MRI vs SPECT-CT in the diagnosis of fracture-related talar osteochondral lesions.

IF 1.9 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery Pub Date : 2025-04-09 DOI:10.1016/j.fas.2025.04.004

J Ojeda-Jiménez, P Vilá-Vives, S Tejero, D González-Martín, D A Rendón-Díaz, S Santini, V Valderrabano, M Herrera-Pérez

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引用次数: 0

Abstract

Background: The high prevalence of osteochondral talar lesions (OCTLs) in ankle fractures could explain the suboptimal functional outcomes in well-treated patients. The presence of OCTLs in magnetic resonance imaging (MRI) is not always related to symptoms, regardless of the existence of bone edema. On the other hand, single photon emission computed tomography (SPECT-CT) provides information on the metabolic activity and could have a better clinical-radiological correlation. The aim of the present study is to compare MRI versus SPECT-CT in terms of the clinical-radiological correlation of hidden OCTLs after ankle fractures considered arthrogenic.

Methods: An ambispective study was conducted in which 40 patients who underwent ankle fracture surgery were included. They completed the AOFAS and EFAS questionnaires and underwent MRI and SPECT-CT. Functional results were compared according to the presence or absence of OCTLs in each technique and based on the existence of bone edema in MRI and radiotracer uptake in SPECT-TC.

Results: The detection of OCTLs by SPECT-CT was statistically related to worse results on the AOFAS scale (p < 0.05). Radiotracer uptake on SPECT-CT was related to worse results on the AOFAS scale (p < 0.05), while this difference was not found in OCTLs where bone edema was observed on MRI.

Conclusion: SPECT-CT appears to be superior to MRI in the detection of symptomatic fracture-related OCTLs. Furthermore, radiotracer uptake on SPECT-CT is associated with worse functional outcomes, being a more reliable marker than bone edema on MRI to evaluate the activity of OCTLs.

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MRI与SPECT-CT对骨折相关距骨软骨病变的诊断价值。

背景：踝关节骨折中骨软骨距骨病变（OCTLs）的高患病率可以解释治疗良好的患者功能预后不理想的原因。无论是否存在骨水肿，磁共振成像（MRI）中octl的存在并不总是与症状相关。另一方面，单光子发射计算机断层扫描（SPECT-CT）提供了代谢活动的信息，可能有更好的临床-放射相关性。本研究的目的是比较MRI与SPECT-CT在关节源性踝关节骨折后隐匿octl的临床与放射学相关性。方法：对40例踝关节骨折患者进行双侧透视研究。他们完成了AOFAS和EFAS问卷，并进行了MRI和SPECT-CT检查。根据每种技术是否存在octl，以及MRI是否存在骨水肿和SPECT-TC的放射性示踪剂摄取来比较功能结果。结果：SPECT-CT检测octl与AOFAS评分差有统计学意义（p ）。结论：SPECT-CT在检测有症状的骨折相关octl方面优于MRI。此外，SPECT-CT上的放射性示踪剂摄取与较差的功能结果相关，是评估octl活性的比MRI上的骨水肿更可靠的标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Foot and Ankle Surgery ORTHOPEDICS-

CiteScore

4.60

自引率

16.00%

发文量

202

期刊介绍： Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.