The role of the subchondral layer in osteonecrosis of the femoral head: analysis based on HR-QCT in comparison to MRI findings

2018 ◽  
Vol 60 (4) ◽  
pp. 501-508 ◽  
Author(s):  
Alexander R Kolb ◽  
Janina M Patsch ◽  
Wolf-Dieter Vogl ◽  
Emir Benca ◽  
David Stelzeneder ◽  
...  
Keyword(s):  
Femoral Head ◽  
Trabecular Bone ◽  
Severe Disease ◽  
Quantitative Computed Tomography ◽  
Young Patients ◽  
High Signal ◽  
Homogeneity Test ◽  
Special Focus ◽  
Mri Findings ◽  
Bone Parameters

Background Non-traumatic avascular osteonecrosis of the femoral head (ONFH) is a severe disease causing destruction of the hip joint, often necessitating total hip arthroplasty (THA) even in young patients. Magnetic resonance imaging (MRI) is commonly used for diagnosis of ONFH, but provides limited insight into the subchondral bone microstructure. Purpose To analyze routine MRI findings in comparison to high-resolution quantitative computed tomography (HR-QCT) with a special focus on the subchondral layer and to estimate the importance of differences determining the indication for THA. Material and Methods Twelve patients with ONFH were included before THA. Preoperative MRI and HR-QCT of the retrieved femoral heads were aligned using a registration algorithm. Pathological findings and trabecular bone parameters in matched areas were analyzed by two readers. McNemar, marginal homogeneity test, and Pearson’s correlation coefficient were used for comparison. Results Subchondral delamination was found in nine cases on HR-QCT, but missed or underestimated in all but one case on MRI ( P = 0.016). Chondral discontinuity was found in all cases on HR-QCT and in two cases on MRI ( P = 0.016). Areas of complete bone resorption on HR-QCT were linked to high signal intensity on 3D gradient-echo MRI sequences with water-selective excitation, while there was no correlation between trabecular bone parameters and MRI signal intensities in other areas ( P = 0.304). Conclusion Subchondral delamination, subchondral resorption, and chondral discontinuity are found frequently in advanced stages of ONFH. These lesions tend to be underestimated on conventional MRI. Our results support the importance of CT imaging in the evaluation of ONFH.

Cortical and trabecular bone parameters from HR-Pqct images at the Tibia: a local comparison with synchrotron radiation micro-computed tomography

2013 ◽  
Author(s):  
Agnes Ostertag ◽  
Francoise Peyrin ◽  
Sylvie Fernandez ◽  
Jean-Denis Laredo ◽  
Vernejoul Marie-Christine De ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Synchrotron Radiation ◽  
Trabecular Bone ◽  
Micro Computed Tomography ◽  
Bone Parameters ◽  
Local Comparison

Quantitative computed tomography in measurement of vertebral trabecular bone mass

1988 ◽  
Vol 29 (6) ◽  
pp. 719-725 ◽  
Author(s):  
M. Nilsson ◽  
O. Johnell ◽  
K. Jonsson ◽  
I. Redlund-Johnell
Keyword(s):  
Computed Tomography ◽  
Bone Mass ◽  
Trabecular Bone ◽  
Quantitative Computed Tomography ◽  
Vertebral Trabecular Bone ◽  
Trabecular Bone Mass

Epidemiological Study of Femoral Head Osteonecrosis

2017 ◽  
Vol 68 (5) ◽  
pp. 974-976
Author(s):  
Alexandru Patrascu ◽  
Liliana Savin ◽  
Dan Mihailescu ◽  
Victor Grigorescu ◽  
carmen Grierosu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Young Patients ◽  
Head Group ◽  
Bipolar Hemiarthroplasty ◽  
Aseptic Necrosis ◽  
Total Hip ◽  
Femoral Head Osteonecrosis

In recent years, there has been an increase in the number of studies on the etiology of femoral head necrosis. We retrospectively reviewed all patients diagnosed with aseptic necrosis of the femoral in the period of 2010-2015. We recorded a total of 230 cases diagnosed with aseptic necrosis of the femoral head, group was composed of 65.7% men and 34.3% women, risk factors identified was 19.13% (post-traumatic), 13.91% (glucocorticoids), 26.52% (alcohol), 3.47% (another cause) and in 36 95% of the cases no risk factors were found. The results of the study based on the type of surgery performed on the basis of stages of disease progression, 8 patients (3.48%) benefited from osteotomy, 28 patients (12.17%) benefited of bipolar hemiarthroplasty prosthesis and 188 patients (81.74%) benefited of total hip arthroplasty. Osteonecrosis of the femoral head is characteristic to young patients between the age of 30-50 years old. Predisposing factors, alcohol and corticosteroid therapy remains an important cause of the disease. Total hip arthroplasty remains the best option for the patients with osteonecrosis of the femoral head.

scholarly journals Preoperative Magnetic Resonance Cholangiopancreatography for Detecting Difficult Laparoscopic Cholecystectomy in Acute Cholecystitis

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 383
Author(s):  
Kojiro Omiya ◽  
Kazuhiro Hiramatsu ◽  
Yoshihisa Shibata ◽  
Masahide Fukaya ◽  
Masahiro Fujii ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Magnetic Resonance ◽  
Acute Cholecystitis ◽  
Signal Intensity ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Gallbladder Wall ◽  
High Signal ◽  
Mri Findings ◽  
Open Conversion ◽  
Preoperative Magnetic Resonance

Previous studies have shown that signal intensity variations in the gallbladder wall on magnetic resonance imaging (MRI) are associated with necrosis and fibrosis in the gallbladder of acute cholecystitis (AC). However, the association between MRI findings and operative outcomes remains unclear. We retrospectively identified 321 patients who underwent preoperative magnetic resonance cholangiopancreatography (MRCP) and early laparoscopic cholecystectomy (LC) for AC. Based on the gallbladder wall signal intensity on MRI, these patients were divided into high signal intensity (HSI), intermediate signal intensity (ISI), and low signal intensity (LSI) groups. Comparisons of bailout procedure rates (open conversion and laparoscopic subtotal cholecystectomy) and operating times were performed. The recorded bailout procedure rates were 6.8% (7/103 cases), 26.7% (31/116 cases), and 40.2% (41/102 cases), and the median operating times were 95, 110, and 138 minutes in the HSI, ISI, and LSI groups, respectively (both p < 0.001). During the multivariate analysis, the LSI of the gallbladder wall was an independent predictor of both the bailout procedure (odds ratio [OR] 5.30; 95% CI 2.11–13.30; p < 0.001) and prolonged surgery (≥144 min) (OR 6.10, 95% CI 2.74–13.60, p < 0.001). Preoperative MRCP/MRI assessment could be a novel method for predicting surgical difficulty during LC for AC.

Non-Invasive Analysis of the Micro-Structural and Biomechanical Properties of Trabecular Bone in Human Femoral Head

2006 ◽  
Vol 321-323 ◽  
pp. 1070-1073
Author(s):  
Ye Yeon Won ◽  
Myong Hyun Baek ◽  
Wen Quan Cui ◽  
Kwang Kyun Kim
Keyword(s):  
Mechanical Properties ◽  
Mechanical Property ◽  
Femoral Head ◽  
Trabecular Bone ◽  
Volume Fraction ◽  
Reaction Force ◽  
Bone Volume ◽  
Fe Model ◽  
Micro Ct ◽  
Trabecular Thickness

This study investigates micro-structural and mechanical properties of trabecular bone in human femoral head with and without osteoporosis using a micro-CT and a finite element model. 15 cored trabecular bone specimens with 20 of diameter were obtained from femoral heads with osteoporosis resected for total hip arthroplasty, and 5 specimens were removed from femoral head of cadavers, which has no history of musculoskeletal diseases. A high-resolution micro-CT system was used to scan each specimen to obtain histomorphometry indexes. Based on the micro-images, a FE-model was created to determine mechanical property indexes. While the non-osteoporosis group had increases the trabecular thickness, the bone volume, the bone volume fraction, the degree of anisotropy and the trabecular number compared with those of osteoporotic group, the non-osteoporotic group showed decreases in trabecular separation and structure model index. Regarding the mechanical property indexes, the reaction force and the Young's modulus were lower in the osteoporotic group than in non-osteoporotic group. Our data shows salient deteriorations in trabecular micro-structural and mechanical properties in human femoral head with osteoporosis.

scholarly journals Region specific Raman spectroscopy analysis of the femoral head reveals that trabecular bone is unlikely to contribute to non-traumatic osteonecrosis

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Tristan Pascart ◽  
Guillaume Falgayrac ◽  
Henri Migaud ◽  
Jean-François Quinchon ◽  
Laurène Norberciak ◽  
...  
Keyword(s):  
Raman Spectroscopy ◽  
Femoral Head ◽  
Trabecular Bone ◽  
Spectroscopy Analysis

Heterogeneity of Cortical Breaks in Hand Joints of Patients with Rheumatoid Arthritis and Healthy Controls Imaged by High-resolution Peripheral Quantitative Computed Tomography

2016 ◽  
Vol 43 (10) ◽  
pp. 1914-1920 ◽  
Author(s):  
Andrea Scharmga ◽  
Michiel Peters ◽  
Astrid van Tubergen ◽  
Joop van den Bergh ◽  
Cheryl Barnabe ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Computed Tomography ◽  
High Resolution ◽  
Trabecular Bone ◽  
Quantitative Computed Tomography ◽  
Peripheral Quantitative Computed Tomography ◽  
Healthy Controls ◽  
Poor Prognostic Factor ◽  
Bone Erosions ◽  
Bone Changes

Objective.Conventional radiographs (CR) of the hands are the gold standard for imaging bone erosions. The presence of bone erosions, reflected by the presence of cortical breaks, is a poor prognostic factor in patients with rheumatoid arthritis (RA). The availability of high-resolution peripheral quantitative computed tomography (HR-pQCT) enables detailed investigation of cortical breaks in rheumatic diseases. The aim of this image review is to show HR-pQCT images of the spectrum of cortical breaks with and without underlying trabecular bone changes in metacarpophalangeal (MCP) joints of healthy controls (HC) and patients with RA, with corresponding images on CR and magnetic resonance imaging (MRI).Methods.Second and third MCP joints of 41 patients (of which 10 were early RA with ≤ 2 years and 24 longstanding RA with ≥ 10 years of disease duration) and 38 HC were imaged by CR, MRI, and HR-pQCT (XtremeCT1, Scanco Medical AG). Representative images of the spectrum of cortical breaks were selected.Results.Cortical breaks were found in early and longstanding RA, but also in HC. They were heterogeneous in size, location, and number per joint, with a variety of surrounding cortical and underlying trabecular bone characteristics.Conclusion.Using HR-pQCT images of MCP joints, heterogeneous cortical breaks with and without surrounding trabecular bone changes were found, not only in RA but also in HC. The underlying mechanisms and significance of this spectrum of cortical breaks as found with high 3-D resolution needs further investigation.

scholarly journals A vaginal fibroepithelial stromal polyp: a case report with magnetic resonance images

2022 ◽  
Author(s):  
Naoko Ogura ◽  
Mieko Inagaki ◽  
Ritsuko Yasuda ◽  
Shigeki Yoshida ◽  
Tetsuo Maeda
Keyword(s):  
Magnetic Resonance ◽  
Signal Intensity ◽  
Vaginal Wall ◽  
Magnetic Resonance Images ◽  
High Signal ◽  
Soft Tissue Tumour ◽  
Mri Findings ◽  
Vaginal Mass ◽  
Diffusion Weighted Images ◽  
Tissue Tumour

A fibroepithelial stromal polyp is a benign soft tissue tumour that can occur in the vagina, vulva and uterine cervix. Magnetic resonance imaging (MRI) findings have been reported in patients with vulvar fibroepithelial stromal polyps, not in those with vaginal polyps. We present MRI findings of vaginal fibroepithelial stromal polyp in a postmenopausal female. A 1 to 2 cm firm vaginal mass arising from the left side of the vaginal wall with hypointense signal changes on T1W MRI was identified. A well-defined vaginal mass (1 cm diameter) was detected with inhomogeneous signal intensity on T2W images. However, a major portion had high signal intensity on diffusion-weighted images. A benign vaginal lesion with oedematous changes or myxoid degeneration was suspected. Vaginal resection was performed, and fibroepithelial stromal polyp was pathologically diagnosed. MRI may be a useful non-invasive modality for preoperatively diagnosing vaginal fibroepithelial stromal polyps.

Sign in / Sign up

Export Citation Format

Share Document