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Evaluation of ankle ligaments with CT: A feasibility study
A Sterzik1, F Mueck2, S Wirth3
1Radiologie Ottobrunn, Haidgraben 2, 81553, Ottobrunn, Germany; Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
European Journal of Radiology
|December 14, 2020
Summary
Standard CT imaging can assess normal ankle ligaments, with MRI as a reference. CT shows good visualization and concordance with MRI for ligament appearance and thickness, though some limitations exist with specific ligaments and soft tissue edema.
Area of Science:
- Radiology
- Orthopedic Imaging
- Anatomy
Background:
- Ankle ligament injuries are common.
- MRI is the gold standard for assessing ankle ligaments.
- CT's role in evaluating normal ankle ligaments is less established.
Purpose of the Study:
- To systematically evaluate the feasibility of assessing normal ankle ligaments using CT imaging.
- To compare CT findings with MRI as the reference standard.
Main Methods:
- Retrospective analysis of 35 patients with CT and MRI ankle scans.
- Independent evaluation of syndesmotic, lateral, and medial ankle ligaments by three readers.
- Assessment of ligament visibility, density, thickness, and appearance on multiplanar MDCT bone kernel reconstructions.
- Comparison and validation of CT findings with corresponding MRI images.
Main Results:
- Most ankle ligaments were adequately depicted on CT, with a mean visual score of 2.7/3.
- Excellent interreader agreement (Fleiss Kappa >0.8) was observed for CT assessment.
- Good concordance between CT and MRI was found for ligament thickness and appearance.
- CT density measurements showed inter- and intraindividual variations.
- Delineation challenges occurred with filiform ligaments and soft tissue edema.
Conclusions:
- Standard CT imaging in bone kernel reconstructions is feasible for assessing normal ankle ligaments.
- CT assessment of normal ankle ligaments has limitations, particularly for medial collateral ligaments and in cases of soft tissue edema.
