral soft tissue impingement of ankle was defined as a nodular thick enhancement with internal intrusion (arrow).
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Figure 2: Imaging findings of normal anterolateral recess of ankle and soft tissue impingement at anterolateral recess of ankle by use of 3D-FSPGR MR. Images are reformatted-axial contrast-enhanced fat-suppressed 3D-FSPGR images (TR/TE of 20.9/2.2 msec, flip angle of 15°, 256 × 192 matrix, 1 number of excitatid, field of view of 12 cm) using coronal contrast enhanced 3D-FSPGR imaging.A. Normal image shows no enhancing lesion at anterolateral recess of ankle.B. Anterolateral soft tissue impingement of ankle was defined as a nodular thick enhancement with internal intrusion (arrow).

Mentions: Each observer recorded the presence of anterolateral soft tissue impingement using a five-point confidence rating score for each lesion; 1 equals "no lesion," 2 equals "probably not a lesion," 3 equals "an equivocal lesion," 4 equals "a probable lesion" and 5 equals "a definite lesion." The features suggesting anterolateral soft tissue impingement as depicted on routine MRI were soft tissue fullness at the anterolateral gutter of the ankle or fuzzy and marked-thickening of the anterior talofibular ligament (Fig. 1). In contrast, the feature suggesting anterolateral soft tissue impingement as depicted on CE fat-suppressed 3D-FSPGR MRI was focal nodular or irregular thick enhancement in the anterolateral recess (Fig. 2).


Ankle MRI for anterolateral soft tissue impingement: increased accuracy with the use of contrast-enhanced fat-suppressed 3D-FSPGR MRI.

Choo HJ, Suh JS, Kim SJ, Huh YM, Kim MI, Lee JW - Korean J Radiol (2008 Sep-Oct)

Imaging findings of normal anterolateral recess of ankle and soft tissue impingement at anterolateral recess of ankle by use of 3D-FSPGR MR. Images are reformatted-axial contrast-enhanced fat-suppressed 3D-FSPGR images (TR/TE of 20.9/2.2 msec, flip angle of 15°, 256 × 192 matrix, 1 number of excitatid, field of view of 12 cm) using coronal contrast enhanced 3D-FSPGR imaging.A. Normal image shows no enhancing lesion at anterolateral recess of ankle.B. Anterolateral soft tissue impingement of ankle was defined as a nodular thick enhancement with internal intrusion (arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627205&req=5

Figure 2: Imaging findings of normal anterolateral recess of ankle and soft tissue impingement at anterolateral recess of ankle by use of 3D-FSPGR MR. Images are reformatted-axial contrast-enhanced fat-suppressed 3D-FSPGR images (TR/TE of 20.9/2.2 msec, flip angle of 15°, 256 × 192 matrix, 1 number of excitatid, field of view of 12 cm) using coronal contrast enhanced 3D-FSPGR imaging.A. Normal image shows no enhancing lesion at anterolateral recess of ankle.B. Anterolateral soft tissue impingement of ankle was defined as a nodular thick enhancement with internal intrusion (arrow).
Mentions: Each observer recorded the presence of anterolateral soft tissue impingement using a five-point confidence rating score for each lesion; 1 equals "no lesion," 2 equals "probably not a lesion," 3 equals "an equivocal lesion," 4 equals "a probable lesion" and 5 equals "a definite lesion." The features suggesting anterolateral soft tissue impingement as depicted on routine MRI were soft tissue fullness at the anterolateral gutter of the ankle or fuzzy and marked-thickening of the anterior talofibular ligament (Fig. 1). In contrast, the feature suggesting anterolateral soft tissue impingement as depicted on CE fat-suppressed 3D-FSPGR MRI was focal nodular or irregular thick enhancement in the anterolateral recess (Fig. 2).

Bottom Line: The overall accuracy for lesion characterization was significantly higher (p < 0.05) using the CE fat-suppressed 3D-FSPGR MR images (Az = 0.892 and 0.881 for reader 1 and 2, respectively) than using the routine MR images (Az = 0.763 and 0.745).The use of CE fat-suppressed 3D-FSPGR MRI enhanced impingement depiction in most cases.However, in cases with a thickened non-enhancing scar or joint effusion, the routine images better depicted a soft tissue mass that intruded into anterolateral gutter than the CE images.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, College of Medicine, Inje University, Busan, Korea.

ABSTRACT

Objective: To validate the use of contrast-enhanced (CE) fat-suppressed three-dimensional (3D) fast gradient-recalled acquisition in the steady state with radiofrequency spoiling (FSPGR) magnetic resonance imaging (MRI) for the diagnosis of anterolateral soft tissue impingement of the ankle, as compared to the use of routine ankle MRI.

Materials and methods: Contrast-enhanced fat-suppressed 3D-FSPGR MRI and routine MRI scans were retrospectively reviewed for 45 patients with arthroscopically proven anterolateral impingement. In addition, scans were reviewed in 45 control subjects with diagnoses other than impingement. Two radiologists independently reviewed the two sets of images in random order. Using areas (Az) under the receiver operating characteristic curve (ROC), we compared the depiction of anterolateral soft tissue impingement in the two sets of images.

Results: The overall accuracy for lesion characterization was significantly higher (p < 0.05) using the CE fat-suppressed 3D-FSPGR MR images (Az = 0.892 and 0.881 for reader 1 and 2, respectively) than using the routine MR images (Az = 0.763 and 0.745). The use of CE fat-suppressed 3D-FSPGR MRI enhanced impingement depiction in most cases. However, in cases with a thickened non-enhancing scar or joint effusion, the routine images better depicted a soft tissue mass that intruded into anterolateral gutter than the CE images.

Conclusion: The use of CE fat-suppressed 3D-FSPGR MRI of the ankle allows a more accurate assessment of anterolateral soft tissue impingement of the ankle, as compared to the use of routine MRI.

Show MeSH
Related in: MedlinePlus