Aspects of postoperative magnetic resonance imaging of patients with avascular necrosis of the femoral head, treated by advanced core decompression
| Autor: | Jens M. Theysohn, Oliver Kraff, Thomas C. Lauenstein, Andrea Lazik, Tim Claßen, Stefan Landgraeber |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Decompression medicine.medical_treatment Medizin Avascular necrosis Asymptomatic Bone remodeling Femoral head Postoperative Complications Femur Head Necrosis medicine Humans Radiology Nuclear Medicine and imaging Postoperative Period Reduction (orthopedic surgery) Observer Variation Bone Transplantation medicine.diagnostic_test business.industry Femur Head Magnetic resonance imaging Middle Aged Decompression Surgical medicine.disease Magnetic Resonance Imaging Treatment Outcome medicine.anatomical_structure Orthopedic surgery Female Bone Remodeling Radiology medicine.symptom business Follow-Up Studies |
| Zdroj: | Skeletal Radiology. 44:1467-1475 |
| ISSN: | 1432-2161 0364-2348 |
| DOI: | 10.1007/s00256-015-2192-7 |
| Popis: | To analyze remodeling processes after advanced core decompression (ACD) in patients with avascular femoral head necrosis by means of 3T MRI and to identify indicators for clinical outcome considering the defect size and characteristics of the bone graft and of the neighboring regeneration tissue. Thirty-four hips, with preexisting preoperative MRIs in 21 cases, were examined 1–34 months (mean 12.7) postoperatively by 3T MRI. The volume of necrosis was measured manually pre- and postoperatively to calculate absolute as well as percentage necrosis reduction. The signal intensity of the bone graft was quantified using a 4-point scale. Border phenomena between the bone graft and bone were described and classified into groups. Wilcoxon sign-rank test was used to identify correlations between the analyzed items and clinical signs of femoral head collapse after a mean follow-up time of 28.6 months (10.4–46.8). Mean percentage reduction of necrosis was significantly higher in asymptomatic patients (59.36 %) compared to patients with signs of femoral head collapse (28.78 %, p = 0.008). Signal intensity of the bone graft increased in T1w and T2w TIRM sequences over time after surgery and was significantly higher in asymptomatic patients. Five border phenomena between the bone graft and healthy bone were identified. Among them, the so-called “rail sign” representing three layers of remodeling tissue correlated with the histological observations. A variety of border phenomena representing remodeling processes have been described using 3T MRI. Beneath the percentage amount of necrosis reduction, we identified the signal intensity of the bone graft as an indicator for clinical outcome. |
| Databáze: | OpenAIRE |
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