Osteochondral lesions of the talus: comparison of three-dimensional fat-suppressed fast spoiled gradient-echo magnetic resonance imaging and conventional magnetic resonance imaging.
BACKGROUND
Conventional magnetic resonance imaging (MRI) has been demonstrated to be a valuable tool in diagnosing osteochondral lesions of the talus. No previous study, to our knowledge, has evaluated the diagnostic ability of fat-suppressed fast spoiled gradient-echo (FSPGR) MRI in osteochondral lesions of the talus. We sought to compare three-dimensional fat-suppressed FSPGR MRI with conventional MRI in diagnosing osteochondral lesions of the talus.


METHODS
Thirty-two consecutive patients with clinically suspected cartilage lesions undergoing three-dimensional fat-suppressed FSPGR MRI and conventional MRI were assessed. Sensitivity, specificity, and accuracy of diagnosis were determined using arthroscopic findings as the standard of reference for the different imaging techniques. The location of the lesion on the talar dome was recorded on a nine-zone anatomical grid on MRIs.


RESULTS
Arthroscopy revealed 21 patients with hyaline cartilage defects and 11 with normal ankle joints. The sensitivity, specificity, and accuracy of the two methods for detecting articular cartilage defect were 62%, 100%, and 75%, respectively, for conventional MRI and 91%, 100%, and 94% for three-dimensional fat-suppressed FSPGR MRI. Sensitivity and accuracy were significantly higher for FSPGR imaging than for conventional MRI (P < .05), but there was no difference in specificity between these two methods. According to the nine-zone anatomical grid, the area most frequently involved was the middle of the medial talar dome (16 lesions, 76%).


CONCLUSIONS
T1-weighted three-dimensional fat-suppressed FSPGR MRI is more sensitive than is conventional MRI in detecting defects of articular cartilage covering osteochondral lesions of the talus.
Hao
Da-Peng
DP
Radiology Department, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Zhang
Jian-Zhong
JZ
Wang
Zhen-Chang
ZC
Xu
Wen-Jian
WJ
Liu
Ji-Hua
JH
Yang
Ben-Tao
BT
D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy; D002358:Cartilage, Articular / Q000473:pathology*; D003937:Diagnosis, Differential; D017352:Echo-Planar Imaging / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D055034:Osteochondrosis / Q000175:diagnosis*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013628:Talus / Q000473:pathology*; D055815:Young Adult