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Advantages of Color B-mode Imaging With Contrast Optimization in Sonography of Low-Contrast Musculoskeletal Lesions and Structures in the Foot and Ankle

Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York USA.

Address correspondence and reprint requests to Carolyn M. Sofka, MD, Department of Radiology and Imaging, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021. E-mail: sofkac{at}hss.edu

Objective. The purpose of this study was to evaluate the utility of color B-mode imaging with contrast optimization in evaluating low-contrast lesions of the foot and ankle (Morton neuromas and plantar fasciitis). Methods. The sonographic examinations of 49 consecutive patients with a diagnosis of plantar fasciitis or Morton neuroma imaged with both conventional gray scale imaging and color B-mode imaging with contrast optimization (Photopic; Siemens Medical Solutions, Mountain View, CA) were reviewed. In every patient, matched pairs of images obtained with conventional gray and color maps (Photopic) were acquired and stored as DICOM (Digital Imaging and Communications in Medicine) images on a sonographic workstation. Each image was assessed independently by 2 musculoskeletal radiologists trained in musculoskeletal sonography for overall image contrast (lesion to background), conspicuity of regional tissue boundaries, visualization of deep tissue boundaries, and how well the internal characteristics of the structure were visualized. Results. Three-way analysis of variance showed that Photopic imaging resulted in statistically significantly improved overall image contrast, definition of regional soft tissue boundaries, including deep soft tissue boundaries, and depiction of the internal characteristics of the structure being examined. Conclusions. Color imaging with contrast optimization improves overall image contrast and better defines deep soft tissue boundaries and the internal morphologic characteristics of Morton neuromas and the plantar fascia compared with conventional gray scale imaging.

Key Words: image optimization • musculoskeletal sonography • Morton neuromas • plantar fasciitis