[Diagnostic value of magnetic resonance tomography of the upper ankle joint--imaging of ligaments and tendons in standard slice orientation].
OBJECTIVE
Evaluation of the capability of high field strength MRI in depicting clinically important tendons and ligaments of the ankle joint using slice orientations parallel to the standard space directions without angulation.


METHODS
65 patients whose ankle joint complaints were not sufficiently clarified by conventional radiology sphere underwent MRI using plain T1-weighted spin echo sequences. Tendons and ligaments were classified by three independent radiologists with regard to their perceptibility on images of the different slice orientations.


RESULTS
Good perceptibility of at least two-thirds of each structure with the possibility for a decision regarding continuity or rupture of the remaining part was given most frequently in the following slice orientations: Axially for the tendons of peroneus longus, peroneus brevis, tibialis posterior, flexor digitorum longus, flexor hallucis longus, tibialis anterior, extensor digitorum longus, and extensor hallucis longus muscles, and for the calcanear tendon (each over 94% of cases), anterior (68%) talofibular ligament, deltoid (77%), anterior (63%), and posterior (72%) tibiofibular ligaments and coronally for the calcaneofibular (39%) and posterior talofibular ligaments (70%). The sagittal orientation was never the favoured one.


CONCLUSIONS
All tendons and ligaments of the ankle joint, except for the calcaneofibular and anterior tibiofibular ligaments, can be sufficiently visualized in the majority of cases by non-angulated spin echo sequences in standard slice orientations if the examination is performed in at least two slice directions. Thus, the minimal examination program should be: one T2-weighted sequence, T1-weighted sequences axially and in a further orientation, i.e. slightly angulated coronally for depicting the calcaneofibular ligament.
Schröder
R I
RI
Strahlenklinik und Poliklinik, Medizinische Fakultät der Humboldt-Universität zu Berlin.
Siewert
C
C
Mäurer
J
J
Vogl
T J
TJ
Südkamp
N
N
Felix
R
R
D000125:Achilles Tendon / Q000293:injuries / Q000473:pathology; D000328:Adult; D016512:Ankle Injuries / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis*; D006801:Humans; D008023:Ligaments, Articular / Q000293:injuries* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012421:Rupture; D013708:Tendon Injuries; D013710:Tendons / Q000473:pathology