Biochemical MRI With dGEMRIC Corresponds to 3D-CT Based Impingement Location for Detection of Acetabular Cartilage Damage in FAI Patients.

Lerch, Till D.; Ambühl, Dimitri; Schmaranzer, Florian; Todorski, Inga A. S.; Steppacher, Simon D.; Hanke, Markus S.; Haefeli, Pascal C.; Liechti, Emanuel F.; Siebenrock, Klaus A.; Tannast, Moritz (2021). Biochemical MRI With dGEMRIC Corresponds to 3D-CT Based Impingement Location for Detection of Acetabular Cartilage Damage in FAI Patients. Orthopaedic journal of sports medicine, 9(3), p. 2325967120988175. Sage Publications 10.1177/2325967120988175

[img]
Preview
Text
Lerch_Biochemical_MRI.pdf - Published Version
Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND).

Download (766kB) | Preview

Background

Anterior femoroacetabular impingement (FAI) is associated with labral tears and acetabular cartilage damage in athletic and young patients. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) is an imaging method for detecting early damage to cartilage.

Purpose

We evaluated the following questions: (1) What is the sensitivity and specificity of morphological magnetic resonance imaging (MRI) and dGEMRIC for detecting cartilage damage? Do the mean acetabular and femoral dGEMRIC indices differ between (2) superior acetabular clock positions with and without impingement and (3) between cam- and pincer-type FAI?

Study Design

Cohort study (diagnosis); Level of evidence, 2.

Methods

This was a retrospective comparative study of 21 hips (20 patients with symptomatic anterior FAI) without osteoarthritis on anteroposterior radiographs. Morphological MRI and dGEMRIC (3.0-T, 3-dimensional [3D] T1 maps, dual-flip angle technique) of the same hip joint were compared. Intraoperative acetabular cartilage damage was assessed in patients who underwent surgical treatment. Computed tomography (CT)-based 3D bone models of the same hip joint were used as the gold standard for the detection of impingement, and dGEMRIC indices and zones of morphologic damage were compared with the CT-based impingement zones.

Results

Of the 21 hips, 10 had cam-type FAI and 8 had pincer-type FAI according to radiographs. The mean age was 30 ± 9 years (range, 17-48 years), 71% were female, and surgical treatment was performed in 52%. We found a significantly higher sensitivity (69%) for dGEMRIC compared with morphological MRI (42%) in the detection of cartilage damage (P < .001). The specificity of dGEMRIC was 83% and accuracy was 78%. The mean peripheral acetabular and femoral dGEMRIC indices for clock positions with impingement (485 ± 141 and 440 ± 121 ms) were significantly lower compared with clock positions without impingement (596 ± 183 and 534 ± 129 ms) (P < .001). Hips with cam-type FAI had significantly lower acetabular dGEMRIC indices compared with hips with pincer-type FAI on the anterosuperior clock positions (1 to 3 o'clock) (P = .018).

Conclusion

MRI with dGEMRIC was more sensitive than morphological MRI, and lower dGEMRIC values were found for clock positions with impingement as detected on 3D-CT. This could aid in patient-specific diagnosis of FAI, preoperative patient selection, and surgical decision making to identify patients with cartilage damage who are at risk for inferior outcomes after hip arthroscopy.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Lerch, Till; Schmaranzer, Florian; Todorski, Inga Almut Senta; Steppacher, Simon Damian; Hanke, Markus; Liechti, Emanuel; Siebenrock, Klaus-Arno and Tannast, Moritz

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2325-9671

Publisher:

Sage Publications

Language:

English

Submitter:

Maria de Fatima Henriques Bernardo

Date Deposited:

07 Apr 2021 07:54

Last Modified:

07 Apr 2021 07:54

Publisher DOI:

10.1177/2325967120988175

PubMed ID:

33816640

Uncontrolled Keywords:

3D-CT FAI dGEMRIC femoroacetabular impingement hip arthroscopy hip preservation surgery hip preserving surgery

BORIS DOI:

10.48350/155639

URI:

https://boris.unibe.ch/id/eprint/155639

Actions (login required)

Edit item Edit item
Provide Feedback