MR arthrography of the hip with and without leg traction: Assessing the diagnostic performance in detection of ligamentum teres lesions with arthroscopic correlation.

Schmaranzer, F; Klauser, Andrea; Kogler, Michael; Henninger, Benjamin; Forstner, Thomas; Reichkendler, Markus; Schmaranzer, Ehrenfried (2016). MR arthrography of the hip with and without leg traction: Assessing the diagnostic performance in detection of ligamentum teres lesions with arthroscopic correlation. European journal of radiology, 85(2), pp. 489-497. Thieme 10.1016/j.ejrad.2015.11.027

[img] Text
1-s2.0-S0720048X15301698-main.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (1MB) | Request a copy

OBJECTIVES To retrospectively assess the diagnostic performance of hip MR arthrography with and without traction in detecting ligamentum teres (LT) lesions with arthroscopic correlation and to evaluate the effect of traction on the imaging appearance of the LT. METHODS 73 MR arthrograms (73 consecutive patients, mean age, 34.5 years; range, 14-55 years) obtained without and with leg traction (application of 15-23 kg, use of a supporting plate for the contralateral leg) were included. Two blinded readers independently evaluated LT lesions on MR arthrograms on separate occasions: coronal images without traction; coronal images with traction; a multiplanar traction protocol. MR findings were correlated with arthroscopic records. Sensitivity/specificity of traction and non-traction imaging was compared on coronal images with the exact McNemar test. Imaging appearance of the LT with and without traction was assessed in consensus and compared on coronal images using McNemar and McNemar-Bowker tests. (p<0.05, * corrected for type I error). RESULTS With arthroscopy 29 (40%) LT lesions were identified in 73 patients. Sensitivity was 72%/90% (without traction/with traction; p=0.25*), specificity was 89%/77% (p=0.25*) for reader 1 in assessing coronal images and for reader 2 sensitivity was 59%/86% (p=0.044*) and specificity was 93%/82% (p=0.25*). Alterations in fiber orientation, signal intensity, surface, dimension, fiber continuity after application of traction were observed in 33/73 (45%, p=0.002*), 6/73 (8%, p=0.223), 9/73 (12%, p=0.36*), 6/73 (8%, p=0.031) respectively 9/73 (12%, p=0.003) cases. Traction-related alterations in at least one criterion were observed in 41/73 (56%) cases. CONCLUSION Application of traction can considerably alter the imaging appearance of the LT and resulted in higher rates of true-positive and false-positive findings compared to conventional MR arthrography.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)

UniBE Contributor:

Schmaranzer, Florian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0720-048X

Publisher:

Thieme

Language:

English

Submitter:

Lilianna Bolliger

Date Deposited:

27 Apr 2017 10:18

Last Modified:

20 Jul 2017 12:27

Publisher DOI:

10.1016/j.ejrad.2015.11.027

PubMed ID:

26781156

Uncontrolled Keywords:

Arthrography; Hip joint; Ligamentum teres; Magnetic resonance imaging; Traction

BORIS DOI:

10.7892/boris.95054

URI:

https://boris.unibe.ch/id/eprint/95054

Actions (login required)

Edit item Edit item
Provide Feedback