Value rapid magnetic resonance imaging protocol for detecting femoral head avascular necrosis in high risk patient

Ngo Thi Thanh Tu, Pham Manh Cuong, Dam Thuy Trang, Nguyen Hong Hai

Main Article Content

Abstract

Purpose: Evaluate the agreement between limited MRI, which using T1W sequence or STIR sequence in coronal direction, with standard MRI in diagnosis early femoral head necrosis(FHN) occurring in high risk
patients.
Subjects and methods: descriptive cross-sectional study was performed on 58 patients, who warediagnosed of femoral head osteonecrosis at stage 2 or higher according to the Arlet Ficat classification. The patients were performed hip joints MRI at the Radiology Center, Bach Mai Hospital from June 2020 to August 2021.
Results: The agreement in FHN staggingbetween limited MRI using T1Wsequence, or limited MRI using STIR sequence with the standard MRI was 0.98 and 0.86, respectively. The agreement in measurement extent of osteonecrosis areabetween limited MRI using T1Wsequence, or limited MRI using STIR sequence with the standard MRI was 0.98 and 0.85.
Conclusion: There was excellent agreement between the full and limited MR examinations both forstagging and determining the extent of osteonecrosis area. The time and potential cost reduction achieved when taking limited MRImay lead to more widespread using in patient care.

Article Details

References

1. Shimizu K, Moriya H, Akita T, Sakamoto M, Suguro T. Prediction of collapse with magnetic resonance imaging of avascular necrosis of the femoral head. JBJS. 1994;76 (2): 215-223
2. Lafforgue P, Dahan E, Chagnaud C, Schiano A, Kasbarian M, Acquaviva PC. Early-stage avascular necrosis of the femoral head: MR imaging for prognosis in 31 cases with at least 2 years of follow-up. Radiology. 1993;187(1): 199-204. doi:10.1148/radiology.187.1.8451413
3. Beltran J, Knight CT, Zuelzer WA, et al. Core decompression for avascular necrosis of the femoral head: correlation between long-term results and preoperative MR staging. Radiology. 1990;175 (2): 533-536. doi:10.1148/radiology.175.2.2326478
4. Petek D, Hannouche D, Suva D. Osteonecrosis of the femoral head: pathophysiology and current concepts of treatment. EFORT Open Rev. 2019;4(3):85-97. doi:10.1302/2058-5241.4.180036
5. Nam KW, Kim YL, Yoo JJ, Koo KH, Yoon KS, Kim HJ. Fate of Untreated Asymptomatic Osteonecrosis of the Femoral Head. JBJS. 2008;90 (3):477-484. doi:10.2106/JBJS.F.01582
6. Hungerford DS, Zizic TM. Alcoholism associated ischemic necrosis of the femoral head. Early diagnosis and treatment. Clin Orthop Relat Res. 1978;(130):144-153.
7. Lang P, Jergesen HE, Moseley ME, Block JE, Chafetz NI, Genant HK. Avascular necrosis of the femoral head: high-field-strength MR imaging with histologic correlation. Radiology. 1988;169(2):517-524. doi:10.1148/radiology.169.2.3175001
8. Bluemke DA, Zerhouni EA. MRI of avascular necrosis of bone. Top Magn Reson Imaging. 1996;8 (4): 231-246. doi:10.1097/00002142-199608000-00003
9. Khanna AJ, Yoon TR, Mont MA, Hungerford DS, Bluemke DA. Femoral Head Osteonecrosis: Detection and Grading by Using a Rapid MR Imaging Protocol. Radiology. 2000;217 (1): 188-192. doi:10.1148/radiology.217.1.r00oc26188
10. Mont MA, Hungerford DS. Non-traumatic avascular necrosis of the femoral head. JBJS. 1995;77 (3):459-474.
11. Ficat RP, Arlet J. Necrosis of the Femoral Head.; 1980. In: Hungerford DS, ed. Ischemia and necrosis of bone. Baltimore, Md: Williams & Wilkins, 1980; 171–182