{
 "serie": "s601_T1W_aTSE",
 "n_imgs": 24,
 "s": 48.1,
 "respuesta": "**Series:** Coronal T1‑weighted TSE, right ankle, 24 slices anterior → posterior (talar head/navicular anteriorly through tibiotalar joint, hindfoot, Achilles/posterior calf). Image left = lateral (fibula), image right = medial.\n\n**Findings**\n\n1. **Medial talar dome – osteochondral lesion (medium confidence)**\n Slices 7–9: at the medial shoulder of the talar dome, directly beneath the tibial plafond, there is a focal, well‑defined low‑T1‑signal area in the subchondral bone with slight irregularity/flattening of the overlying articular contour. This appearance is typical of a chronic post‑traumatic osteochondral lesion (subchondral sclerosis/cyst/marrow change). Fluid‑sensitive sequences would be needed to assess fragment stability and cyst/edema component. The lateral talar dome appears preserved.\n\n2. **Lateral ligament complex / lateral gutter – chronic sprain sequelae (medium–low confidence)**\n Slices 7–10: the soft tissue in the lateral gutter between the distal fibula and lateral talar body/neck (region of the anterior talofibular ligament and anterior aspect of the calcaneofibular ligament) shows intermediate‑signal, somewhat thickened tissue rather than a crisp thin ligament, consistent with scarring/thickening from the remote inversion injury. No clear discrete ligament is separately identified. Deltoid ligament (medial, slices 9–10) appears intact and of normal low signal.\n\n3. **Sinus tarsi (low confidence)**\n Slices 4–7: the sinus tarsi fat appears partially replaced by intermediate‑signal strands around the interosseous talocalcaneal/cervical ligaments, which may represent post‑traumatic fibrosis (sinus tarsi syndrome). This is subtle on T1 alone.\n\n**Structures assessed as normal**\n- Tibia, fibula (including distal fibula/lateral malleolus), calcaneus, navicular, cuboid: normal marrow signal, no fracture line, no marrow replacement.\n- Tibiofibular syndesmosis: no widening.\n- Posterior tibial, FDL, FHL tendons (medial, slices 11–15) and peroneal tendons (lateral, slices 11–15): normal caliber and low signal, no split or dislocation.\n- Achilles tendon (slices 18–24): normal thickness, insertion normal; Kager fat pad clear; no retrocalcaneal bursal mass.\n- Plantar fascia origin and plantar fat pad: unremarkable.\n- No significant tibiotalar or subtalar effusion apparent on T1 (limited assessment); no soft‑tissue mass; muscle bulk and signal normal, no fatty atrophy.\n\n**Impression**\nChronic post‑sprain findings: probable osteochondral lesion of the medial talar dome with subchondral low‑T1 change, and thickening/scarring of the lateral (ATFL) ligament complex; possible sinus tarsi fibrosis. Correlation with fluid‑sensitive (PD/STIR) sequences is recommended to characterize the talar lesion and ligament integrity."
}