Journal of the Chinese Medical Association
Volume 69, Issue 1 , Pages 26-31, January 2006

Comparison of Plain MRI and MR Arthrography in the Evaluation of Lateral Ligamentous Injury of the Ankle Joint

  • Mei-Chun Chou

      Affiliations

    • Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
    • Department of Radiology, Chi-Mei Medical Center, Yung Kang Campus, Taiwan, R.O.C.
    • ,
  • Lee-Ren Yeh

      Affiliations

    • Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Clement Kuen-Huang Chen

      Affiliations

    • Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr. Clement Kuen-Huang Chen, Department of Radiology, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan, R.O.C.
    • ,
  • Huay-Ban Pan

      Affiliations

    • Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Yi-Jiun Chou

      Affiliations

    • Department of Orthopedics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
    • ,
  • Huei-Lung Liang

      Affiliations

    • Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.

Received 25 February 2005; accepted 3 November 2005.

Article Outline

Background

The purpose of this study was to determine the efficacy of plain magnetic resonance imaging (MRI) and magnetic resonance (MR) arthrography for detecting collateral ligamentous injury of the ankle joint.

Methods

Fifty patients (October 2001 to November 2003) suffering from ankle disability who underwent plain MRI and MR arthrographic studies were enrolled in this study. The diagnostic criteria for ligament disruption on plain MRI included nonvisualization, disruption, waviness of the ligament, or coexistent avulsion fracture. The MR arthrographic findings of ligament disruption were based on leakage of gadolinium contrast medium anterior to the anterior talofibular (ATaF) ligament following ATaF ligament disruption, and the contrast medium filling into the common peroneal tendon sheath after calcaneofibular (CF) ligament disruption. The 2 modalities were interpreted respectively and blindly.

Results

Seventeen patients received surgical intervention. There were 14 patients who had a torn ATaF ligament and 6 patients who suffered from CF ligament disruption proved by surgery. Limited detection of preoperative plain MRI survey, which showed 12 patients had torn ATaF and 2 patients had torn CF ligament, was noted. However, most patients with ligamentous injury were correctly diagnosed by MR arthrography preoperatively (only 1 case of CF injury was missed). The plain MRI alone had a higher incidence of false negative and false positive detection. MR arthrography was also valuable for evaluating the coexisting intra-articular pathologies of the ankle joint.

Conclusion

For evaluating ankle disability, using plain MRI alone is not adequate for correctly detecting lateral collateral ligamentous injury of the ankle joint. MR arthrography improves the sensitivity and the accuracy for ATaF and CF ligament injuries. It also helps in assessing coexisting pathologic lesions of ankle joints, especially impingement syndromes and osteochondral lesions, and provides more information for therapeutic decision making.

Key Words:  ankle joint , arthrography , collateral ligament , MRI

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PII: S1726-4901(09)70107-8

doi:10.1016/S1726-4901(09)70107-8

Journal of the Chinese Medical Association
Volume 69, Issue 1 , Pages 26-31, January 2006

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