Comprehensive Assessment of Ankle Syndesmosis Injury Using 3D Isotropic Turbo Spin-Echo Sequences: Diagnostic Performance Compared With That of Conventional and Oblique 3-T MRI.
OBJECTIVE
The objective of this study is to evaluate the diagnostic performance of 3D sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) sequences in the evaluation of ankle syndesmosis injuries, compared with that of conventional orthogonal MRI and oblique proton density-weighted turbo spin-echo (TSE) sequences performed with 3-T MRI.


METHODS
This retrospective study included 98 patients with suspected ankle syndesmosis injuries who underwent both MRI and surgery. Fifty patients (mean [± SD] age, 34.5 ± 15.3 years) had acute injuries, and 48 patients (mean age, 28.5 ± 9.6 years) had chronic injuries. For both groups, the diagnostic performance of each MRI sequence with regard to syndesmosis injuries was evaluated. Arthroscopy findings were used as a reference standard to confirm diagnosis.


RESULTS
No statistically significant differences in the sensitivity, specificity, accuracy, and AUC values were noted between images of the syndesmosis obtained using proton density-weighted TSE sequences and images of the syndesmosis obtained using 3D SPACE sequences (p > 0.05). Interobserver agreement regarding the diagnosis of both acute and chronic syndesmosis injuries was almost perfect for proton density-weighted TSE images (κ > 0.80) and was substantial for 3D SPACE images (κ > 0.75). Both methods of obtaining images of the syndesmosis had a diagnostic performance superior to that of conventional orthogonal MRI.


CONCLUSIONS
The performance of 3D SPACE sequences is comparable to that of 2D proton density-weighted MR images for the diagnosis of acute and chronic syndesmosis injuries.
1 Department of Radiology, Eulji University Medical Center, 68 Hangeulbiseok-ro, Nowon-gu, Seoul, 01830, Korea.
Minchul
M
Kim
1 Department of Radiology, Eulji University Medical Center, 68 Hangeulbiseok-ro, Nowon-gu, Seoul, 01830, Korea.
Yun Sun
YS
Choi
1 Department of Radiology, Eulji University Medical Center, 68 Hangeulbiseok-ro, Nowon-gu, Seoul, 01830, Korea.
Min Sun
MS
Jeong
2 Department of Preventive Medicine, School of Medicine, Eulji University, Daejeon, Korea.
Mira
M
Park
1 Department of Radiology, Eulji University Medical Center, 68 Hangeulbiseok-ro, Nowon-gu, Seoul, 01830, Korea.
Tong Jin
TJ
Chun
3 Department of Orthopedic Surgery, Eulji University Medical Center, Seoul, Korea.
Jin Su
JS
Kim
3 Department of Orthopedic Surgery, Eulji University Medical Center, Seoul, Korea.
Ki Won
KW
Young
D000293:Adolescent; D000328:Adult; D000368:Aged; D016880:Anisotropy; D016512:Ankle Injuries / Q000000981:diagnostic imaging*; D000843:Ankle Joint / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted; D055815:Young Adult
3.0 T; 3D SPACE; 3D isotropic; MRI; tibiofibular syndesmosis