Radiology Department, SBU Ankara Oncology Education and Research Hospital, Ankara 06110, Turkey.
Radiology Department, Erzincan Binali Yıldırım University, Erzinkan 24000, Turkey.
Medicina (Kaunas). 2022 Feb 20;58(2):321. doi: 10.3390/medicina58020321.
Our aim is to determine the diagnostic performance and utility of Diffusion Weighted MR Imaging (DWI) against the routine Magnetic Resonance Imaging (MRI) for the evaluation of patients with tendon injuries of the ankle and foot. After institutional review board approval and informed consent taken from all the patients, ankle and foot MR imaging and DWI-Apparent Diffusion Coefficient (ADC) mapping were performed on the 81 injured tendons of 50 patients. All tendon injuries were named as Rupture (R), Partial tear (PT), and Tenosynovitis (T). Diagnostic interpretation was based on the MRI-DWI and ADC mapping, verified by either open surgery, diagnostic arthroscopy, or conservative procedures-splint application. Statistical analysis of this research was assessed by Fischer's exact test, variance analysis test between dependent groups, Receiver Operating Characteristics (ROC) curve, and Pearson chi square statistics. MRI depicted all tendon injuries with 70% sensitivity and 100% specificity, and showed a significant statistical relationship to surgical and arthroscopic references with high agreement ( < 0.05, k: 0.609). DWI had 100% sensitivity and 83-90% specificity for the visualization of tendon injuries with certain agreement and a significant statistical relationship to the gold standard ( < 0.05, k: 0.890-0.899). For all those injured tendons, DWI had 100% sensitivity for the diagnosis of R, and 92-97% sensitivity corresponding to PT and T over routine ankle MR imaging. The specificity of DWI to MRI ranged from 75 to 44% for all the injured tendons. DWI had significant statistical superiority over MRI for the visualization of R, PT, and T of all tendons included in this research ( < 0.05). DWI is a good imaging modality for the visualization of ankles with tendon injuries, possibly further improving the sensitivity of the classical ankle and foot MRI, and supplying more beneficial and diagnostic information than routine MR imaging on the basis of R, PT, and T of tendons at the ankle and foot.
我们的目的是确定弥散加权磁共振成像（DWI）在评估踝关节和足部肌腱损伤患者中的诊断性能和实用性，与常规磁共振成像（MRI）相比。在获得所有患者的机构审查委员会批准和知情同意后，对 50 名患者的 81 根受伤肌腱进行了踝关节和足部 MRI 和 DWI-表观弥散系数（ADC）映射。所有肌腱损伤均命名为断裂（R）、部分撕裂（PT）和腱鞘炎（T）。诊断解释基于 MRI-DWI 和 ADC 映射，通过开放手术、诊断性关节镜检查或保守治疗（夹板应用）进行验证。本研究的统计分析采用 Fisher 精确检验、方差分析检验、受试者工作特征（ROC）曲线和 Pearson 卡方检验进行评估。MRI 以 70%的敏感性和 100%的特异性描绘了所有肌腱损伤，与手术和关节镜参考具有显著的统计学关系，具有高度一致性（<0.05，k：0.609）。DWI 对肌腱损伤的可视化具有 100%的敏感性和 83-90%的特异性，具有一定的一致性和与金标准的显著统计学关系（<0.05，k：0.890-0.899）。对于所有受伤的肌腱，DWI 对 R 的诊断具有 100%的敏感性，对于 PT 和 T 的敏感性为 92-97%，高于常规踝关节 MRI。DWI 对 MRI 的特异性对于所有受伤的肌腱范围为 75-44%。DWI 在 R、PT 和 T 的可视化方面明显优于 MRI ，包括本研究中的所有肌腱（<0.05）。DWI 是一种很好的踝关节肌腱损伤可视化成像方式，可能进一步提高了经典踝关节和足部 MRI 的敏感性，并提供了比常规 MRI 更有益和诊断性的信息，在踝关节和足部的 R、PT 和 T 基础上。
