title: Three-dimensional isotropic T2-weighted fast spin-echo (VISTA) ankle MRI versus two-dimensional fast spin-echo T2-weighted sequences for the evaluation of anterior talofibular ligament injury.
abstract: OBJECTIVE
  To compare the performance of axial images of the ankle joint on three-dimensional (3D) volume isotropic turbo spin echo acquisition (VISTA) with that of two-dimensional (2D) fast spin echo (FSE) T2-weighted images for the diagnosis of anterior talofibular ligament (ATFL) injury.
  
  
  METHODS
  This retrospective study included 101 patients who underwent both 2D FSE T2-weighted and 3D VISTA magnetic resonance imaging (MRI) of the ankle. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of both sequences were measured. The anatomical identification score and diagnostic performances of both sequences were evaluated by two radiologists. The diagnostic performances of 3D VISTA and 2D FSE images were analysed in terms of sensitivity, specificity, and accuracy for diagnosing ATFL injury. Surgically or clinically confirmed diagnoses were used as reference standards.
  
  
  RESULTS
  The margin sharpness scores on 3D VISTA were significantly inferior to those of 2D FSE (p<0.001). Other scores (entire length, entire width) were not significantly different between the two imaging methods. The SNRs and CNRs of 3D VISTA were significantly higher than those of 2D FSE (p<0.001). When diagnoses were classified as normal and abnormal, the specificity of the 3D VISTA images for the diagnosis of ATFL injury was 95.7%, significantly superior to 2D FSE (84.3-85.7%). There were no significant differences between 3D VISTA and 2D FSE images in sensitivity or accuracy for diagnosis (p=0.227-1.000), with the exception of accuracy by reader 1 (p=0.039).
  
  
  CONCLUSIONS
  3D VISTA imaging has a diagnostic performance comparable to that of 2D FSE for the diagnosis of ATFL injury, although 3D VISTA is inferior to 2D FSE for the evaluation of margin sharpness. Replacing axial and coronal images with 3D VISTA can save imaging time without negatively impacting the diagnostic ability for ATFL injury.
authors.affiliation: Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Republic of Korea.
authors.forename: H J
authors.initials: HJ
authors.lastname: Park
authors.affiliation: Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Republic of Korea.
authors.forename: S Y
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Radiology, Myongji Hospital, Seonam University College of Medicine, Republic of Korea. Electronic address: radiology11@hanmail.net.
authors.forename: N H
authors.initials: NH
authors.lastname: Park
authors.affiliation: Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Republic of Korea.
authors.forename: M H
authors.initials: MH
authors.lastname: Rho
authors.affiliation: Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Republic of Korea.
authors.forename: E C
authors.initials: EC
authors.lastname: Chung
authors.affiliation: Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Republic of Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Republic of Korea.
authors.forename: S J
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016512:Ankle Injuries / Q000175:diagnosis*; D000843:Ankle Joint / Q000473:pathology*; D002648:Child; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D017844:Lateral Ligament, Ankle / Q000293:injuries* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D059629:Signal-To-Noise Ratio; D055815:Young Adult