Flat-panel CT arthrography for cartilage defect detection in the ankle joint: first results in vivo.
OBJECTIVES
The purpose of this study was to compare the diagnostic performance of flat-panel computed tomography (FPCT) arthrography for cartilage defect detection in the ankle joint to direct magnetic resonance (MR) arthrography using multidetector computed tomography (MDCT) arthrography as the reference standard.


METHODS
Twenty-seven patients with specific suspicion of articular cartilage lesion underwent ankle arthrography with injection of a mixture of diluted gadolinium and iobitridol and were examined consecutively with the use of FPCT, MDCT, and 1.5 T MR imaging. FPCT, MDCT, and MR arthrography examinations were blinded and randomly evaluated by two musculoskeletal radiologists in consensus. In each ankle, eight articular cartilage areas were assessed separately: medial talar surface, medial talar trochlea, lateral talar trochlea, lateral talar surface, tibial malleolus, medial tibial plafond, lateral tibial plafond, and fibular malleolus. Findings at FPCT and MR were compared with MDCT assessments in 216 cartilage areas.


RESULTS
For the detection of cartilage defects, FPCT demonstrated a sensitivity of 97%, specificity of 95%, and accuracy of 96%; and MR arthrography showed a sensitivity of 69%, specificity of 94%, and accuracy of 87%. FPCT and MR arthrography presented almost perfect agreement (κ = 0.87) and moderate agreement (κ = 0.60), respectively, with MDCT arthrography. Mean diagnostic confidence was higher for FPCT (2.9/3) than for MR (2.3/3) and MDCT (2.7/3) arthrography.


CONCLUSIONS
FPCT demonstrated better accuracy than did 1.5 T MR arthrography for cartilage defect detection in the ankle joint. Therefore, FPCT should be considered in patients scheduled for dedicated imaging of ankle articular cartilage.
['Pagliano|Sarah|S|', 'Chemouni|David|D|', 'Guggenberger|Roman|R|', 'Pauly|Vanessa|V|', 'Guenoun|Daphné|D|', 'Champsaur|Pierre|P|', 'Le Corroller|Thomas|T|']
D000293:Adolescent D000328:Adult D000368:Aged D000843:Ankle Joint D001175:Arthrography D002357:Cartilage Diseases D003287:Contrast Media D005260:Female D005682:Gadolinium D006801:Humans D007472:Iohexol D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D061330:Multidetector Computed Tomography D011446:Prospective Studies D012680:Sensitivity and Specificity D014057:Tomography, X-Ray Computed
CT Arthrography Ankle MRI