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M Reiser

Publications and source records attributed to M Reiser.

At least 235 records · Page 13Linked to original sources

[A new in vivo technique for 3-dimensional analysis of the translation of femoral condyles and the menisci responding to antagonistic muscle forces].

The aim of our study was to develop a 3-D MR-based technique for the analysis of meniscal and femoral translations during flexion of the knee, and under the influence of antagonistic muscle forces in healthy subjects. In an open MR system, 5 knees were examined at 30 degrees and 90 degrees flexion using a T1-weighted 3-D gradient echo sequence. A force of 30 Newtons, first in the extending and then in the flexing direction, was applied to the distal lower leg. After three-dimensional reconstruction, the minimal distances between the centre of the tibial plateau and the posterior edge of the menisci and femoral condyles were determined. At 30 degrees flexion, the minimum distance for the meniscus was larger medially than laterally (23.2 +/- 1.8 mm vs. 16.2 +/- 3.3 mm), and this also applied to the condyles (25.1 +/- 1.5 vs. 19.0 +/- 3.0 mm). During flexion to 90 degrees, a posterior translation of 0.5 +/- 0.2 mm was observed for the lateral, and of 3.4 +/- 1.2 mm for the medial, meniscus. The condyles demonstrated a different posterior translation (lateral 2.2 +/- 0.56 mm; medial 1.8 +/- 1.9 mm). No obvious differences were found between extension and flexion muscle activity for the different positions of the knee. In the present study, a new 3-D technique is presented for the analysis of the femoral and meniscal translation at various positions of the knee, and under muscle activity. The results suggest different translation for the menisci and condyles.

Adult↗

[Precision MRI-based joint surface and cartilage density analysis of the knee joint using rapid water-excitation sequence and semi-automatic segmentation algorithm].

The aim of this study was to analyse the precision of three-dimensional joint surface and cartilage thickness measurements in the knee, using a fast, high-resolution water-excitation sequence and a semiautomated segmentation algorithm. The knee joint of 8 healthy volunteers, aged 22 to 29 years, were examined at a resolution of 1.5 mm x 0.31 mm x 0.31 mm, with four sagittal data sets being acquired after repositioning the joint. After semiautomated segmentation with a B-spline Snake algorithm and 3D reconstruction of the patellar, femoral and tibial cartilages, the joint surface areas (triangulation), cartilage volume, and mean and maximum thickness (Euclidean distance transformation) were analysed, independently of the orientation of the sections. The precision (CV%) for the surface areas was 2.1 to 6.6%. The mean cartilage thickness and cartilage volume showed coefficients of 1.9 to 3.5% (except for the femoral condyles), the value for the medial femoral condyle being 9.1%, and for the lateral condyle 6.5%. For maximum thickness, coefficients of between 2.6 and 5.9% were found. In the present study we investigate for the first time the precision of MRI-based joint surface area measurements in the knee, and of cartilage thickness analyses in the femur. Using a selective water-excitation sequence, the acquisition time can be reduced by more than 50%. The poorer precision in the femoral condyles can be attributed to partial volume effects that occur at the edges of the joint surfaces with a sagittal image protocol. Since MRI is non-invasive, it is highly suitable for examination of healthy subjects (generation of individual finite element models, analysis of functional adaptation to mechanical stimulation, measurement of cartilage deformation in vivo) and as a diagnostic tool for follow-up, indication for therapy, and objective evaluation of new therapeutic agents in osteoarthritis.

Adult↗

Dynamic contrast-enhanced MR angiography from the distal aorta to the ankle joint with a step-by-step technique.

OBJECTIVE: The aim of this study was to visualize the arteries from the distal aorta to the ankle joint and to determine the accuracy of MR angiography for detecting stenoses and occlusions. SUBJECTS AND METHODS: Twenty-four patients with peripheral arterial occlusive disease underwent digital subtraction angiography and were examined on a 1.5-T MR scanner. The transit time for contrast material was determined with a test bolus injection. A T1-weighted three-dimensional gradient-echo sequence with short TR and TE was used for a dynamic measurement at the level of the iliac arteries, the upper leg, and the lower leg arteries. For each level a single dose of gadolinium was injected into an antecubital vein with an MR power injector. Maximal-intensity-projection reconstructions were calculated after subtraction of the first measurement at each level. Two experienced MR radiologists who were unaware of the digital subtraction angiography results interactively evaluated both the MIP reconstructions and the single slices on a workstation, first independently and then in a consensus interpretation. RESULTS: With digital subtraction angiography, 80 hemodynamically significant stenoses and 39 occlusions were detected. For the stenoses and occlusions, a sensitivity of 100% was found for MR angiography. The specificity for the assessment of stenoses and occlusions was 98% and 94%, respectively, for the iliac arteries; 98% and 94%, respectively, for the upper leg arteries; and 94% and 95%, respectively, for the lower leg arteries. Most false-positive findings of occlusion were due to metal stents present in the iliac (n = 3) and upper leg (n = 4) arteries. CONCLUSION: The MR imaging technique that we used revealed the arteries from the distal aorta to the ankle and proved to be reliable at showing arterial stenoses and occlusions.

Aged↗

Dexamethasone, carmustine, etoposide, cytarabine, and melphalan (dexa-BEAM) followed by high-dose chemotherapy and stem cell rescue--a highly effective regimen for patients with refractory or relapsed indolent lymphoma.

We performed a phase II study to determine the efficacy of maximal cytoreductive therapy with up to five cycles of Dexa-BEAM (dexamethasone, carmustine [BCNU], etoposide, cytarabine, and melphalan) followed by high-dose chemotherapy (HDCT) and autologous stem cell transplantation (ASCT) for patients with advanced relapsed or refractory indolent lymphoma. Thirty-two patients with primary refractory or relapsed indolent lymphoma were treated with the Dexa-BEAM regimen. Thirteen patients had primary refractory disease, 4 patients partial remission, and 15 patients first or subsequent relapse. Patients achieving PR or CR received HDCT with ASCT. The conditioning regimen used was BEAM (carmustine [BCNU], etoposide, cytarabine, and melphalan). Twenty-two patients responded to Dexa-BEAM resulting in a response rate of 78%. Maximum response was observed after 3.2 (range 2-5) courses. One patient with progressive disease died in septic shock during neutropenia. Nineteen patients with partial or complete remission after Dexa-BEAM received HDCT. Hematopoietic stem cells (HSC) were collected after two cycles of Dexa-BEAM. The median number of CD34+ HSC reinfused was 3.1 x 10(6)/kg (range 1.6-8.2 x 10(6)/kg). There was no transplantation-related death. All patients receiving HDCT achieved complete remission. Overall survival (OS) and freedom from treatment failure (FFTF) for all patients are estimated to be 68% and 65% at two years, respectively. With a mean follow-up of 20 months (range 8-42 months), 16/19 patients receiving HDCT are in continuous complete remission. The Dexa-BEAM regimen is effective in overcoming drug resistance in patients with indolent lymphoma who failed to respond to conventional treatment or who relapsed. The CR rate of 100% of those patients receiving HDCT and ASCT after maximal cytoreductive treatment with Dexa-BEAM suggests the use of HDCT at the time of maximal response.

Adult↗

Dexa-BEAM: an effective regimen for cytoreduction prior to high-dose chemotherapy with autologous stem cell support for patients with relapsed/refractory mantle-cell lymphoma.

Mantle-cell lymphoma (MCL) is not a curable disease using conventional chemotherapy. Patients with MCL have the shortest median time to progression and the shortest median survival of all lymphoma subtypes after first-line treatment. In the present study we determined the efficacy of maximal cytoreductive therapy with up to four cycles of Dexa-BEAM (dexamethasone, carmustine [BCNU], etoposide, cytarabine, and melphalan) followed by high-dose chemotherapy (HDCT) and autologous hematopoietic stem cell support (ASCT) for patients with advanced relapsed or refractory MCL. Nine consecutive patients with relapsed or refractory MCL were included. Three patients had partial remission (PR), three patients progressive disease (PD) upon first line tretment, and three patients first or subsequent relapse. After 2 to four cycles of Dexa-BEAM eight patients achieved complete remission (CR), resulting in a response rate of 88%. Six of 8 patients responding to Dexa-BEAM received high-dose chemotherapy HDCT (BEAM) and autologous hematopoietic stem cell transplantation (ASCT). With a median follow up of 24 months six patients are alive. Five of those six patients are still in contiuous CR (range 13-54 months).

Adult↗

Effects of three different doses of a bolus injection of gadodiamide: assessment of regional cerebral blood volume maps in a blinded reader study.

BACKGROUND AND PURPOSE: Reconstruction of first-pass bolus information to derive regional cerebral blood volume (rCBV) maps is commonly performed in many centers; however, various protocols with different doses of paramagnetic contrast injections have been reported. We evaluated the dose dependency of rCBV maps in a brain tumor population by using three different doses of gadodiamide injection to evaluate their diagnostic accuracy in blinded reader sessions. METHODS: Eighty-three patients with intraaxial brain tumors (72 gliomas) were studied at three centers and randomized to receive a bolus injection of 0.1, 0.2, or 0.3 mmol/kg per body weight of gadodiamide. rCBV maps were generated from T2*-weighted gradient-echo echoplanar sequences at 1.5 T. Data processing was performed according to the indicator dilution theory. RESULTS: The mean contrast-to-noise ratio (CNR) was significantly different between gadodiamide doses of 0.1 and 0.2 mmol/kg (CNR = 8.7 and 15.7) and between 0.1 and 0.3 mmol/kg (CNR = 17.7). No significant difference was found between doses of 0.2 and 0.3 mmol/kg. Sensitivity for the differentiation of benign and malignant brain tumors was 80%, 95%, and 91%, and specificity was 45%, 54%, and 43% by blinded readings at 0.1, 0.2, and 0.3 mmol/ kg, respectively, as compared with histologic findings. Nonblinded readings had a sensitivity of 83%, 100%, and 90% and a specificity of 82%, 100%, and 73% at 0.1, 0.2, and 0.3 mmol/kg, respectively. CONCLUSION: A dose of 0.2 mmol/kg of gadodiamide is recommended for reconstruction of rCBV maps if data are acquired with the T2*-weighted protocol described.

Blood Volume↗

Salvage therapy with regimens containing ritonavir and saquinavir in extensively pretreated HIV-infected patients.

OBJECTIVE: To evaluate the efficacy and toxicity of salvage regimens containing ritonavir and saquinavir in patients failing highly active antiretroviral therapy (HAART), and to correlate outcome with plasma concentrations of protease inhibitors. DESIGN: Prospective, non-randomized interventional study. SUBJECTS AND METHODS: Thirty extensively pretreated HIV-infected patients with virological failure under HAART were treated with ritonavir (400 mg twice daily) and saquinavir (600 mg twice daily) and at least one reverse transcriptase inhibitor. HIV-RNA, CD4 cell counts and plasma concentrations of protease inhibitors were determined, and patients were monitored for toxicity at monthly intervals. RESULTS: Six patients showed complete virological success (HIV-RNA <200 copies/ml at week 12) which was sustained for a median follow-up of 6.3 months. Partial virological response (decrease of HIV-RNA of >1 log10 at week 12) was achieved by a further three patients. Patients with a virological response had significantly higher CD4 cell increases than patients without virological response (mean increase at week 12: 66x10(6) cells/l versus 6x10(6) cells/l; P = 0.01). No clinical events were observed during 6 months of follow-up. Neither the use of a non-nucleoside reverse transcriptase inhibitor (NNRTI) nor the number of newly introduced drugs influenced the virological response. Plasma concentrations of protease inhibitors did not statistically differ between patients with and without success. Toxicity included gastrointestinal disturbances, lipid abnormalities and liver dysfunction. CONCLUSIONS: In extensively pretreated patients, salvage regimens containing ritonavir and saquinavir had only limited and short-term anti-HIV activity and were associated with substantial toxicity. Plasma concentrations of saquinavir were not predictive for virological response.

Adult↗

[Role of high-dose chemotherapy in hematology and internal medicine/ oncology].

BACKGROUND: High-dose chemotherapy (HDCT) with stem cell rescue is increasingly being used as a salvage or consolidation therapy for patients with a variety of malignant diseases. The authors give an overview of the current role of HDCT in lympho-hematopoietic malignancies and solid tumors. METHODS: The use of allogenic or autologous hematopoietic stem cells allows an increase of the dose of chemotherapeutic drugs by a factor of between 4- and 30-fold compared to conventional chemotherapy protocols. In recent years mobilized peripheral blood stem cells (PBSC) have largely replaced the use of autologous bone marrow due to more rapid hematopoietic reconstitution and are increasingly used in the allogenic setting. This article reviews the data of high-dose chemotherapy in non-Hodgkin's lymphoma, Hodgkin's lymphoma, multiple myeloma, acute leukemias, chronic myelogenous leukemia, chronic lymphatic leukemia, myelodysplastic syndrome, breast cancer, ovarian cancer, germ cell cancer, and lung cancer. Current clinical trials further evaluating the role of HDCT are described. RESULTS: Data on results of HDCT are available for a variety of malignancies showing the feasibility and efficacy of the procedure with tolerable toxicity. Although numerous clinical trials of HDCT have been performed, only few randomized trials have demonstrated that such strategies are statistically significantly better than conventional forms of therapy. CONCLUSION: HDCT has been shown to be useful in the treatment of certain patients with lymphomas, leukemias, myeloma, breast cancer, and testicular cancer. Most of these findings still have to be confirmed by randomized clinical trials. Therefore, HDCT should only be given in controlled studies and at suitable centers.

Antineoplastic Combined Chemotherapy Protocols↗

Insulin-degrading enzyme in the Alzheimer's disease brain: prominent localization in neurons and senile plaques.

The anatomical distribution of insulin-degrading enzyme (IDE) was studied in normal and Alzheimer's disease (AD) human brains. By use of a monospecific, polyclonal antiserum against the enzyme we identified IDE antigen in multiple cortical and subcortical neurons. Glia did not show IDE immunoreactivity. In AD brains immunostaining appeared stronger than in controls and appeared not only in neurons but also in senile plaques. In a probable case of Lewy body variant of AD Lewy bodies in neurons of the Nuc. basalis of Meynert were immunopositive for IDE. Our anatomical data suggest that the enzyme is associated with typical neuropathologic hallmarks of AD and its expression appears up-regulated in some brain areas.

Adult↗

Virological efficacy and plasma drug concentrations of nelfinavir plus saquinavir as salvage therapy in HIV-infected patients refractory to standard triple therapy.

Therapeutic options are limited for patients refractory to triple therapy with two reverse transcriptase inhibitors and one protease inhibitor. Preliminary results showing favorable effects of protease inhibitor combination therapy with nelfinavir and saquinavir due to inhibition of metabolism by cytochrome P450 (CYP450) prompted us to study this combination. - Thirteen patients with incomplete suppression of plasma HIV-RNA were enrolled and treatment was started with nelfinavir 750 mg tid and saquinavir 400 mg bid. Saquinavir-dosage was escalated in weekly intervals to 400 mg tid and 600 mg tid, respectively. All doses were given with food, and plasma levels of saquinavir and nelfinavir were assessed 4 hours post-dosing after 1, 2, 3, 4 and 8 weeks. Treatment was considered virologically efficacious if HIV-viral load was reduced by at least 0.5 log10 from baseline. - Double protease inhibitor-treatment with nelfinavir and saquinavir was virologically efficacious in 5/13 (39%) patients after 4 weeks but only in 4/13 (31%) patients after 8 and 1/13 (8%) after 16 and 24 weeks, respectively. No statistical difference in plasma concentrations was observed when saquinavir was administered in increasing doses of 400 mg bid, 400 mg tid or 600 mg tid in combination with nelfinavir. 5/13 (39%) patients developed diarrhea (>4/d), no other serious side-effects were observed. By eight weeks, the mean CD4 count for all patients was significantly higher when compared to baseline. - In patients refractory to standard triple therapy the combination of nelfinavir and saquinavir showed significant elevation of CD4-count, but only short term virological efficacy in a minority of patients. Plasma concentrations of saquinavir could not be increased by weekly dose escalation of the drug from 400 mg bid to 600 mg tid. Saquinavir drug concentrations of 600 mg saquinavir tid and nelfinavir showed rather non-significant lower values when compared to historical controls treated with a double-dose 1200 mg saquinavir tid regimen alone. We conclude that in these patients the combination of nelfinavir plus saquinavir has no advantage in terms of increasing bioavailibility of saquinavir or virological efficacy. During short observation time a beneficial effect on CD4-count was observed.

Adult↗

Magnetic resonance imaging to detect bone marrow metastases in the initial staging of small cell lung carcinoma and breast carcinoma.

BACKGROUND: Bone marrow is a common site of metastases in patients with small cell lung carcinoma (SCLC) and female breast carcinoma (FBC). Metastatic bone marrow involvement is found in approximately 50% of SCLC patients and up to 85% of FBC patients at autopsy. Initial staging procedures detect malignant bone marrow lesions in only 2-30% of patients with these tumors. This study was performed to assess whether MRI can improve the detection rate of bone marrow metastases in tumors with a high incidence of skeletal involvement. METHODS: Fifty-two patients with histologically verified SCLC (25 with limited stage disease and 27 with extensive stage disease) and 33 women with FBC were entered into a prospective study. The MRI protocol was comprised of coronal slices in the pelvic region and sagittal slices of the whole spine utilizing a T1-weighted spin echo sequence with a field of view of 50 cm. All patients underwent initial routine diagnostic staging procedures including bone scintigraphy, unilateral crest biopsy, and plain film radiography of suspicious skeletal areas. RESULTS: Only in two SCLC patients, MRI was positive in 25 cases. All SCLC patients with bone marrow lesions histologically verified, diagnosed by crest biopsy (six patients) or by bone scan (seven patients) had the correct diagnosis of metastases by MRI. In addition MRI revealed hypointense bone marrow foci in 14 cases. In contrast, 28 of 33 FBC patients examined during the initial staging procedure showed no evidence of bone marrow involvement. MRI was not superior compared with bone scintigraphy in FBC patients. CONCLUSIONS: The staging results obtained in SCLC and FBC patients are different, although both tumors have a high incidence of bone marrow metastases. It may be assumed that the biologic behavior of these tumors is reflected by the initial bone marrow involvement. Because of its superiority compared with biopsy and bone scan, the authors believe MRI should become an integral part of the initial staging procedures in patients with SCLC. When staging patients with FBC, MRI should be applied only in clinically indicated cases.

Bone Marrow Neoplasms↗

A review and methodologic critique of the literature refuting whiplash syndrome.

The validity of whiplash syndrome has been a source of debate in the medical literature for many years. Some authors have published articles suggesting that whiplash injuries are impossible at certain collision speeds; others have stated that the problem is psychological, or is feigned as a means to obtain secondary financial gain. These articles contradict the majority of the literature, which shows that whiplash injuries and their sequelae are a highly prevalent problem that affects a significant proportion of the population. The authors of the current literature critique reviewed the biomedical and engineering literature relating to whiplash syndrome, searching for articles that refuted the validity of whiplash injuries. Twenty articles containing nine distinct statements refuting the validity of whiplash syndrome were found that fit the inclusion criteria. The methodology described in these articles was evaluated critically to determine if the authors' observations regarding the validity of whiplash syndrome were scientifically sound. The authors of the current critique found that all of the articles contained significant methodologic flaws with regard to their respective authors' statements refuting the validity of whiplash syndrome. The most frequently found flaws were inadequate study size, nonrepresentative study sample, nonrepresentative crash conditions (for crash tests), and inappropriate study design. As a result of the current literature review, it was determined that there is no epidemiologic or scientific basis in the literature for the following statements: whiplash injuries do not lead to chronic pain, rear impact collisions that do not result in vehicle damage are unlikely to cause injury, and whiplash trauma is biomechanically comparable with common movements of daily living.

Accidents, Traffic↗

MR measurement of regional relative cerebral blood volume in epilepsy.

The purpose of this study was to evaluate the utility of magnetic resonance (MR) relative cerebral blood volume (rCBV) maps for studying regional hemodynamic changes in interictal and ictal epilepsy patients. Ten epilepsy patients were examined on a 1.5 T MR system. Nine patients were investigated interictally and one patient ictally. In the nine interictal patients, the dynamic plane was defined coronally through the hippocampus symmetrically. For the ictal patient, an axial dynamic plane was defined and the patient was scanned during seizure. Positron emission tomography (PET) studies were performed in 8 of the 10 patients. Lower rCBV of the left hippocampus was predicted by rCBV maps in seven of the nine interictal patients. The mean ratios of rCBV were 1.96 for left hippocampus/white matter and 2.49 for right hippocampus/white matter. The difference between these two ratios is statistically significant (P = 0.01, t-test). In two of the nine interictal temporal lobe epilepsy patients, lower rCBV areas were observed in the right hippocampus. In the ictal patient, the regional rCBV map demonstrated increased blood volume in the lesions. In eight of eight patients who underwent PET studies, MR rCBV findings were consistent with PET findings. The results show that regional hemodynamic changes in epilepsy can be evaluated with dynamic contrast-enhanced MR imaging. MR rCBV maps are sensitive to characterize seizure foci both ictally and interictally.

Adult↗

Determination of 3D cartilage thickness data from MR imaging: computational method and reproducibility in the living.

The objective of this work was to develop a computational approach for quantifying the three-dimensional (3D) thickness distribution of articular cartilage with magnetic resonance (MR) imaging, independent of the imaging plane, and to test the reproducibility of the method in the living. An algorithm was implemented, based on a 3D Euclidean distance transformation, and its accuracy was assessed in geometric test objects, for which an analytic solution was available. The precision of the method was evaluated in six replicated MR data sets of the knee joint cartilage of eight volunteers. The algorithm produced 3D thickness values identical to those of the analytic solutions in the test objects. The reproducibility of the mean cartilage thickness in the patellar and tibial cartilages was 1.5-3.4% (root-mean-square average of the individual coefficient of variation percent), that of the maximal thickness 2.1-7.9%, and that of the thickness distribution 2.3-6.1%. The method presented allows for noninvasive analysis of 3D cartilage thickness from MR images in biomechanical and clinical investigations.

Algorithms↗

Subacromial space width changes during abduction and rotation--a 3-D MR imaging study.

The objectives of this study were to determine systematic changes of the normal subacromial space width during abduction and rotation, and to analyze the spatial relationship of the supraspinatus muscle with the acromion and clavicle. 12 healthy volunteers were imaged by an open MR scanner in 5 different positions of abduction and in 3 positions of rotation. After three dimensional (3D) reconstruction and 3D Euclidian distance transformation, the minimal spatial distances between the humerus and the acromion and the humerus and clavicle were computed. The minimal acromio-humeral distance decreased significantly from 30 degrees of abduction (mean 7.0 mm +/- 1.6 mm) to 120 degrees (mean 3.9 mm; +/- 1.8 mm; p < 0.0001). At 30 degrees, the minimal distance penetrated the supraspinatus, whereas at 120 degrees it was always located lateral to the supraspinatus tendon. At 90 degrees with internal rotation (7.6 mm, +/- 2.3 mm) the minimal acromio-humeral distance was larger than in neutral rotation (5.4 mm, +/- 2.3 mm) or external rotation (4.4 mm, +/- 2.2 mm; p < 0.05), but it penetrated the supraspinatus tendon at its most vulnerable part, reaching the acromion at its anterior inferior border. We conclude that the subacromial space width changes during abduction and rotation and that the supraspinatus is in closest contact to the anterior inferior border of the acromion in 90 degrees of abduction with 45 degrees internal rotation. These values obtained in volunteers can be used as a basis for further investigations in patients with the impingement syndrome.

Acromion↗

[Diagnosis and staging of liver metastases with imaging methods].

Liver metastases are much more common than primary hepatic malignancies and may occur in up to 80% of patients with extrahepatic malignancies. To optimize the patient's management, precise detection or exclusion of liver metastases, as well as assessment of their number and extent, is indispensable. For imaging of liver metastases, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), scintigraphy, and angiography can be utilized. All these methods have been technically improved with benefits for diagnostic utility. Biphasic contrast-enhanced spiral CT (SCT) and MRI with modern pulse sequences and tissue-specific contrast agents are superior to other imaging modalities in terms of diagnostic efficacy and reproducibility of results. With SCT and MRI sensitivities and specificities in the diagnosis of focal hepatic disease are in the range of 80-95%. Moreover, their non-invasiveness is a strong advantage. The diagnostic strategy in the assessment of liver metastases has to take into account both the strengths and limitations of the respective method. Additionally, the clinical situation of a particular patient has to be considered, and conclusive diagnostic results have to be achieved in a short time in order to ensure a favourable cost-effectiveness relation.

Colorectal Neoplasms↗

[13-MHc high frequency ultrasound of the lateral ligaments of the ankle joint and the anterior tibia-fibular ligament. Comparison and results of MRI in 64 patients].

PURPOSE: Determination of the value of 13-MHz high-frequency ultrasound in the diagnosis of acute injuries of the lateral ankle ligaments and the anterior tibiofibular ligament by comparison with MRI. METHOD: Sonography was performed prospectively in 64 acutely injured patients using a mechanical 13-MHz sector probe; for diagnosis of the anterior tibiofibular ligament a 15-MHz sector probe was employed during the course of this trial. Using a 0.2-T unit for MRI examination, T1-weighted (TR 580 ms, TE 24 ms) and T2-weighted (TR 3000 ms, TE 80 ms) spin-echo sequences were obtained in various oblique axial imaging planes. RESULTS: In the differentiation of intact and injured ligaments, ultrasound and MRI agreed in 95.3% of cases for the anterior fibulotalar ligament, in 88.3% for the fibulocalcanear ligament and in 85.0% for the anterior tibiofibular ligament. CONCLUSION: Lesions of the anterior talofibular and fibulocalcanear ligament can be accurately demonstrated by ultrasound if a 13-MHz sector scanner is used. The detection of lesions in the anterior tibiofibular ligament is more difficult. With increasing experience and by using a 15-MHz sector scanner, better results can be expected for this ligament.

Ankle Injuries↗