Evaluation of 3-Dimensional Magnetic Resonance Imaging (3D MRI) in Diagnosing Anterior Talofibular Ligament Injury

Background: It is challenging to entirely show the anterior talofibular ligament (ATFL) and accurately diagnose ATFL injury with traditional 2-dimensional (2D) magnetic resonance imaging (MRI). With the introduction of 3.0T MRI, a 3-dimensional (3D) MRI sequence can achieve images with high spatial resolution. This study aimed to evaluate the accuracy of 3D MRI and compare it with 2D MRI in diagnosing ATFL injury. Material/Methods: This was a prospective study in which 45 patients with clinically suspected ATFL injury underwent 2D MRI, 3D MRI, and 3D model reconstruction followed by arthroscopic surgery between February 2018 and April 2019. Two radiologists who had over 11 and 13 years of musculoskeletal experience assessed the injury of ATFL in consensus without any clinical clues. Arthroscopic surgery results were the standard reference of MRI accuracy. Result: The 3D MRI results of ATFL injury showed the sensitivity of diagnosis of complete tears of 83% and specificity of 82%. The partial tears diagnosis sensitivity was 78%, and specificity was 100%. The sensitivity of diagnosis of sprains was 100%, and the specificity was 97%. The 3D MRI accuracy of diagnosis was 98% for no injury, 98% for sprain, 91% for partial tear, and 82% for complete tear. The difference in the diagnosis of sprain and partial tears by 3D MRI and 2D MRI was statistically significant (P<0.05). A 3D reconstruction model was successfully created for all patients. Conclusions: 3D MRI may be a reliable and accurate method to detect ATFL injury. The 3D reconstruction model using 3D MRI sequences has excellent prospects in application.