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| 21KF-007 |
Prediction of suspicious ankle instability using the calcaneofibular ligament cross-sectional area
Department of
Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University,
Seongnam, Republic of Korea1, Department of Anesthesiology and Pain
Medicine, Catholic Kwandong University of Korea College of Medicine,
International ST. Mary`s Hospital, Incheon, Republic of Korea2
Background: An injured calcaneofibular ligament (CFL) has been a crucial cause of ankle instability (AI). Previous research has demonstrated that the calcaneofibular ligament thickness (CFLT) is correlated with higher-grade sprains and ankle instability in patients. However, inflammatory hypertrophy is distinct from thickness. Accordingly, we considered that the calcaneofibular ligament cross-sectional area (CFLCSA) might be a morphological parameter to analyze inflammatory CFL. We hypothesized that the CFLCSA is a key morphologic parameter in AI diagnosis.
Methods: We acquired CFL data from 26 patients with AI and from 25 control subjects who had undergone ankle magnetic resonance imaging (A-MRI) and who revealed no evidence of AI. T1-weighted coronal A-MRI images were acquired at the ankle. We analyzed the CFLT and CFLCSA at the CFL on the A-MRI using our image analysis program. The CFLCSA was measured as the whole ligament cross-sectional area of the CFL that was most hypertrophied in the transverse A-MR images. The CFLT was measured as the thickest level of CFL.
Results: The mean CFLT was 3.49 ± 0.82 mm in the control subject sand 4.82 ± 0.76 mm in the AI group. The mean CFLCSA was 33.31 ± 7.02 mm2 in the control group and 65.33 ± 20.91 mm2 in the AI group. AI patients had significantly greater CFLT (p < 0.001) and CFLCSA (p < 0.001) than the control groups. An ROC curve analysis in the evaluation of the diagnostic tests showed that the optimal cut-off score of the CFLT was 4.06 mm, with 76.9% sensitivity, 76.0% specificity, and an AUC of 0.89 (95% CI, 0.79-0.99). The optimal cut-off threshold of the CFLCSA was 43.85 mm2, with 92.3% sensitivity, 92.0% specificity, and AUC of 0.94 (95% CI, 0.86-1.00).
Conclusion: Even though the CFLT and CFLCSA were both significantly associated with AI, the CFLCSA was a more sensitive diagnostic test.
Methods: We acquired CFL data from 26 patients with AI and from 25 control subjects who had undergone ankle magnetic resonance imaging (A-MRI) and who revealed no evidence of AI. T1-weighted coronal A-MRI images were acquired at the ankle. We analyzed the CFLT and CFLCSA at the CFL on the A-MRI using our image analysis program. The CFLCSA was measured as the whole ligament cross-sectional area of the CFL that was most hypertrophied in the transverse A-MR images. The CFLT was measured as the thickest level of CFL.
Results: The mean CFLT was 3.49 ± 0.82 mm in the control subject sand 4.82 ± 0.76 mm in the AI group. The mean CFLCSA was 33.31 ± 7.02 mm2 in the control group and 65.33 ± 20.91 mm2 in the AI group. AI patients had significantly greater CFLT (p < 0.001) and CFLCSA (p < 0.001) than the control groups. An ROC curve analysis in the evaluation of the diagnostic tests showed that the optimal cut-off score of the CFLT was 4.06 mm, with 76.9% sensitivity, 76.0% specificity, and an AUC of 0.89 (95% CI, 0.79-0.99). The optimal cut-off threshold of the CFLCSA was 43.85 mm2, with 92.3% sensitivity, 92.0% specificity, and AUC of 0.94 (95% CI, 0.86-1.00).
Conclusion: Even though the CFLT and CFLCSA were both significantly associated with AI, the CFLCSA was a more sensitive diagnostic test.
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