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Cartilage lesions in the ankle joint: comparison of MR arthrography and CT arthrography
M R Schmid1, C W A Pfirrmann, J Hodler
1Department of Radiology, Orthopedic University Hospital Balgrist, Forchstrasse 340, 8008 Zurich, Switzerland. mariusschmid@hotmail.com
Objective:
To compare MR arthrography and CT arthrography for the evaluation of cartilage lesions in the ankle joint.
Design And Patients:
Thirty-six consecutive patients with clinically suspected cartilage lesions were prospectively included in the study. A 1:1 mixture of diluted gadoteridol (4 mmol/l) and iopamidol (300 mg iodine/ml) was injected. The articular cartilages of the talus, tibia, and fibula were analyzed separately by two musculoskeletal radiologists. A review panel consisting of two musculoskeletal radiologists and an orthopedic surgeon represented the standard of reference.
Results:
For reader 1 accuracy of MR arthrography in the talus/tibia/fibula (88%/88%/94%) was slightly inferior to CT arthrography (90%/94%/92%). For reader 2, the accuracy was 76%/78%/83% for MR arthrography, and 92%/93%/92% for CT arthrography, respectively. Interobserver agreement for MR arthrography was 79%/74%/89% (kappa 0.47/0.34/0.27), while interobserver agreement for CT arthrography was 89%/90%/89% (kappa 0.69/0.54/0.54).
Conclusion:
CT arthrography appears to be more reliable than MR arthrography for the detection of cartilage lesions in the ankle joint.