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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

33-year-old man with chronic ankle pain. This was contrast enhanced 3D-FSPGR MRI false negative case but routine MRI truepositive case.A. Axial T2-weighted spin echo (2000/70) MRI shows focal soft tissue mass.B. Reformatted axial contrast enhanced fat-suppressed 3D-FSPGR MRI shows no enhancing lesion in anterolateral recess of ankle.C. Arthroscopic findings confirm presence of anterolateral impinged soft tissue (*).
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Figure 5: 33-year-old man with chronic ankle pain. This was contrast enhanced 3D-FSPGR MRI false negative case but routine MRI truepositive case.A. Axial T2-weighted spin echo (2000/70) MRI shows focal soft tissue mass.B. Reformatted axial contrast enhanced fat-suppressed 3D-FSPGR MRI shows no enhancing lesion in anterolateral recess of ankle.C. Arthroscopic findings confirm presence of anterolateral impinged soft tissue (*).

Mentions: Readers 1 and 2 identified 17 and 20 false negatives, respectively, for the detection of anterolateral soft tissue impingement using routine MRI. There were fewer false negative results with the use of CE fat-suppressed 3D-FSPGR MRI, as reader 1 identified 11 of the 17 routine MRI false negatives and reader 2 identified 11 of the 20 routine MRI false negatives (Fig. 4). Readers 1 and 2 identified 10 and 11 false positives, respectively, using routine MRI. Using CE fat-suppressed 3D-FSPGR MRI, reader 1 correctly diagnosed 9 of 10 false positives that were diagnosed by the use of routine MRI, and reader 2 correctly diagnosed 9 of 11 false positives that were diagnosed by the use of routine MRI. For CE fat-suppressed 3D-FSPGR MRI, readers 1 and 2 both diagnosed 6 false negative results (Fig. 5) and 2 false positive results.


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)

33-year-old man with chronic ankle pain. This was contrast enhanced 3D-FSPGR MRI false negative case but routine MRI truepositive case.A. Axial T2-weighted spin echo (2000/70) MRI shows focal soft tissue mass.B. Reformatted axial contrast enhanced fat-suppressed 3D-FSPGR MRI shows no enhancing lesion in anterolateral recess of ankle.C. Arthroscopic findings confirm presence of anterolateral impinged soft tissue (*).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 5: 33-year-old man with chronic ankle pain. This was contrast enhanced 3D-FSPGR MRI false negative case but routine MRI truepositive case.A. Axial T2-weighted spin echo (2000/70) MRI shows focal soft tissue mass.B. Reformatted axial contrast enhanced fat-suppressed 3D-FSPGR MRI shows no enhancing lesion in anterolateral recess of ankle.C. Arthroscopic findings confirm presence of anterolateral impinged soft tissue (*).
Mentions: Readers 1 and 2 identified 17 and 20 false negatives, respectively, for the detection of anterolateral soft tissue impingement using routine MRI. There were fewer false negative results with the use of CE fat-suppressed 3D-FSPGR MRI, as reader 1 identified 11 of the 17 routine MRI false negatives and reader 2 identified 11 of the 20 routine MRI false negatives (Fig. 4). Readers 1 and 2 identified 10 and 11 false positives, respectively, using routine MRI. Using CE fat-suppressed 3D-FSPGR MRI, reader 1 correctly diagnosed 9 of 10 false positives that were diagnosed by the use of routine MRI, and reader 2 correctly diagnosed 9 of 11 false positives that were diagnosed by the use of routine MRI. For CE fat-suppressed 3D-FSPGR MRI, readers 1 and 2 both diagnosed 6 false negative results (Fig. 5) and 2 false positive results.

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