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 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
.