title: Diagnostic Value of CT Arthrography for Evaluation of Osteochondral Lesions at the Ankle.
abstract: Background. To retrospectively determine the diagnostic value of computed tomography arthrography (CTA) of the ankle in the evaluation of (osteo)chondral lesions in comparison to conventional magnetic resonance imaging (MRI) and intraoperative findings.Methods. A total ofN= 79 patients had CTAs and MRI of the ankle; in 17/79 cases surgical reports with statements on cartilage integrity were available. Cartilage lesions and bony defects at talus and tibia were scored according to defect depth and size by two radiologists. Statistical analysis included sensitivity analyses and Cohen's kappa calculations.Results. On CTA, 41/79 and 31/79 patients had full thickness cartilage defects at the talus and at the tibia, respectively. MRI was able to detect 54% of these defects. For the detection of full thickness cartilage lesions, interobserver agreement was substantial (0.72 ± 0.05) for CTA and moderate (0.55 ± 0.07) for MRI. In surgical reports, 88-92% and 46-62% of full thickness defects detected by CTA and MRI were described. CTA findings changed the further clinical management in 15.4% of cases.Conclusions. As compared to conventional MRI, CTA improves detection and visualization of cartilage defects at the ankle and is a relevant tool for treatment decisions in unclear cases.
authors.affiliation: Department of Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675 Munich, Germany.
authors.forename: Jan S
authors.initials: JS
authors.lastname: Kirschke
authors.affiliation: Department of Orthopaedic Sports Medicine, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675 Munich, Germany.
authors.forename: Sepp
authors.initials: S
authors.lastname: Braun
authors.affiliation: Department of Radiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675 Munich, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Baum
authors.affiliation: Department of Orthopaedic Sports Medicine, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675 Munich, Germany; Department of Trauma and Orthopaedic Surgery, BG Unfallklinik Murnau, Professor-Küntscher-Strasse 8, 82418 Murnau, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Holwein
authors.affiliation: Musculoskeletal Imaging, Kantonsspital Graubuenden, Loestrasse 170, 7000 Chur, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Schaeffeler
authors.affiliation: Department of Orthopaedic Sports Medicine, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675 Munich, Germany.
authors.forename: Andreas B
authors.initials: AB
authors.lastname: Imhoff
authors.affiliation: Department of Radiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675 Munich, Germany.
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Rummeny
authors.affiliation: Department of Radiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675 Munich, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Woertler
authors.affiliation: Department of Radiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675 Munich, Germany.
authors.forename: Pia M
authors.identifier: 0000-0003-2198-3678
authors.initials: PM
authors.lastname: Jungmann
mesh_terms: D000328:Adult; D000843:Ankle Joint / Q000000981:diagnostic imaging*; D001175:Arthrography / Q000379:methods*; D002356:Cartilage / Q000000981:diagnostic imaging / Q000293:injuries; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D013628:Talus / Q000000981:diagnostic imaging / Q000293:injuries; D013977:Tibia / Q000000981:diagnostic imaging / Q000293:injuries; D014057:Tomography, X-Ray Computed / Q000379:methods*