Khil Eun Kyung, Cha Jang Gyu, Kim Sung Jae, Yoon Yu Sung
Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea.
Department of Radiology, Graduate School, Soonchunhyang University College of Medicine, Asan, Republic of Korea.
Korean J Radiol. 2025 May;26(5):435-445. doi: 10.3348/kjr.2024.0773.
This study aimed to quantitatively assess abnormalities in the talar dome cartilage using MRI T2 mapping, with additional analyses based on the Lauge-Hansen (LH) classification and anatomical locations.
This retrospective study analyzed 78 patients who underwent ankle MRI with T2 mapping for acute ankle trauma between January 2021 and October 2022. Patients were classified into the supination (S) and pronation (P) groups based on the LH classification, and then divided into subgroups based on posterior malleolus (PM) involvement. The T2 values for the talar cartilage were quantitatively measured in six anatomical regions defined by the combination of medial vs. lateral and anterior vs. central vs. posterior. The T2 mapping values in each region of the talus were compared between the S and P groups and between the PM and non-PM injury groups using -tests. The T2 values were also compared between the medial and lateral sides within each group.
Among the 78 patients (mean age, 38.62 ± 14.82 years; 47 male), 53 and 25 were in the S and P groups, respectively, and 53 patients showed PM involvement. In comparison with the P group, the S group exhibited higher T2 values in the medial portion (61.27 ± 8.30 vs. 54.03 ± 6.96; < 0.001) and lower T2 values in the lateral talus (54.95 ± 8.47 vs. 64.15 ± 7.31; < 0.001). The PM injury group showed higher T2 values in the posterior region than the non-PM injury group ( ≤ 0.011). Within the PM injury group, T2 values were higher in the anteromedial and posterolateral regions than on the opposite sides ( = 0.037 and 0.011, respectively).
MRI T2 values demonstrated significant regional variations in the talar dome cartilage in acute ankle trauma, and the T2 values may reflect different ankle trauma mechanisms and PM involvement. Thus, T2 mapping can facilitate evaluation of talar cartilage alterations.
本研究旨在利用MRI T2 mapping定量评估距骨穹窿软骨异常，并根据Lauge-Hansen（LH）分类和解剖位置进行额外分析。
这项回顾性研究分析了2021年1月至2022年10月期间接受踝关节MRI T2 mapping检查的78例急性踝关节创伤患者。根据LH分类将患者分为旋后（S）组和旋前（P）组，然后根据后踝（PM）受累情况分为亚组。在由内侧与外侧以及前侧与中央与后侧组合定义的六个解剖区域中定量测量距骨软骨的T2值。使用t检验比较S组和P组以及PM损伤组和非PM损伤组之间距骨每个区域的T2 mapping值。还比较了每组内侧和外侧之间的T2值。
78例患者（平均年龄38.62±14.82岁；47例男性）中，S组和P组分别有53例和25例，53例患者有PM受累。与P组相比，S组在内侧部分的T2值较高（61.27±8.30对54.03±6.96；P<0.001），在距骨外侧的T2值较低（54.95±8.47对64.15±7.31；P<0.001）。PM损伤组在后侧区域的T2值高于非PM损伤组（P≤0.011）。在PM损伤组中，前内侧和后外侧区域的T2值高于对侧（分别为P = 0.037和0.011）。
MRI T2值显示急性踝关节创伤中距骨穹窿软骨存在明显的区域差异，T2值可能反映不同的踝关节创伤机制和PM受累情况。因此，T2 mapping有助于评估距骨软骨改变。
