The Added Diagnostic Value of the Bright Rim Sign to Conventional MRI Assessment of Anterior Talofibular Ligament Disruption

Basha, Mohammad Abd Alkhalik; Eldib, Diaa Bakry; Zaitoun, Mohamed; Ghandour, Tarek Mohamed; Aly, Tarek; Mostafa, Shaimaa; Atta, Doaa S; Algazzar, Hesham Youssef

doi:10.1016/j.acra.2020.05.005

Cited by 5 publications

(7 citation statements)

References 16 publications

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“…The data were available in eight studies [37][38][39][40][41][42][43][44], but we only analyzed seven because one (Kreitner 1998) did not recruit any non-diseased subjects.…”

Section: Results Of Meta-analysismentioning

confidence: 99%

“…Four of the included studies provided data regarding MRI diagnostic performance in detecting both partial and complete ATFL lesions [37,41,42,44]. Three of them [38][39][40] provided data regarding complete lesions only.…”

Section: Discussionmentioning

confidence: 99%

“…For example, great heterogeneity was present among the included studies in terms of timing of MRI after the traumatic event; further research is needed to identify any differences in the diagnostic performance of MRI as its timing varies. Furthermore, while some of the studies [39][40][41] did not report precise selection criteria for patients operated on and/or undergoing arthroscopy, others considered for these procedures only patients with particularly severe clinical pictures [37,43] or with other clinical or instrumental findings suggestive of ATFL lesions [38,42,44], such as Talar Tilt > 15 • on stress X rays or a positive Drawer test on physical examination. This may have biased our results, since MRI was performed on a patient population with a high pretest probability of ATFL injury.…”

Section: Discussionmentioning

confidence: 99%

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Magnetic Resonance Accuracy in the Diagnosis of Anterior Talo-Fibular Ligament Acute Injury: A Systematic Review and Meta-Analysis

et al. 2021

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Background: The studies about injury to the anterior talo-fibular ligament (ATFL) are focused mainly on chronic symptoms and chronic instability, and the literature about the accuracy of magnetic resonance imaging (MRI) in acute injuries is quite lacking. Methods: This systematic review with meta-analysis analyzes the diagnostic accuracy of MRI on acute ATFL injury. Relative studies were retrieved after searching three databases (MEDLINE, SCOPUS, and Cochrane Central Register of Controlled Trails). Eligible studies were summarized. The quality of the included articles was assessed using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Data were extracted to calculate pooled sensitivity and specificity of MRI. Results: Seven studies met our inclusion and exclusion criteria. For MRI, the pooled sensitivities and specificity in diagnosing acute ATFL injury were respectively 1.0 (95% CI: 0.58–1) and 0.9 (95% CI: 0.79–0.96). Pooled LR+ and LR− were respectively 10.4 (95% CI: 4.6–23) and 0 (95% CI: 0–0.82). Conclusion: This systematic review with meta-analysis investigated the accuracy of imaging for the diagnosis of acute ATFL injury. Our results demonstrated that MRI shows high diagnostic accuracy in the diagnosis of acute ATFL lesions. These results suggest that routine MRI in the case of suspected ATFL acute injury may be clinically useful, although this is not done in clinical practice due probably to high cost.

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“…The data were available in eight studies [37][38][39][40][41][42][43][44], but we only analyzed seven because one (Kreitner 1998) did not recruit any non-diseased subjects.…”

Section: Results Of Meta-analysismentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Magnetic Resonance Accuracy in the Diagnosis of Anterior Talo-Fibular Ligament Acute Injury: A Systematic Review and Meta-Analysis

et al. 2021

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“…Liu et al [ 12 ] found that the ligament thickness and signal to noise ratio of ATFL patients were significantly higher than those of the control group. Basha et al [ 13 ] proposed that the bright rim sign was a very helpful diagnostic sign in assessment of ATFL disruption. Mun et al [ 14 ] concluded that the sensitivity, specificity and accuracy of diagnosis using the cross-sectional area of the ligament were higher than the ligament thickness.…”

Section: Introductionmentioning

confidence: 99%

Intelligent localization and quantitative evaluation of anterior talofibular ligament injury using magnetic resonance imaging of ankle

et al. 2021

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Background There is a high incidence of injury to the lateral ligament of the ankle in daily living and sports activities. The anterior talofibular ligament (ATFL) is the most frequent types of ankle injuries. It is of great clinical significance to achieve intelligent localization and injury evaluation of ATFL due to its vulnerability. Methods According to the specific characteristics of bones in different slices, the key slice was extracted by image segmentation and characteristic analysis. Then, the talus and fibula in the key slice were segmented by distance regularized level set evolution (DRLSE), and the curvature of their contour pixels was calculated to find useful feature points including the neck of talus, the inner edge of fibula, and the outer edge of fibula. ATFL area can be located using these feature points so as to quantify its first-order gray features and second-order texture features. Support vector machine (SVM) was performed for evaluation of ATFL injury. Results Data were collected retrospectively from 158 patients who underwent MRI, and were divided into normal (68) and tear (90) group. The positioning accuracy and Dice coefficient were used to measure the performance of ATFL localization, and the mean values are 87.7% and 77.1%, respectively, which is helpful for the following feature extraction. SVM gave a good prediction ability with accuracy of 93.8%, sensitivity of 88.9%, specificity of 100%, precision of 100%, and F1 score of 94.2% in the test set. Conclusion Experimental results indicate that the proposed method is reliable in diagnosing ATFL injury. This study may provide a potentially viable method for aided clinical diagnoses of some ligament injury.

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“…Liu et al [12] found that the ligament thickness and signal to noise ratio of ATFL patients with chronic ankle instability were significantly higher than those of the control group. Basha et al [13] proposed that the bright rim sign was a very helpful diagnostic sign in assessment of ATFL disruption. Mun et al [14] concluded that the sensitivity, specificity and accuracy of diagnosis using the cross-sectional area of the ligament were higher than the ligament thickness.…”

Section: Introductionmentioning

confidence: 99%

Intelligent Localization and Quantitative Evaluation of Anterior Talofibular Ligament Injury using Magnetic Resonance Imaging of Ankle

Yan

Meng

Sun

et al. 2021

Preprint

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Background: There is a high incidence of injury to the lateral ligament of the ankle in daily living and sports activities. The anterior talofibular ligament (ATFL) is the most frequent types of ankle injuries. It is of great clinical significance to achieve intelligent localization and injury evaluation of ATFL due to its vulnerability.Methods: According to the specific characteristics of bones in different slices, the key slice was extracted by image segmentation and characteristic analysis. Then, the talus and fibula in the key slice were segmented by distance regularized level set evolution (DRLSE), and the curvature of their contour pixels was calculated to find useful feature points including the neck of talus, the inner edge of fibula, and the outer edge of fibula. ATFL area can be located using these feature points so as to quantify its first-order gray features and second-order texture features. Support vector machine (SVM) was performed for evaluation of ATFL injury.Results: Data were collected retrospectively from 158 patients who underwent MRI, and were divided into normal (68) and tear (90) group. The positioning accuracy and Dice coefficient were used to measure the performance of ATFL localization, and the mean values are 87.7% and 77.1%, respectively, which is helpful for the following feature extraction. SVM gave a good prediction ability with accuracy of 93.8%, sensitivity of 88.9%, specificity of 100%, precision of 100%, and F1 score of 94.2% in the test set.Conclusion: Experimental results indicate that the proposed method is reliable in diagnosing ATFL injury. This study may provide a potentially viable method for aided clinical diagnoses of some ligament injury.

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The Added Diagnostic Value of the Bright Rim Sign to Conventional MRI Assessment of Anterior Talofibular Ligament Disruption

Cited by 5 publications

References 16 publications

Magnetic Resonance Accuracy in the Diagnosis of Anterior Talo-Fibular Ligament Acute Injury: A Systematic Review and Meta-Analysis

Magnetic Resonance Accuracy in the Diagnosis of Anterior Talo-Fibular Ligament Acute Injury: A Systematic Review and Meta-Analysis

Intelligent localization and quantitative evaluation of anterior talofibular ligament injury using magnetic resonance imaging of ankle

Intelligent Localization and Quantitative Evaluation of Anterior Talofibular Ligament Injury using Magnetic Resonance Imaging of Ankle

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