Comparison of MRI T2 Mapping and T2 Multi-Echo 3D Water Excitation in Assessing Cartilage Injury of Ankle Joint

AIM: The ankle joint is vulnerable to injuries. However, utilizing conventional magnetic resonance imaging (MRI) to detect early compositional changes of cartilage injury in the ankle joint poses significant challenges, and the diagnostic value of T2 mapping and T2 multi-echo 3D water excitation (T2-me3d-we) versus conventional MRI remains unclear. To explore the clinical value of T2 mapping and T2-me3d-we quantitative parameters in MRI in the diagnosis of cartilage injury of the ankle joint based on the receiver operating characteristic (ROC) curve. METHODS: -test, and intraclass correlation coefficient (ICC) were used for comparative analysis. RESULTS: T2 mapping demonstrated superior efficacy, as evidenced by a higher area under the curve (AUC) (0.879 vs. 0.868) and a higher Youden index (0.608 vs. 0.607) in the ROC analysis. The combination of T2 mapping-derived T2 values and diffusion tensor imaging ADC metrics using an integrated model achieved an AUC of 0.942 (95% confidence interval [CI]: 0.897-0.987). This result indicates that the model performed better than the performance of each individual parameter when used on its own. The diagnostic coincidence rate of T2 mapping was 97.80%, higher than the T2-me3d-we rate of 93.41% (p < 0.05). Compared with the normal group (NG), the injury group (IG) exhibited higher T2 values (p < 0.001) and ADC values, but lower FA values (p < 0.001). The ROC curve showed that the quantitative parameters of T2 mapping and T2-me3d-we demonstrated good diagnostic efficacy for cartilage injury of the ankle joint. CONCLUSIONS: T2 mapping demonstrated superior quantitative diagnostic performance compared to T2-me3d-we for detecting ankle chondral lesions and may therefore serve as a promising first-line imaging biomarker for routine clinical evaluation. Combined image assessment further enhanced discriminatory power, offering incremental value for surgical decision-making.