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العنوان
The role of MRI in assessment of collateral ligaments injuries around the ankle/
المؤلف
Khattab, Walaa Ahmed Mostafa.
هيئة الاعداد
باحث / Walaa Ahmed Mostafa Khattab
walaa_khattab84@yahoo.com
مشرف / Ali Abdel-Karim Farahat
مشرف / Mohamad Sami Barakat
مشرف / Ahmed El-Sayed Ahmed Semaya
مناقش / Hesham Taha Kotb
مناقش / Hesham Fathy Ghoneem
الموضوع
Radiodiagnosis.
تاريخ النشر
2013.
عدد الصفحات
68 p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
الأشعة والطب النووي والتصوير
تاريخ الإجازة
3/7/2013
مكان الإجازة
جامعة الاسكندريه - كلية الطب - Radiodiagnosis
الفهرس
Only 14 pages are availabe for public view

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Abstract

Ankle injury is a very common type of injury worldwide, with most of these being sprains.
The aim of the work was to evaluate the role of magnetic resonance imaging in the assessment of collateral ligaments around the ankle region in various conditions from intact to disrupted.
The present work included forty subjects, including 10 non complaining subjects with no history of trauma and normal MRI findings and 30 patients with positive ankle collateral ligament affection. All patients were recommended for MRI after being primarily evaluated by x-ray and CT.
Forty cases were subjected to MRI evaluation using 1.5 T units Philips Intera (Best, Netherlands) closed MRI. A standard knee or ankle coil was used.
Routine ankle T1-weighted MR imaging is performed in the axial, coronal, and sagittal planes & T2 is performed in axial, with and without fat sat, coronal with and without fat sat and sagittal T2 with fat sat. Standard spin-echo (SE) pulse sequences usually adequate for evaluating ligamentous injury.
MRI demonstrated the 32 ankles of ATFL injury. Among these, 25 ankles (78.13%) showed grade I tear, four ankles (12.50%) showed grade II tear, and 3 ankles (9.38%) showed grade III tear.
Out of the 33 injured ankles, 21 ankles showed isolated ATFL injury, one ankle showed isolated PTFL injury, 7 ankles showed combined ATFL and CFL injury, 2 ankles showed combined ATFL and deltoid ligaments injury, 1 ankle showed combined ATFL, CFL and deltoid ligament injuries and the last ankle showed combined ATFL, CFL, PTFL and deltoid ligament injuries.
The diagnosis was done depending on the axial and coronal planes of T1 and T2 weighted images with and without fat sat. The ATFL& PTFL were best assessed in axial planes while the coronal planes were the most appropriate to assess CFL and deltoid ligaments.
The posterior talofibular and deep portion of the deltoid ligament may demonstrate heterogenous appearance due to interspersed fat, which should not be misinterpreted as a tear. The ATFL is the weakest ligament and is the first to be involved, followed by CFL and deltoid ligament. PTFL is the last to be involved.
The MR imaging criteria for the diagnosis of injury of the collateral ligament include morphologic and signal intensity alterations within and around the ligament as, thickening, thinning, or irregularity of the ligament, increased intra-ligamentous signal intensity and extravasation of joint fluid into the adjacent soft tissues.
Ankle collateral ligament injuries are classified as grade I sprain (stretching/peri-ligamentous edema), grade II injury (partial tear), or grade III injury (complete disruption).