Ligaments of the Lisfranc joint in MRI: 3D-SPACE (sampling perfection with application optimized contrasts using different flip-angle evolution) sequence compared to three orthogonal proton-density fat-saturated (PD fs) sequences.
OBJECTIVE
To compare the detection rate and visibility of the ligaments in the Lisfranc joint with a single 3D (-SPACE) MR sequence and three orthogonal PD fat-saturated sequences.


METHODS
Thirty-one asymptomatic feet and 15 patients with posttraumatic pain in the Lisfranc joint were evaluated with a 3D-SPACE-sequence (0.5 mm section thickness, acquisition time 10:22 min, secondary reformations) and three orthogonal PD fs sequences (2 mm section thickness, 9:20 min). The Lisfranc-ligament, the dorsal and plantar tarsometatarsal ligaments (TMT), the dorsal, interosseous, and plantar intermetatarsal ligaments (IMT) (24 ligaments for each foot) were assessed.


RESULTS
In asymptomatic feet, 692 ligaments were detected with the SPACE sequence, thereof 90.6 % exhibited normal signal, and most (96.9 %) were completely visible on one single image. A total of 659 ligaments were detected with the PD fs sequence, thereof 86.6 % yielded normal signal, and 28.5 % were completely visible on one single image. In patients, 327 ligaments were detected with SPACE, thereof 50.6 % appeared completely visible with high signal. On PD fs, 308 ligaments were detected, 42.2 % of the ligaments had high signals.


CONCLUSIONS
The ligaments of the Lisfranc joint are better detected with a single 3D-SPACE sequence and secondary reformations than with three orthogonal PD fs sequences.
Department of Diagnostic and Interventional Radiology, University Hospital Zürich, Zürich, Switzerland. erikajulbrich@googlemail.com
Erika J
EJ
Ulbrich
Veronika
V
Zubler
Reto
R
Sutter
Norman
N
Espinosa
Christian W
CW
Pfirrmann
Marco
M
Zanetti
D000273:Adipose Tissue / Q000473:pathology*; D000328:Adult; D000368:Aged; D000465:Algorithms; D003287:Contrast Media; D005260:Female; D033023:Foot Joints / Q000293:injuries* / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008023:Ligaments, Articular / Q000293:injuries* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011522:Protons; D015203:Reproducibility of Results; D018401:Sample Size; D012680:Sensitivity and Specificity
D003287:Contrast Media; D011522:Protons