Christian Seebauer, Presenter: Nothing to Disclose

Hermann Josef Bail, Abstract Co-Author: Nothing to Disclose

Jens Rump, Abstract Co-Author: Nothing to Disclose

Bernd K. Hamm MD, Abstract Co-Author: Research Consultant, Bayer AG Research Consultant, Toshiba Corporation Stockholder, Siemens AG Stockholder, General Electric Company Stockholder, Biomed Research grant, Toshiba Corporation Research grant, Koninklijke Philips Electronics NV Research grant, Siemens AG Research grant, General Electric Company Research grant, Elbit Medical Imaging Ltd Research grant, Bayer AG Research grant, Guerbet AG Research grant, Bracco Group Research grant, B. Braun Research grant, Knauth Research grant, Boston Group Equipment support, Elbit Medical Imaging Ltd Investigator, Copenhagen Malmo Contrast AB, Lund, Sweden

Felix V. Guettler, Abstract Co-Author: Nothing to Disclose

Ulf Karl Martin Teichgraeber MD, Abstract Co-Author: Nothing to Disclose

Stress radiography using X-ray commonly is used to assess disorders of the ankle in patients with a history of ankle sprain. No reports have been documented so far combining the advantages of MRI with stress radiography using the Telos stress device. The purpose of this study was to determine feasibility and value of MR-stress radiography.

A MR-compatible stress device was developed in cooperation with Telos (Hungen,D) and tested for safety and applicability in MR environment. 64 ankle joints of 32 healthy volunteers (16m;16f=group A) were evaluated and compared with 20 ankles of 10 (8m;2f=group B) volunteers who suffer from chronic instability of the ankle joint. Measurements were performed in a 1T open MRI (Philips,Eindhoven,NL). T2w FSE sequences were performed in a cor., sag. and ax. slice orientation during simulation of lateral inversion stress and anterior drawer test. The talar tilt(TT), subtalar tilt(STT), anterior talus translation(ATT), anterior calcaneus translation(ACT), the lateral translation of talus and calcaneus(LTCT) and the ligaments of the lateral ankle(ATFL, CFL, PTFL) were assessed with a 15 kp stress challenge.

The talocrural as well as the subtalar joint could be assessed simultaneously in cor. images and allowed direct differentiation of tilt differences between talocrural and subtalar joint. A significant gender difference (p<0,05) was found for the ATFL(lt:m:3,11;f:2,43mm)(td:m:0,38;f:0,27mm), CFL(lt:m:2,97; f:2,62mm)(td:m:0,25; f:0,2mm) and PTFL(lt:m:8,65; f:7,88mm)(td:m:0,28; f:0,16mm) in ligament thickness(lt) and thickness decrease(td); and the TT(m:3,09; f:4,53°),STT(m:5,14; f:7,44°) and ATT(m:1,73; f:2,41mm) in group A. Significant differences between group A and B were found for the TT, ATT and ACT. A correlation was found for the TT/ATT in group A(r=0,42) and group B (r=0,57); for the STT/ACT (r=0,69) and STT/LTCT (r=0,82) in group B.

The MR-stress radiography offers new possibilities in diagnosis of chronic instability of the ankle joint. The direct assessment of ligaments under stress challenge and differentiation between instability of the talocrural and subtalar joints are advantages compared to common stress tests.

Not only MR stress assessments of the ankle, but also stress tests of the knee joint are now possible and offer progress in diagnosis of instability of the ankle and knee joint without x-ray exposure.

Seebauer, C, Bail, H, Rump, J, Hamm, B, Guettler, F, Teichgraeber, U, MR: Stress Radiography of the Ankle Joint—Preliminary Results.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9001635.html