| Objective: To evaluate the value of modified oblique axial MRI,high-frequency ultrasound,and SPECT/CT in the diagnosis of chronic ATFL injury.Methods: 51 patients with lateral ankle instability were included in this study.All patients underwent modified oblique axial MRI,high-frequency ultrasound and SPECT/CT of the injured foot before operation.The ATFL was explored during surgery and used as the gold standard for the diagnosis of chronic injury.The imaging results were compared with the results of arthroscopy to analyze the diagnostic performance of these examination methods.Results: 44 cases were confirmed as chronic ATFL injury and 7 cases were confirmed as synovitis by arthroscopy.Modified oblique axial MRI and high-frequency ultrasound were analyzed by ROC curve.The AUC of the two were 0.878 and 0.885 respectively.The difference was not statistically significant(P=0.8989).The best diagnostic threshold was “>1 points” and “>2 point”,and the Youden index of the corresponding modified oblique axial MRI was 0.6753,the sensitivity was 81.82%,and the specificity was 85.71%.The Youden index of the corresponding high-frequency ultrasound examination is 0.6688,the sensitivity is 95.45%,and the specificity is 71.43%.The difference was statistically significant(P=0.016).In the 51 patients who underwent intraoperative arthroscopic exploration,no obvious talus cartilage injury was found.In the SPECT/CT examination of the talus cartilage articular surface,47 abnormalities were found,including 39 cases of medial talus abnormalities and 8 cases of medial and lateral talus abnormalities.Conclusion: Modified oblique axial MRI and high-frequency ultrasound at the anterior drawer test position have terrific diagnostic effects on the chronic ATFL injury.SPECT/CT examination can diagnose the talar cartilage injury of the ankle joint early and accurately,evaluate the chronic ATFL injury from the functional point of view,and then intervene early to guide the treatment. |
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