TY - JOUR
T1 - Metal artifact reduction MRI for total ankle replacement sagittal balance evaluation
AU - de Cesar Netto, Cesar
AU - Schon, Lew C.
AU - da Fonseca, Lucas Furtado
AU - Chinanuvathana, Apisan
AU - Stern, Steven E.
AU - Fritz, Jan
N1 - Funding Information:
This work was supported by an institutional grant from Siemens Healthcare USA , which provided funding for the MRI exams and remuneration for study participants. The decision to recruit the proper subjects who meet the criteria was based on clinical presentation and decided by the orthopaedic surgeon.
Funding Information:
This work was supported by an institutional grant from Siemens Healthcare USA, which provided funding for the MRI exams and remuneration for study participants. The decision to recruit the proper subjects who meet the criteria was based on clinical presentation and decided by the orthopaedic surgeon.
Publisher Copyright:
© 2018 European Foot and Ankle Society
PY - 2019/12
Y1 - 2019/12
N2 - Background: Restoration of anatomical relationship between talus and tibia is crucial for longevity of total ankle replacement (TAR). Weight-bearing (WB) radiographs are the standard for evaluating the sagittal balance alignment, but are prone to rotational misalignment and altered measurements. Metal artifact reduction sequence (MARS) MRI allows visualization of periprosthetic landmarks and alignment of the image plane to the true sagittal axis of the implant. The purpose of this study was to compare TAR sagittal balance measurements on MARS MRI and WB radiographs. Methods: Twenty-three subjects with TAR [10 men/13 women, age 60 (41–73) years; 13 (3–24) months post-op] underwent MARS MRI and standard lateral WB radiographs. Standardized MARS MR images were aligned to the sagittal talar component axis. Three observers performed sagittal balance alignment measurements twice in an independent, random and blinded fashion. Lateral Talar Station (LTS), tibial axis-to-talus (T-T) ratio and normalized tibial axis-to-lateral-process (T-L) distance were measured. Concordance correlation coefficients (CCC) and intraclass correlation coefficients (ICC) were used for statistical analysis. In addition, mixed effects linear models were employed to assess overall concordance of the two image types. Results: The intraobserver agreement was excellent for radiographic (CCC = 0.96) and MRI (CCC = 0.90–0.97) measurements. Interobserver agreements were good-to-excellent with overall slightly higher agreements for MRI (ICC = 0.78–0.94) than radiography (ICC = 0.78–0.90) measurements. The T-T ratios of radiographs and MRI showed a high degree of concordance, whereas LTS was significantly lower on MRI when compared with radiographs, and T-L distance showed notable disagreement between the two imaging types. Conclusion: Sagittal balance measurements performed on standardized weight-bearing radiographs and standardized MARS MRI demonstrate substantial correlation and similarity. Given its high intra and interobserver agreement, MARS MRI may be helpful for the evaluation of TAR sagittal balance. Level of evidence: Level II - Prospective Comparative Study.
AB - Background: Restoration of anatomical relationship between talus and tibia is crucial for longevity of total ankle replacement (TAR). Weight-bearing (WB) radiographs are the standard for evaluating the sagittal balance alignment, but are prone to rotational misalignment and altered measurements. Metal artifact reduction sequence (MARS) MRI allows visualization of periprosthetic landmarks and alignment of the image plane to the true sagittal axis of the implant. The purpose of this study was to compare TAR sagittal balance measurements on MARS MRI and WB radiographs. Methods: Twenty-three subjects with TAR [10 men/13 women, age 60 (41–73) years; 13 (3–24) months post-op] underwent MARS MRI and standard lateral WB radiographs. Standardized MARS MR images were aligned to the sagittal talar component axis. Three observers performed sagittal balance alignment measurements twice in an independent, random and blinded fashion. Lateral Talar Station (LTS), tibial axis-to-talus (T-T) ratio and normalized tibial axis-to-lateral-process (T-L) distance were measured. Concordance correlation coefficients (CCC) and intraclass correlation coefficients (ICC) were used for statistical analysis. In addition, mixed effects linear models were employed to assess overall concordance of the two image types. Results: The intraobserver agreement was excellent for radiographic (CCC = 0.96) and MRI (CCC = 0.90–0.97) measurements. Interobserver agreements were good-to-excellent with overall slightly higher agreements for MRI (ICC = 0.78–0.94) than radiography (ICC = 0.78–0.90) measurements. The T-T ratios of radiographs and MRI showed a high degree of concordance, whereas LTS was significantly lower on MRI when compared with radiographs, and T-L distance showed notable disagreement between the two imaging types. Conclusion: Sagittal balance measurements performed on standardized weight-bearing radiographs and standardized MARS MRI demonstrate substantial correlation and similarity. Given its high intra and interobserver agreement, MARS MRI may be helpful for the evaluation of TAR sagittal balance. Level of evidence: Level II - Prospective Comparative Study.
KW - MRI
KW - Metal artifact reduction
KW - Sagittal balance
KW - Total ankle arthroplasty
KW - Total ankle replacement
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U2 - 10.1016/j.fas.2018.09.005
DO - 10.1016/j.fas.2018.09.005
M3 - Article
C2 - 30385108
AN - SCOPUS:85055690232
SN - 1268-7731
VL - 25
SP - 739
EP - 747
JO - Foot and Ankle Surgery
JF - Foot and Ankle Surgery
IS - 6
ER -