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Chronic Tibiofibular Syndesmosis Injury of Ankle: Evaluation with Contrast-enhanced Fat-suppressed 5D Fast Spoiled Gradient-recalled Acquisition in the Steady State MR Imaging

 Sungjun Kim  ;  Yong-Min Huh  ;  Jin-Suck Suh  ;  In Hyuk Chung  ;  Jong Eun Lee  ;  Jin-Woo Lee  ;  Sung-Ah Lee  ;  Ho-Taek Song 
 RADIOLOGY, Vol.242(1) : 225-235, 2007 
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To retrospectively determine the accuracy of coronal contrast material-enhanced fat-suppressed three-dimensional (3D) fast spoiled gradient-recalled acquisition in the steady state (SPGR) magnetic resonance (MR) imaging, as compared with that of routine transverse MR imaging, in the assessment of distal tibiofibular syndesmosis injury, with arthroscopy as the reference standard.
The review board of the College of Medicine in Yonsei University approved this study; informed consent was waived. The study group comprised 45 patients (26 men, 19 women; mean age, 32.1 years; range, 18-58 years) with a chronic ankle injury who had undergone MR imaging and arthroscopic surgery. Three independent readers retrospectively reviewed the two sets of MR images (one set of gadolinium-enhanced 3D fast SPGR images and one set of routine T1-, T2-, and intermediate-weighted images). Scores from 1 to 5 in increasing order of the probability of injury were assigned to both sets. Arthroscopy was the reference standard. Syndesmotic recess height was measured on contrast-enhanced images. The two sets of images were compared for diagnostic performance with receiver operating characteristic (ROC) analysis. Dissection and histologic examination of six cadaveric ankles was performed to assess the syndesmotic area and ascertain the enhancing structure at MR imaging.
At arthroscopy, syndesmotic injury was found in 24 ankles but not in 21 ankles. Areas under the ROC curve were significantly higher for the contrast-enhanced images (P<.05). The contrast-enhanced set showed higher accuracy, sensitivity, and specificity compared with the routine set for the assessment of syndesmosis injury. Mean syndesmotic recess height was significantly greater (P<.05) in patients with syndesmotic injury. Dissection and histologic examination revealed a highly vascular synovial fold in the syndesmotic area that is expected to enhance at MR imaging.
In the assessment of chronic syndesmosis injury, coronal gadolinium-enhanced fat-suppressed 3D fast SPGR MR images were more sensitive, specific, and accurate than routine MR images.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anatomy (해부학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sungjun(김성준) ORCID logo https://orcid.org/0000-0002-7876-7901
Suh, Jin Suck(서진석) ORCID logo https://orcid.org/0000-0001-9455-9240
Song, Ho Taek(송호택) ORCID logo https://orcid.org/0000-0002-6655-2575
Lee, Sung Ah(이성아)
Lee, Jong Eun(이종은) ORCID logo https://orcid.org/0000-0001-6203-7413
Lee, Jin Woo(이진우) ORCID logo https://orcid.org/0000-0002-0293-9017
Chung, In Hyuk(정인혁)
Huh, Yong Min(허용민) ORCID logo https://orcid.org/0000-0002-9831-4475
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