Cao Shengxuan, Wang Chen, Ma Xin, Wang Xu, Huang Jiazhang, Zhang Chao, Wang Kan
Department of Orthopedics, Huashan Hospital, Fudan University, No.12, Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.
Department of Radiology, Huashan Hospital, Fudan University, No.12, Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.
J Orthop Surg Res. 2019 Feb 28;14(1):69. doi: 10.1186/s13018-019-1102-4.
The objective of the current study is to compare reliability, accuracy, sensitivity, and specificity in magnetic resonance imaging (MRI) evaluation of anterior talofibular ligament (ATFL) among the routine axial scanning plane, oblique axial-coronal scanning plane, and oblique axial-sagittal scanning plane.
Twenty cadaveric feet were studied. ATFL was exposed before scanning. Routine axial, oblique axial-coronal, and oblique axial-sagittal MRI scanning of 20 ATFL-intact cadaveric feet were acquired utilizing a 1.5-T MRI unit. The scans were repeated on the 20 cadaveric feet after the ATFL was artificially injured. In total, 120 sets of MR images were obtained and were randomly numbered. Three independent observers who were blinded to the experiment evaluated the images. Interobserver agreement, sensitivity, specificity, and accuracy were calculated and compared between different scanning planes utilizing the McNemar test.
The interobserver agreement was fair to good (kappa, 0.55 to 0.65) in the routine axial plane, fair to good (kappa, 0.557 to 0.75) in the oblique axial-sagittal plane, and excellent (kappa, 0.85 to 0.95) in the oblique axial-coronal plane. The accuracy was significantly higher when utilizing oblique axial-coronal MRI scanning than routine axial MRI scanning (reader 1: p = .018; reader 2: p = .005).
The diagnostic accuracy of oblique axial-coronal plane MRI was higher than the routine axial plane concerning ATFL injury, and the interobserver agreement was excellent. The oblique axial-coronal plane could be added to the MRI scanning protocol during clinical practices to improve the diagnostic accuracy of ATFL injury.
本研究的目的是比较在磁共振成像（MRI）评估距腓前韧带（ATFL）时，常规轴位扫描平面、斜轴位-冠状位扫描平面和斜轴位-矢状位扫描平面之间的可靠性、准确性、敏感性和特异性。
对20只尸体足进行研究。在扫描前暴露ATFL。使用1.5-T MRI设备对20只ATFL完整的尸体足进行常规轴位、斜轴位-冠状位和斜轴位-矢状位MRI扫描。在ATFL人为损伤后，对这20只尸体足再次进行扫描。共获得120组MR图像，并随机编号。三名对实验不知情的独立观察者对图像进行评估。利用McNemar检验计算并比较不同扫描平面之间的观察者间一致性、敏感性、特异性和准确性。
在常规轴位平面，观察者间一致性为中等至良好（kappa值，0.55至0.65）；在斜轴位-矢状位平面，为中等至良好（kappa值，0.557至0.75）；在斜轴位-冠状位平面，为优秀（kappa值，0.85至0.95）。使用斜轴位-冠状位MRI扫描时的准确性显著高于常规轴位MRI扫描（读者1：p = 0.018；读者2：p = 0.005）。
在ATFL损伤方面，斜轴位-冠状位平面MRI的诊断准确性高于常规轴位平面，且观察者间一致性优秀。在临床实践中，可将斜轴位-冠状位平面添加到MRI扫描方案中，以提高ATFL损伤的诊断准确性。
