Magnetic resonance imaging of painful total hip replacement: detection and characterisation of periprosthetic fluid collection and interobserver reproducibility

2011 ◽  
Vol 117 (1) ◽  
pp. 85-95 ◽  
Author(s):  
A. Aliprandi ◽  
L. M. Sconfienza ◽  
F. Randelli ◽  
M. Bandirali ◽  
G. Di Leo ◽  
...  
2014 ◽  
Vol 25 (2) ◽  
pp. 313-319 ◽  
Author(s):  
Vassilios S. Nikolaou ◽  
Alain Petit ◽  
Viviane Khoury ◽  
Etienne Blain-Pare ◽  
David J. Zukor ◽  
...  

2021 ◽  
pp. 155633162110092
Author(s):  
Ashley E. Levack ◽  
Chelsea Koch ◽  
Harold G. Moore ◽  
Michael B. Cross

Background: The 2010 American Academy of Orthopaedic Surgeons Clinical Practice Guidelines report insufficient evidence to address the diagnostic efficacy of magnetic resonance imaging (MRI) for periprosthetic joint infection (PJI). Questions/Purposes: The purpose of this study was to determine the utility of MRI with multiacquisition variable-resonance image combination (MAVRIC) metal artifact suppression techniques in diagnosing PJI in the setting of total hip arthroplasty (THA). Methods: Multiacquisition variable-resonance image combination MRIs obtained of THAs between November 2012 and November 2016 were queried. Radiology reports were classified as positive (suspicious for infection), negative (no features of infection), or inconclusive (infection cannot be excluded or correlation with aspiration suggested if clinically concerned). Chart review identified cases of deep PJI according to the modified Musculoskeletal Infection Society criteria. Results: Of 2156 MRIs of THAs included, MRI was concerning for infection in 1.8% (n = 39), inconclusive in 1.2% (n = 26), and negative in 97.0% (n = 2091). Deep PJI was identified in 53 (2.5%) patients, 30 of whom (56.6%) had conclusively positive finding on MRI (false-negative rate: 43.4%, sensitivity: 56.6%). Of 2103 aseptic THAs, only 9 (0.4%) MRIs were read as suspicious for infection (false-positive rate: 0.4%; specificity: 99.6%). Conclusion: Magnetic resonance imaging with MAVRIC is a highly specific test for PJI with a low false-positive rate. This indicates that when clinicians are provided with an MRI that unexpectedly suggests infection, a formal evaluation for infection is indicated. In patients with otherwise equivocal diagnostic findings, MRI may help confirm, but not refute, a diagnosis of PJI. Prospective study with more experienced image reviewers may further support the use of MRI in PJI.


2019 ◽  
Vol 52 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Lorenzo Carlo Pescatori ◽  
Edoardo Savarino ◽  
Giovanni Mauri ◽  
Enzo Silvestri ◽  
Maurizio Cariati ◽  
...  

Abstract Objective: To evaluate the feasibility of quantifying visceral adipose tissue (VAT) on computed tomography (CT) and magnetic resonance imaging (MRI) scans, using freeware, as well as calculating intraobserver and interobserver reproducibility. Materials and Methods: We quantified VAT in patients who underwent abdominal CT and MRI at our institution between 2010 and 2015, with a maximum of three months between the two examinations. A slice acquired at the level of the umbilicus was selected. Segmentation was performed with the region growing algorithm of the freeware employed. Intraobserver and interobserver reproducibility were evaluated, as was the accuracy of MRI in relation to that of CT. Results: Thirty-one patients (14 males and 17 females; mean age of 57 ± 15 years) underwent CT and MRI (mean interval between the examinations, 28 ± 12 days). The interobserver reproducibility was 82% for CT (bias = 1.52 cm2; p = 0.488), 86% for T1-weighted MRI (bias = −4.36 cm2; p = 0.006), and 88% for T2-weighted MRI (bias = −0.52 cm2; p = 0.735). The intraobserver reproducibility was 90% for CT (bias = 0.14 cm2; p = 0.912), 92% for T1-weighted MRI (bias = −3,4 cm2; p = 0.035), and 90% for T2-weighted MRI (bias = −0.30 cm2; p = 0.887). The reproducibility between T1-weighted MRI and T2-weighted MRI was 87% (bias = −0.11 cm2; p = 0.957). In comparison with the accuracy of CT, that of T1-weighted and T2-weighted MRI was 89% and 91%, respectively. Conclusion: The program employed can be used in order to quantify VAT on CT, T1-weighted MRI, and T2-weighted MRI scans. Overall, the accuracy of MRI (in comparison with that of CT) appears to be high, as do intraobserver and interobserver reproducibility. However, the quantification of VAT seems to be less reproducible in T1-weighted sequences.


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