Advanced MRI techniques for the ankle

OBJECTIVE. The purposes of this article are to present a state-of-the-art routine protocol for MRI of the ankle, to provide problem-solving tools based on specific clinical indications, and to introduce principles for the implementation of ultrashort echo time MRI of the ankle, including morphologic and quantitative assessment. CONCLUSION. Ankle injury is common among both athletes and the general population, and MRI is the established noninvasive means of evaluation. The design of an ankle protocol depends on various factors. Higher magnetic field improves signal-to-noise ratio but increases metal artifact. Specialized imaging planes are useful but prolong acquisition times. MR neurography is useful, but metal reduction techniques are needed whenever a metal prosthesis is present. An ultrashort echo time sequence is a valuable tool for both structural and quantitative evaluation.