Department of Radiology, Balgrist University Hospital, Faculty of Medicine, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland.
Swiss Center for Musculoskeletal Imaging, Balgrist Campus AG, Zurich, Switzerland.
Eur Radiol. 2024 May;34(5):3493-3502. doi: 10.1007/s00330-023-10304-z. Epub 2023 Oct 19.
This study aimed to evaluate the diagnostic accuracy, inter-reader agreement, and associated pathologies on MR images of patients with confirmed TC.
In this retrospective study, 168 ankle MRI exams were included, consisting of 56 patients with clinically or surgically confirmed TC and 112 controls without TC, matched for age and sex. Images were analyzed independently by three radiologists blinded to clinical information. The evaluation criteria included the presence, type, and location of TC, as well as associated pathologies. After calculating diagnostic accuracy and the odds ratio of demographic data and anatomic coalition type for associated pathologies, inter-reader agreement was assessed using kappa statistics.
The majority of TCs were non-osseous (91.1%) and located at the calcaneonavicular (33.9%) or talocalcaneal joint (66.1%). Associated pathologies included adjacent and distant bone marrow edema (57.1% and 25.0%), osteochondral defect of the talar dome (OCD, 19.6%), and joint effusion (10.7%) and accessory anterolateral talar facet (17.9%). Talar OCD was associated with increased patient age (p = 0.03). MRI exhibited a cumulative sensitivity and specificity of 95.8% and 94.3% with almost perfect inter-reader agreement (κ = 0.895).
MRI is a reliable method for detecting tarsal coalition and identifying commonly associated pathologies. Therefore, we recommend the routine use of MRI in the diagnostic workup of patients with foot pain and suspected tarsal coalition.
MRI is an accurate and reliable modality for diagnosing tarsal coalitions and detecting associated pathologies, while improving patient safety compared to computed tomography by avoiding radiation exposure.
• Despite the technological progress in magnetic resonance imaging (MRI), computed tomography (CT) is still regarded as the gold standard for diagnosing tarsal coalition (TC). • MRI had a cumulative sensitivity of 95.8% and specificity of 94.3% for detecting tarsal coalition with an almost perfect inter-reader agreement. • MRI demonstrates high accuracy and reliability in diagnosing tarsal coalitions and is useful for identifying associated pathologies, while also improving patient safety by avoiding radiation exposure.
本研究旨在评估经临床或手术证实的 TC 患者的 MR 图像的诊断准确性、读者间一致性和相关病理学。
在这项回顾性研究中，纳入了 168 例踝关节 MRI 检查，包括 56 例经临床或手术证实的 TC 患者和 112 例无 TC 的对照者，年龄和性别相匹配。三位放射科医生独立分析图像，对 TC 的存在、类型和位置以及相关病理学进行评估。计算诊断准确性和与人口统计学数据和解剖联合类型相关的病理学的优势比后，使用kappa 统计评估读者间一致性。
大多数 TC 为非骨化性（91.1%），位于跟舟骨（33.9%）或距跟骨关节（66.1%）。相关病理学包括相邻和远处骨髓水肿（57.1%和 25.0%）、距骨穹隆骨软骨缺损（OCD，19.6%）和关节积液（10.7%）和副前外侧距骨面（17.9%）。距骨 OCD 与患者年龄增加有关（p=0.03）。MRI 的累积敏感性和特异性分别为 95.8%和 94.3%，读者间一致性几乎为完美（κ=0.895）。
MRI 是一种可靠的方法，用于检测跗骨联合和识别常见的相关病理学。因此，我们建议在诊断足部疼痛和疑似跗骨联合的患者时常规使用 MRI。
MRI 是一种准确可靠的诊断跗骨联合和检测相关病理学的方法，与 CT 相比，通过避免辐射暴露，提高了患者安全性。
尽管磁共振成像（MRI）技术取得了进步，但 CT 仍被认为是诊断跗骨联合（TC）的金标准。
MRI 检测跗骨联合的累积敏感性为 95.8%，特异性为 94.3%，读者间一致性几乎为完美。
MRI 在诊断跗骨联合方面具有很高的准确性和可靠性，并且在识别相关病理学方面很有用，同时通过避免辐射暴露提高了患者安全性。
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