title: MRI of the anterior talofibular ligament, talar cartilage and os subfibulare: Comparison of isotropic resolution 3D and conventional 2D T2-weighted fast spin-echo sequences at 3.0 T.
abstract: OBJECTIVE
  To determine the accuracy of a three-dimensional (3D) T2-weighted fast spin-echo (FSE) magnetic resonance (MR) sequence compared with two-dimensional (2D) sequence for diagnosing anterior talofibular ligament (ATFL) tears, chondral lesion of the talus (CLT) and os subfibulare/avulsion fracture of the distal fibula (OSF).
  
  
  METHODS
  Thirty-five patients were included, who had undergone ankle MRI with 3D T2-weighted FSE and 2D T2-weighted FSE sequences, as well as subsequent ankle arthroscopy, between November 2013 and July 2014. Each MR imaging sequence was independently scored by two readers retrospectively for the presence of ATFL tears, CLT and OSF. The area under the receiver operating curve (AUC) was compared to determine the discriminatory power of the two image sequences. Interobserver agreement was expressed as unweighted kappa value.
  
  
  RESULTS
  Arthroscopic findings confirmed 21 complete tears of the ATFL, 14 partial tears of the ATFL, 17 CLTs and 7 OSFs. There were no significant differences in the diagnoses of ATFL tears (p = 0.074-0.501), CLT (p = 0.090-0.450) and OSF (p = 0.317) obtained from the 2D and 3D sequences by either reader. The interobserver agreement rates between two readers using the 3D T2-weighted FSE sequence versus those obtained with the 2D sequence were substantial (κ = 0.659) versus moderate (κ = 0.553) for ATFL tears, moderate (κ = 0.499) versus substantial (κ = 0.676) for CLT and substantial (κ = 0.621) versus substantial (κ = 0.689) for OSF.
  
  
  CONCLUSIONS
  Three-dimensional isotropic T2-weighted FSE MRI of the ankle resulted in no statistically significant difference in diagnostic performance compared to two-dimensional T2-weighted FSE MRI in the evaluation of ATFL tears, CLTs and OSFs.
authors.affiliation: Department of Radiology, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon-si, 14584, Korea.
authors.forename: Jisook
authors.initials: J
authors.lastname: Yi
authors.affiliation: Department of Radiology, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon-si, 14584, Korea. mj4907@schmc.ac.kr.
authors.forename: Jang Gyu
authors.initials: JG
authors.lastname: Cha
authors.affiliation: Department of Orthopedics, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon-si, 14584, Korea.
authors.forename: Young Koo
authors.initials: YK
authors.lastname: Lee
authors.affiliation: Department of Biomedical Statistics, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon-si, 14584, Korea.
authors.forename: Bo Ra
authors.initials: BR
authors.lastname: Lee
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon-si, 14584, Korea.
authors.forename: Chan Hong
authors.initials: CH
authors.lastname: Jeon
mesh_terms: D000293:Adolescent; D000328:Adult; D002356:Cartilage / Q000000981:diagnostic imaging* / Q000293:injuries; D005260:Female; D005360:Fibula / Q000000981:diagnostic imaging; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008022:Ligaments / Q000000981:diagnostic imaging* / Q000293:injuries; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: 3-Tesla; ATFL; Ankle; Chondral lesion of the talus; Isotropic magnetic resonance imaging; Os subfibulare