The accuracy of three-dimensional magnetic resonance imaging in the diagnosis of ruptures of the lateral ligaments of the ankle.

In a prospective study, the diagnostic accuracy of three-dimensional magnetic resonance imaging in the evaluation of ruptures of the lateral ligaments of the ankle was determined by comparing three-dimensional magnetic resonance findings with operative findings. In a series of 18 consecutive cases of acute significant inversion trauma to the ankle, a three-dimensional fast imaging with steady-state precession pulse sequence (3D FISP) was performed. The study included only those cases in which views showed a difference in talar tilt of 15 degrees or more, and a difference in anteroposterior drawer of 10 mm or more between the imaged and the normal ankle. All ankles were scheduled for surgical exploration. Compared with operative findings, the sensitivity, specificity, and accuracy of 3D FISP imaging were, respectively, 100%, 50%, and 94.4% for ruptures of the anterior talofibular ligament and 91.7%, 100%, and 94.4% for ruptures of the calcaneofibular ligament. We believe that 3D FISP magnetic resonance imaging is a noninvasive, fast, and very accurate diagnostic aid to operative planning for double ligament tears in younger competitive athletes.