Min Hee Lee MD, Presenter: Nothing to Disclose

Jang Gyu Cha MD, Abstract Co-Author: Nothing to Disclose

Young Goo Lee, Abstract Co-Author: Nothing to Disclose

Sung Il Park, Abstract Co-Author: Nothing to Disclose

Hye Kyung Lee, Abstract Co-Author:

Hyun-Sook Hong MD, PhD, Abstract Co-Author: Nothing to Disclose

Sang Hyun Paik MD, Abstract Co-Author: Nothing to Disclose

To determine whether the bright dot sign at magnetic resonance (MR) imaging is a marker of anterior talofibular ligament (ATFL) injury.

Ethics review board approval was not required for retrospective study involving image or case record review; informed consent for review was not required. This study included 34 patients (M: F=22: 12; age range: 13-53 years, mean: 29 years) who had ankle injury and underwent arthroscopic surgery. All patients underwent 3T MR imaging for diagnosis of ATFL injury. When MR imaging revealed any of; nonvisualization of the ligament, ligament discontinuity, unusual ligament thickening, cortical disruption (criteria 1) or additional criteria of; bright dot sign (criteria 2), the injury was considered to be a ligament disruption. After MR imaging, ankle arthroscopy was performed in all patients for a definitive diagnosis and repair of ligament disruption.

Arthroscopy showed ATFL disruption in 33 patients. When MR imaging diagnosis was based on criteria 1, ATFL disruption was diagnosed with a sensitivity of 66.7%, and an accuracy of 67.6%. When MR imaging diagnosis was based on both the criteria 1 and 2, ATFL disruption was diagnosed with a sensitivity of 90.9% and an accuracy of 88.2%. By adding criteria 2 for diagnosis, 8 patients with ATFL injury were additionally diagnosed, of which 7 patients had partial tear of ATFL on arthroscopy.

The bright dot sign on MR image may be regarded as an additional morphologic feature that help increase diagnostic performance for detecting ATFL injury including partial tear.

The bright dot sign can improve the detection rate of ATFL injury including partial tear which is easy to miss and provide the reasonability of surgery for ankle instability.

Lee, M, Cha, J, Lee, Y, Park, S, Lee, H, Hong, H, Paik, S, Bright Dot Sign on MR Image for the Anterior Talofibular Ligament Injury.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9007603.html