To determine the effectiveness of contrast enhanced (CE), fat suppressed, 3D-FSPGR MR imaging in the diagnosis of the tibiofibular ligament injury of the ankle, comparing to routine ankle MR imaging.

CE 3D-FSPGR and routine MR images were reviewed in 18 ankles with arthroscopically proved the tibiofibular ligament injury and in 20 control subjects with diagnoses other than the tibiofibular ligament injury. Two sets of images were reviewed in random order: 1) CE 3D-FSPGR MR images (the CE set), 2) the routine MR images (the routine set). When the CE set revealed nodular synovial enhancement on the tibiofibular ligament and the routine set showed either ligament discontinuity or a wavy ligament or nonvisualization of the ligament, the injury was regarded as a ligament disruption, respectively.

The CE set had an accuracy of 82 % (31/38), sensitivity of 100% (18/18), and specificity of 65% (13/20) for the assessment of the tibiofibular ligament injury; whereas the routine set had an accuracy of 84% (32/38), sensitivity of 83% (15/18), and specificity of 85% (17/20).

CE 3D-FSPGR MR imaging of the ankle is more sensitive and less specific in assessing the tibiofibular ligament injury of the ankle, comparing to routine MR imaging.