Both Magnetic Resonance Imaging and Computed Tomography Are Reliable and Valid in Evaluating Cystic Osteochondral Lesions of the Talus

Abstract

Background: Compared with computed tomography (CT), magnetic resonance imaging (MRI) might overestimate the condition of osteochondral lesions of the talus (OLTs) owing to subchondral bone marrow edema and the overlying cartilage defect. However, no study has compared MRI and CT directly in evaluating OLTs with subchondral cysts. Purpose: To compare the reliability and validity of MRI and CT in evaluating OLTs with subchondral cysts. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: An institutional radiology database was queried for inpatients diagnosed with OLTs with subchondral cysts who had undergone surgical treatment between May 2015 and October 2019. A total of 48 patients met the inclusion criteria. Based on our measurement method, 2 experienced observers who were blinded to the study independently measured the length, width, and depth of the cysts using MRI and CT. The classification of cystic lesions was also performed based on MRI and CT findings. Results: Interobserver reliability was almost perfect, with intraclass correlation coefficients (ICCs) ranging from 0.935 to 0.999. ICCs for intraobserver reliability ranged from 0.944 to 0.976. The mean size of cysts measured on MRI (length, 13.38 ± 4.23 mm; width, 9.28 ± 2.28 mm; depth, 11.54 ± 3.69 mm) was not significantly different to that evaluated on CT (length, 13.40 ± 4.08 mm; width, 9.25 ± 2.34 mm; depth, 11.32 ± 3.54 mm). The size of subchondral cysts was precisely estimated on both MRI and CT. The MRI classification and CT classification revealed almost perfect agreement (kappa = 0.831). Conclusion: With our measurement method, both MRI and CT were deemed to be reliable and valid in evaluating the size of subchondral cysts of OLTs, and the MRI classification was well-correlated with the CT classification. The presented measurement method and classification systems could provide more accurate information before surgery.

High resolution flat-panel CT arthrography vs. MR arthrography of artificially created osteochondral defects in ex vivo upper ankle joints

“…Still, there was overall good correlation between FPCT-A and MR-A measurements, as has been recently published in a recent study by Deng et al ., [ 33 ]. Both, MRI and CT were reliable in the assessment of the size of subchondral cysts of talar defects and the MRI classification was well-correlated with the CT classification [ 33 ].…”

SPECT/CT imaging features of cystic degeneration of the talus and their relation to pathological findings

“…Type II is more symptomatic and has a poorer prognosis. (4) The cystic lesion was measured on CT to indirectly reflect the tissue composition within the lesion area [ 4 – 6 ]. (5) The bone continuity of the articular surface above the cystic area was observed in all directions on sagittal, coronal, and transverse views.…”

Autologous matrix induced chondrogenesis (AMIC) as revision procedure for failed AMIC in recurrent symptomatic osteochondral defects of the talus

“…On admission, the following data were recorded: age, gender, side, date of surgeries, additional autologous cancellous bone grafting during the index procedure, BMI (Kg/m 2 ), symptoms duration prior of the revision surgery and length of the hospitalisation. The area of the defect was measured using MRI sequences 29 . In May 2021, with informed consent, patients were invited to complete the following patient reported outcome measures (PROMs): Visual Analogic Scale (VAS), Tegner Activity Scale, and the American Orthopaedic Foot and Ankle Score (AOFAS).…”