Medical Image Analysis Based on T2 Mapping and Intravoxel-Incoherent-Motion Diffusion-Weighted Imaging in the Diagnosis of Plantar Fasciitis

Abstract

Objective: Plantar fasciitis is the most common cause of heel pain, which often influence the patient's daily activities. An early and quantitative evaluation helps an effective treatment in plantar fasciitis. Our aims were to explore the feasibility of T2 mapping and intravoxel-incoherent-motion diffusion-weighted imaging (IVIM-DWI) in the quantitative evaluation of plantar fasciitis. Methods: A 3.0T MR scanner was performed on 23 feet of 18 patients with plantar fasciitis and 24 feet of 19 healthy subjects. The imaging protocol consisted of conventional sequences including coronal and sagittal T1- and T2-weighted imaging (T2WI) with and without fat saturation, as well as T2 mapping and IVIM-DWI. The fascial thickness, effusion, tissue edema and other related manifestations were noted. The quantitative parameters including D, D*, f, and T2 values were measured in the fascia, muscle, and subcutaneous fat pad, respectively. Two independent t-test was mainly used for statistical analysis.Results: Qualitatively, bone spur, subcutaneous effusion, and soft tissue edema around the plantar fascia were observed; the fascias were thickened; and the signal intensity of T2WI of soft tissues increased in the patients compared to the healthy subjects. Quantitatively, both D and T2 values were found significant differences in the fascia, muscle, and fat pad between the patients and healthy subjects, except D *; and f values. Conclusions: Both T2 mapping and IVIM-DWI had high clinical values in the quantitative evaluation of plantar fasciitis. D and T2 values may be useful surrogate markers in predicting the severity of plantar fasciitis clinically.