Simplified diagnostic algorithm for Lauge-Hansen classification of ankle injuries.

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Abstract

[Indexed for MEDLINE] 15. Korean J Radiol. 2025 May;26(5):435-445. doi: 10.3348/kjr.2024.0773. Quantitative T2 Mapping Analysis With MRI of Talar Cartilage in Ankle Trauma: A Study Based on Lauge-Hansen Classification and Anatomical Locations. Khil EK(1)(2)(3), Cha JG(2)(4), Kim SJ(5)(6), Yoon YS(7). Author information: (1)Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea. (2)Department of Radiology, Graduate School, Soonchunhyang University College of Medicine, Asan, Republic of Korea. (3)Department of Radiology, Fastbone Orthopedic Hospital, Hwaseong, Republic of Korea. (4)Department of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea. mj4907@gmail.com. (5)Department of Orthopedic Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea. (6)Department of Orthopedic Surgery, Foot and Ankle Division, Hanyang University Guri Hospital, Guri, Republic of Korea. (7)Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea. OBJECTIVE: This study aimed to quantitatively assess abnormalities in the talar dome cartilage using MRI T2 mapping, with additional analyses based on the Lauge-Hansen (LH) classification and anatomical locations. MATERIALS AND METHODS: This retrospective study analyzed 78 patients who underwent ankle MRI with T2 mapping for acute ankle trauma between January 2021 and October 2022. Patients were classified into the supination (S) and pronation (P) groups based on the LH classification, and then divided into subgroups based on posterior malleolus (PM) involvement. The T2 values for the talar cartilage were quantitatively measured in six anatomical regions defined by the combination of medial vs. lateral and anterior vs. central vs. posterior. The T2 mapping values in each region of the talus were compared between the S and P groups and between the PM and non-PM injury groups using t-tests. The T2 values were also compared between the medial and lateral sides within each group. RESULTS: Among the 78 patients (mean age, 38.62 ± 14.82 years; 47 male), 53 and 25 were in the S and P groups, respectively, and 53 patients showed PM involvement. In comparison with the P group, the S group exhibited higher T2 values in the medial portion (61.27 ± 8.30 vs. 54.03 ± 6.96; P < 0.001) and lower T2 values in the lateral talus (54.95 ± 8.47 vs. 64.15 ± 7.31; P < 0.001). The PM injury group showed higher T2 values in the posterior region than the non-PM injury group (P ≤ 0.011). Within the PM injury group, T2 values were higher in the anteromedial and posterolateral regions than on the opposite sides (P = 0.037 and 0.011, respectively). CONCLUSION: MRI T2 values demonstrated significant regional variations in the talar dome cartilage in acute ankle trauma, and the T2 values may reflect different ankle trauma mechanisms and PM involvement. Thus, T2 mapping can facilitate evaluation of talar cartilage alterations. Copyright © 2025 The Korean Society of Radiology. DOI: 10.3348/kjr.2024.0773 PMCID: PMC12055265