scholarly journals Delayed gadolinium-enhanced magnetic resonance imaging (dGEMRIC) of hip joint cartilage in femoroacetabular impingement (FAI): Are pre- and postcontrast imaging both necessary?

2009 ◽  
Vol 62 (6) ◽  
pp. 1362-1367 ◽  
Author(s):  
Bernd Bittersohl ◽  
Harish S. Hosalkar ◽  
Young-Jo Kim ◽  
Stefan Werlen ◽  
Klaus A. Siebenrock ◽  
...  
Cartilage ◽  
2018 ◽  
Vol 11 (1) ◽  
pp. 32-37 ◽  
Author(s):  
Tobias Hesper ◽  
Bernd Bittersohl ◽  
Christoph Schleich ◽  
Harish Hosalkar ◽  
Rüdiger Krauspe ◽  
...  

Objective Automatic segmentation for biochemical cartilage evaluation holds promise for an efficient and reader-independent analysis. This pilot study aims to investigate the feasibility and to compare delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) hip joint assessment with manual segmentation of acetabular and femoral head cartilage and dGEMRIC hip joint assessment using automatic surface and volume processing software at 3 Tesla. Design Three-dimensional (3D) dGEMRIC data sets of 6 patients with hip-related pathology were assessed (1) manually including multiplanar image reformatting and regions of interest (ROI) analysis and (2) automated by using a combined surface and volume processing software. For both techniques, T1Gd values were obtained in acetabular and femoral head cartilage at 7 regions (anterior, anterior-superior, superior-anterior, superior, superior-posterior, posterior-superior, and posterior) in central and peripheral portions. Correlation between both techniques was calculated utilizing Spearman’s rank correlation coefficient. Results A high correlation between both techniques was observed for acetabular (ρ = 0.897; P < 0.001) and femoral head (ρ = 0.894; P < 0.001) cartilage in all analyzed regions of the hip joint (ρ between 0.755 and 0.955; P < 0.001). Conclusions Automatic cartilage segmentation with dGEMRIC assessment for hip joint cartilage evaluation seems feasible providing high to excellent correlation with manually performed ROI analysis. This technique is feasible for an objective, reader-independant and reliable assessment of biochemical cartilage status.


2011 ◽  
Vol 3 (2) ◽  
pp. 11 ◽  
Author(s):  
Bernd Bittersohl

With the increasing advances in hip joint preservation surgery, accurate diagnosis and assessment of femoral head and acetabular cartilage status is becoming increasingly important. Magnetic resonance imaging (MRI) of the hip does present technical difficulties. The fairly thin cartilage lining necessitates high image resolution and high contrast-to-noise ratio (CNR). With MR arthrography (MRA) using intraarticular injected gadolinium, labral tears and cartilage clefts may be better identified through the contrast medium filling into the clefts. However, the ability of MRA to detect varying grades of cartilage damage is fairly limited and early histological and biochemical changes in the beginning of osteoarthritis (OA) cannot be accurately delineated. Traditional MRI thus lacks the ability to analyze the biological status of cartilage degeneration. The technique of delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) is sensitive to the charge density of cartilage contributed by glycosaminoglycans (GAGs), which are lost early in the process of OA. Therefore, the dGEMRIC technique has a potential to detect early cartilage damage that is obviously critical for decision-making regarding time and extent of intervention for joint-preservation. In the last decade, cartilage imaging with dGEMRIC has been established as an accurate and reliable tool for assessment of cartilage status in the knee and hip joint. This review outlines the current status of dGEMRIC for assessment of hip joint cartilage. Practical modifications of the standard technique including three-dimensional (3D) dGEMRIC and dGEMRIC after intra-articular gadolinium instead of iv-dGEMRIC will also be addressed.


2006 ◽  
Vol 47 (4) ◽  
pp. 391-396 ◽  
Author(s):  
M. Boesen ◽  
K. E. Jensen ◽  
E. Qvistgaard ◽  
B. Danneskiold-SamsØe ◽  
C. Thomsen ◽  
...  

Purpose: To investigate and compare delayed gadolinium (Gd-DTPA)-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) in the hip joint using intravenous (i.v.) or ultrasound-guided intra-articular (i.a.) Gd-DTPA injection. Material and Methods: In 10 patients (50% males, mean age 58 years) with clinical and radiographic hip osteoarthritis (OA; Kellgren score II–III), MRI of the hip was performed twice on a clinical 1.5T MR scanner: On day 1, before and 90–180 min after 0.3 mmol/kg body weight i.v. Gd-DTPA and, on day 8, 90–180 min after ultrasound-guided i.a. injection of a 4 mmol/l Gd-DTPA solution. Coronal STIR, coronal T1 fat-saturated spin-echo, and a cartilage-sensitive gradient-echo sequence (3D T1 SPGR) in the sagittal plane were applied. Results: Both the post-i.v. and post-i.a. Gd-DTPA images showed significantly higher signal-to-noise (SNR) and contrast-to-noise (CNR) in the joint cartilage compared to the non-enhanced images ( P<0.002). I.a. Gd-DTPA provided significantly higher SNR and CNR compared to i.v. Gd-DTPA ( P<0.01). Furthermore, a better delineation of the cartilage in the synovial/cartilage zone and of the chondral/subchondral border was observed. Conclusion: The dGEMRIC MRI method markedly improved delineation of hip joint cartilage compared to non-enhanced MRI. The i.a. Gd-DTPA provided the best cartilage delineation. dGEMRIC is a clinically applicable MRI method that may improve identification of early subtle cartilage damage and the accuracy of volume measurements of hip joint cartilage.


10.4081/2641 ◽  
2011 ◽  
Vol 3 (2) ◽  
Author(s):  
Christoph Zilkens ◽  
Falk Miese ◽  
Marcus Jager ◽  
Bernd Bittersohl ◽  
Rüdiger Krauspe

2012 ◽  
Vol 42 (5) ◽  
pp. 699-705 ◽  
Author(s):  
Christoph Zilkens ◽  
Falk R. Miese ◽  
Clemens Crumbiegel ◽  
Young-Jo Kim ◽  
Monika Herten ◽  
...  

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Abeer Abd El Maksoud Hafez ◽  
Tarek Wahby Hameda ◽  
Ghadier Ibrahim Attia

Abstract Background Magnetic resonance is the best imaging modality to assess hip joint in non-traumatic cases. It has a great ability to diagnose disorders of bone, cartilage, ligaments, muscles and soft tissue. MRI can also detect joint effusion and bone marrow edema. Aim of the Work: To assess the value of MRI as the imaging modality in children presenting with acute non-traumatic hip pain and its ability to assess the cause of the pain early without the use of another imaging modality. Patients and Methods A retrospective study was conducted on pediatric patients with non-traumatic hip pain, referred from the outpatient pediatric clinic, orthopedic clinic, Ain Shams University hospitals. The patients were investigated using magnetic resonance imaging (MRI) for detection the cause of non-traumatic hip pain. Results In this study we found that avascular necrosis is the commonest cause of non-traumatic hip pain followed by isolated hip effusion then synovitis. Other causes included perthes, septic arthritis, osteomyelitis, aneurysmal bone cyst, SCFE, PFFD and Osteomalacia. Magnetic resonance imaging doesn’t only demonstrate disorders of hip joint only; it also gives an accurate assessment of other extra-articular causes of referred hip pain. Conclusion Hip MRI is a practical, well accepted and accurate non-invasive imaging technique in children presenting with acute non-traumatic hip pain.


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