Usefulness of black boundary artifact on opposed-phase imaging from turbo spin-echo two-point mDixon MRI for delineation of an arthroscopically confirmed small fracture of the lateral talar dome: A case report. Issue 52 (December 2017)

• Record Type: Journal Article
• Authors: Park, Eun Hae; Lee, Kwang-Bok
• Other Names: NA. section editor.
• Is Part Of: Medicine. Volume 96:Issue 52(2017)
• Publication Date: 2017-12
• Subjects: ankle -- black boundary artifact -- Dixon MRI -- fracture; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000009497
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: A nondisplaced chip fracture can be missed on MRI. Opposed-phase imaging from mDixon MRI produces an interesting artifact called black boundary artifact. This artifact can provide better contrast at the fracture line resulting in better depiction of a small chip fracture on MRI. Patient concerns: We present a case of small nondisplaced chip fracture at the lateral talar dome that was well delineated only with the aid of a black boundary artifact after using T2-weighted opposed-phase imaging from turbo spin-echo two-point modified Dixon ankle MRI. In other sequences, the lesion demonstrated a focal full thickness cartilage defect, subtle cortical irregularity, or subcortical bone marrow edema but the full delineation of the fracture line was not possible. Diagnoses: Opposed-phase imaging from mDixon MRI aided in the diagnosis of lateral talar dome osteochondral fracture (osteochondral lesion), which was confirmed arthroscopically. Interventions: The osteochondral fragment was removed by arthroscopy. Outcomes: The patient did well with recovery of full range of motion after 2 months. Lessons: We have identified a black boundary artifact using opposed-phase imaging from mDixon MRI that can aid in detection of small fracture, which can be missed by conventional MRI, by providing a dark linear signal at the fracture line.