Department of Radiology, Armed Forces Capital Hospital, Gyeonggi, Republic of Korea.
Foot Ankle Int. 2012 Dec;33(12):1058-62. doi: 10.3113/FAI.2012.1058.
Magnetic resonance imaging (MRI) is widely used for diagnosing osteochondral lesions in the talus. The purpose of this study was to directly compare the MRI with the arthroscopic findings.
MR images of 42 ankles were retrospectively reviewed during a period of 67 months. The osteochondral lesions were evaluated by both MRI (0, normal; 1, subchondral trabecular compression and marrow edema; 2A, subchondral cyst; 2B incomplete separation fragment; 3, unattached, nondisplaced fragment with synovial fluid surrounding it; 4, displaced fragment) and arthroscopy (A, smooth and intact, but soft and ballottable cartilage; B, rough surfaces; C, fibrillations or fissures; D, flap present or bone exposed; E, loose, undisplaced fragment; F, displaced fragment). Arthroscopic grade A was considered to be equivalent to MR grade 1, B and C to MR grade 2A, D to 2B, E to 3, and F to 4.
Of the 44 lesions in 42 ankles, 29 lesions marked the same grade on both MRI and arthroscopy (65.9%). Nine lesions were upgraded on arthroscopy (20.5%), and six were downgraded (13.6%). MR grade 3 lesions showed the best correlation (83.3%) and MR grade 1 and 2B lesions showed the worst (50.0 and 55.6 %). Arthroscopic grade A and F showed good correlation (80 and 100%). Grade C and E showed poor (25.0%) and intermediate correlation (66.7%), respectively.
The MRI grading of osteochondral lesions in the talus was useful and showed a fairly good correlation with arthroscopic classification.
磁共振成像（MRI）广泛用于诊断距骨的骨软骨病变。本研究的目的是直接比较 MRI 和关节镜检查结果。
回顾性分析了 67 个月期间的 42 例踝关节的 MRI 图像。通过 MRI（0，正常；1，软骨下骨小梁压缩和骨髓水肿；2A，软骨下囊肿；2B 不完全分离碎片；3，无附着、无移位、周围有滑液的碎片；4，移位碎片）和关节镜（A，光滑完整但柔软可压缩的软骨；B，粗糙表面；C，纤维化或裂隙；D，瓣状结构或骨暴露；E，无移位、无松动的碎片；F，移位碎片）对骨软骨病变进行评估。关节镜分级 A 被认为等同于 MRI 分级 1，B 和 C 等同于 MRI 分级 2A，D 等同于 2B，E 等同于 3，F 等同于 4。
在 42 例踝关节的 44 个病变中，29 个病变在 MRI 和关节镜检查上的分级相同（65.9%）。9 个病变在关节镜下升级（20.5%），6 个病变降级（13.6%）。MRI 分级 3 病变相关性最好（83.3%），MRI 分级 1 和 2B 病变相关性最差（50.0%和 55.6%）。关节镜分级 A 和 F 相关性较好（80%和 100%）。分级 C 和 E 相关性较差（25.0%）和中等（66.7%）。
MRI 对距骨骨软骨病变的分级是有用的，与关节镜分类有较好的相关性。
