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Biochemical MRI With dGEMRIC Corresponds to 3D-CT Based Impingement Location for Detection of Acetabular Cartilage Damage in FAI Patients
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:...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7988263/ https://www.ncbi.nlm.nih.gov/pubmed/33816640 http://dx.doi.org/10.1177/2325967120988175 |
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author | 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 |
author_facet | 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 |
author_sort | Lerch, Till D. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7988263 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-79882632021-04-02 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 Orthop J Sports Med Article 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. SAGE Publications 2021-03-19 /pmc/articles/PMC7988263/ /pubmed/33816640 http://dx.doi.org/10.1177/2325967120988175 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Article 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 Biochemical MRI With dGEMRIC Corresponds to 3D-CT Based Impingement Location for Detection of Acetabular Cartilage Damage in FAI Patients |
title | Biochemical MRI With dGEMRIC Corresponds to 3D-CT Based Impingement Location for Detection of Acetabular Cartilage Damage in FAI Patients |
title_full | Biochemical MRI With dGEMRIC Corresponds to 3D-CT Based Impingement Location for Detection of Acetabular Cartilage Damage in FAI Patients |
title_fullStr | Biochemical MRI With dGEMRIC Corresponds to 3D-CT Based Impingement Location for Detection of Acetabular Cartilage Damage in FAI Patients |
title_full_unstemmed | Biochemical MRI With dGEMRIC Corresponds to 3D-CT Based Impingement Location for Detection of Acetabular Cartilage Damage in FAI Patients |
title_short | Biochemical MRI With dGEMRIC Corresponds to 3D-CT Based Impingement Location for Detection of Acetabular Cartilage Damage in FAI Patients |
title_sort | biochemical mri with dgemric corresponds to 3d-ct based impingement location for detection of acetabular cartilage damage in fai patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7988263/ https://www.ncbi.nlm.nih.gov/pubmed/33816640 http://dx.doi.org/10.1177/2325967120988175 |
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