{
 "serie": "s601_T1W_aTSE",
 "n_imgs": 24,
 "s": 60.0,
 "respuesta": "**Series:** Coronal T1W TSE, right ankle, 24 slices ordered anterior (talar head/navicular, sinus tarsi) → posterior (calcaneal tuberosity, Achilles). Single sequence, so fluid‑sensitive assessment is limited.\n\n**Findings**\n\n1. **Lateral talar dome / lateral gutter (slices 8–9)** – Focal irregular low T1 signal at the lateral shoulder of the talar dome extending to the subchondral plate, adjacent to the distal tibiofibular region, with mild contour irregularity of the articular surface. Appearance suspicious for an osteochondral lesion / subchondral marrow change of the lateral talar dome. Confidence: **medium**.\n\n2. **Distal tibia (slices 11–13)** – Patchy, ill‑defined intermediate‑to‑low T1 signal within the distal tibial metaphysis just above the plafond and toward the posterior malleolus, replacing normal fatty marrow. Could represent marrow edema/contusion or prominent hematopoietic marrow; needs correlation with fluid‑sensitive images. Confidence: **low**.\n\n3. **Achilles tendon (slices 17–20)** – The tendon appears somewhat broad in its distal portion as it approaches the calcaneal insertion, without a discrete gap; mild thickening (tendinopathy) is possible but not confidently established on T1 coronal images. Confidence: **low**.\n\n4. **Tibiotalar joint (slices 7–10)** – Slightly prominent intermediate/low signal in the anterior and lateral joint recess, possibly a small effusion/synovitis. Confidence: **low**.\n\n**Structures appearing normal**\n- Medial talar dome, talar neck/head, navicular and cuneiforms: normal marrow signal, no fracture line.\n- Calcaneus: homogeneous fatty marrow, no fracture or stress reaction; posterior subtalar joint congruent.\n- Sinus tarsi: fat preserved with intact interosseous/cervical ligaments.\n- Deltoid ligament complex and syndesmotic region: no clear disruption on T1.\n- Medial tendons (tibialis posterior, FDL, FHL) and lateral peroneal tendons: normal caliber and dark signal, no obvious split or dislocation.\n- Plantar fascia and heel fat pad: normal.\n- Distal fibula marrow normal; no fibular fracture.\n- Muscles of the leg and foot: normal bulk, no fatty atrophy; subcutaneous tissues unremarkable.\n\n**Impression:** Suspected osteochondral lesion of the lateral talar dome with possible associated distal tibial marrow signal change; possible mild distal Achilles thickening and small tibiotalar effusion. Recommend correlation with the PD/T2 fat‑suppressed sequences of the same study for confirmation."
}