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ANKLE MRI PROTOCOL
 

Ankle MRI 

ANKLE AXIAL IMAGING PLANE-PLANNING

Axial Imaging Plane

 

Prescribe plane parallel to axis of calcaneus.

Scan ankle from distal tibia through subcutaneous

soft tissues (include plantar fascia).

 

Cover from inferior cortex of the fifth metatarsal and cover up as far as 

possible ( approx. five slices above the tibiotalar joint)

- Parallel Sat Bands

 

- Cover from 3-4 Slices above the inferior margin of the tibiotalar joint (the 

 

joint is best seen posteriorly) down as far as the slices go

- Parallel Sat Band

 

 

 

 

 

 

 


ANKLE SAGITAL REFERENCE LINES-PLANNING

 

 

 

 

Prescribe plane with line parallel to talus. Cover ankle from medial through lateral malleolus.

 

 

 

 Perpendicular to COR 

- Angled perpendicular to talar dome

- Cover at least 1 slice out of both malleoli

- All of the plantar soft tissues should be included in the FOV

- Superior Sat Band

 

 

 

 

 

 


ANKLE CORONAL REFERENCE IMAGES-PLANNING 

 

 

Prescribe plane perpendicular to axial imaging plane.  Scan ankle from calcaneus through metatarsal bases.

 

 

 

Use axial LOC and angle perpendicular to the inner cortex of the medial malleolus

- Use sagittal LOC and angle parallel to distal tibial shaft and cover from the talonavicular joint to at least 2 slices posterior to the talus

- The COR PD FS sequence is thicker and can cover more of the talonavicular joint anteriorly and plantar fascia posteriorly

- All of the plantar(inferior) soft tissues should be included in the FOV

- Superior Sat Band

 

 

 

 

Ankle tendons and ligaments are best imaged with the foot plantar flexed 15-30°. So don't use the chimney in the coil. Position the calcaneus in the middle of the coil and the relaxed foot will fit comfortably in the coil at the correct degree of plantar flexion.

 

 

 

 

 


 


ankle rx


 

 

 



 


ANKLE MRI SEQUNCES


Sag T1
Sag T2 FSE STIR (or fat sat)
Ax T2 FSE STIR (or fat sat)
Cor T2 STIR (or fat sat)
Cor T1/PD FSE

AXIAL PD FSE NON FAT SAT


POST GAD ANKLE MRI SEQUENCES


AXIAL FMPSPGR  FAT SAT PRE/POST

 

SAG T1 SE NON FAT SAT

AXIAL T1 SE FAT SAT

AXIAL PD FSE FAT SAT

COR T1 SE FAT SAT

 

ANKLE MRI ARTHROGRAM SEQUENCES

 

SAG T1 SE FAT SAT

SAG STIR

AXIAL  T1 SE FAT SAT

AXIAL PD FSE NON FAT SAT

COR  T1 SE FAT SAT

COR T2 FSE FAT SAT

 

 

T1 SAGITAL

SAGITAL IR

Sagittal T1 and IR allow for the evaluation of the Achilles tendon, plantar aponeurosis, talar dome, subtalar facets and Sinus Tarsi.

 

AXIAL PD FAT SAT FSE

 

Axial PD fat suppression evaluates the tendons and ligaments of the ankle particularly after acute/subacute injuries.  It also is sensitive to talar dome osteochondral defects. Alternatively, a T2 sequence can be used to eliminate magic angle artifact that may occur as the tendons travel around the malleolar turns

 

COR OBLIQUE T1

The coronal oblique T1 sequence follows the tendons of the ankle around the malleolar turns and also evaluates the medial ankle ligaments.

COR PD FSE FAT SAT

The coronal oblique PD fat suppressed sequence follows the tendons of the ankle around the malleolar turns and is particularly important in evaluation of the Posterior tibialis tendon.

 

 

Ankle MR Arthrogram

 

Arthrogram sequences of the ankle evaluate the talar cartilage and allow for staging of ostechondral defects of the talar dome.  They can also better evaluate the joint capsule and its boundaries such as the anterior talofibular ligament
.

 
 
   
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