Relationship of idiopathic osteonecrosis of the femoral head to perfusion changes in the proximal femur by dynamic contrast-enhanced MRI

Wing P. Chan, Yi Jui Liu, Guo Shu Huang, Min Fang Lin, Sydney Huang, Yue Cune Chang, Ching Chuan Jiang

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of this article is to relate intramedullary perfusion of the proximal femur to severity of osteonecrosis of the femoral head by using dynamic contrast-enhanced MRI (DCE-MRI). SUBJECTS AND METHODS. Twelve patients (14 symptomatic hips) who underwent DCE-MRI and had subsequent core decompression of the femoral head were examined. Hips were graded for severity according to MRI findings and were assigned scores of 0 (negative findings), 1 (focal marrow abnormalities), and 2 (subchondral collapse). Thirteen asymptomatic hips acted as controls. The DCE-MRI data were analyzed by use of a pharmacokinetic two-compartment model. RESULTS. Compared with control hips, there was significantly greater peak enhancement in the femoral head in hips of all grades (p <0.001) and in the femoral neck (p = 0.001) and intertrochanteric area (p = 0.001) in grade 2 hips. The time to peak was significantly delayed in the femoral head in grade 0 hips (p = 0.02) and in the intertrochanteric area in grade 2 hips (p = 0.003) compared with the controls. CONCLUSION. As evaluated by DCE-MRI, intramedullary peak enhancement in the femoral head increased with progression of idiopathic osteonecrosis of the femoral head, whereas there was delayed peak enhancement in the femoral head in hips with negative findings and intertrochanteric stasis in advanced osteonecrosis of the femoral head. Such perfusion changes as shown on MRI can occur with early osteonecrosis in the absence of other MRI abnormalities.

Original languageEnglish
Pages (from-to)637-643
Number of pages7
JournalAmerican Journal of Roentgenology
Volume196
Issue number3
DOIs
Publication statusPublished - Mar 2011

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Osteonecrosis
Thigh
Femur
Hip
Perfusion
Femur Neck
Decompression
Pharmacokinetics
Bone Marrow

Keywords

  • Bone marrow
  • Dynamic contrast-enhanced MRI
  • Femur
  • Osteonecrosis
  • Perfusion

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Relationship of idiopathic osteonecrosis of the femoral head to perfusion changes in the proximal femur by dynamic contrast-enhanced MRI. / Chan, Wing P.; Liu, Yi Jui; Huang, Guo Shu; Lin, Min Fang; Huang, Sydney; Chang, Yue Cune; Jiang, Ching Chuan.

In: American Journal of Roentgenology, Vol. 196, No. 3, 03.2011, p. 637-643.

Research output: Contribution to journalArticle

Chan, Wing P. ; Liu, Yi Jui ; Huang, Guo Shu ; Lin, Min Fang ; Huang, Sydney ; Chang, Yue Cune ; Jiang, Ching Chuan. / Relationship of idiopathic osteonecrosis of the femoral head to perfusion changes in the proximal femur by dynamic contrast-enhanced MRI. In: American Journal of Roentgenology. 2011 ; Vol. 196, No. 3. pp. 637-643.
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abstract = "OBJECTIVE. The purpose of this article is to relate intramedullary perfusion of the proximal femur to severity of osteonecrosis of the femoral head by using dynamic contrast-enhanced MRI (DCE-MRI). SUBJECTS AND METHODS. Twelve patients (14 symptomatic hips) who underwent DCE-MRI and had subsequent core decompression of the femoral head were examined. Hips were graded for severity according to MRI findings and were assigned scores of 0 (negative findings), 1 (focal marrow abnormalities), and 2 (subchondral collapse). Thirteen asymptomatic hips acted as controls. The DCE-MRI data were analyzed by use of a pharmacokinetic two-compartment model. RESULTS. Compared with control hips, there was significantly greater peak enhancement in the femoral head in hips of all grades (p <0.001) and in the femoral neck (p = 0.001) and intertrochanteric area (p = 0.001) in grade 2 hips. The time to peak was significantly delayed in the femoral head in grade 0 hips (p = 0.02) and in the intertrochanteric area in grade 2 hips (p = 0.003) compared with the controls. CONCLUSION. As evaluated by DCE-MRI, intramedullary peak enhancement in the femoral head increased with progression of idiopathic osteonecrosis of the femoral head, whereas there was delayed peak enhancement in the femoral head in hips with negative findings and intertrochanteric stasis in advanced osteonecrosis of the femoral head. Such perfusion changes as shown on MRI can occur with early osteonecrosis in the absence of other MRI abnormalities.",
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AU - Chang, Yue Cune

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N2 - OBJECTIVE. The purpose of this article is to relate intramedullary perfusion of the proximal femur to severity of osteonecrosis of the femoral head by using dynamic contrast-enhanced MRI (DCE-MRI). SUBJECTS AND METHODS. Twelve patients (14 symptomatic hips) who underwent DCE-MRI and had subsequent core decompression of the femoral head were examined. Hips were graded for severity according to MRI findings and were assigned scores of 0 (negative findings), 1 (focal marrow abnormalities), and 2 (subchondral collapse). Thirteen asymptomatic hips acted as controls. The DCE-MRI data were analyzed by use of a pharmacokinetic two-compartment model. RESULTS. Compared with control hips, there was significantly greater peak enhancement in the femoral head in hips of all grades (p <0.001) and in the femoral neck (p = 0.001) and intertrochanteric area (p = 0.001) in grade 2 hips. The time to peak was significantly delayed in the femoral head in grade 0 hips (p = 0.02) and in the intertrochanteric area in grade 2 hips (p = 0.003) compared with the controls. CONCLUSION. As evaluated by DCE-MRI, intramedullary peak enhancement in the femoral head increased with progression of idiopathic osteonecrosis of the femoral head, whereas there was delayed peak enhancement in the femoral head in hips with negative findings and intertrochanteric stasis in advanced osteonecrosis of the femoral head. Such perfusion changes as shown on MRI can occur with early osteonecrosis in the absence of other MRI abnormalities.

AB - OBJECTIVE. The purpose of this article is to relate intramedullary perfusion of the proximal femur to severity of osteonecrosis of the femoral head by using dynamic contrast-enhanced MRI (DCE-MRI). SUBJECTS AND METHODS. Twelve patients (14 symptomatic hips) who underwent DCE-MRI and had subsequent core decompression of the femoral head were examined. Hips were graded for severity according to MRI findings and were assigned scores of 0 (negative findings), 1 (focal marrow abnormalities), and 2 (subchondral collapse). Thirteen asymptomatic hips acted as controls. The DCE-MRI data were analyzed by use of a pharmacokinetic two-compartment model. RESULTS. Compared with control hips, there was significantly greater peak enhancement in the femoral head in hips of all grades (p <0.001) and in the femoral neck (p = 0.001) and intertrochanteric area (p = 0.001) in grade 2 hips. The time to peak was significantly delayed in the femoral head in grade 0 hips (p = 0.02) and in the intertrochanteric area in grade 2 hips (p = 0.003) compared with the controls. CONCLUSION. As evaluated by DCE-MRI, intramedullary peak enhancement in the femoral head increased with progression of idiopathic osteonecrosis of the femoral head, whereas there was delayed peak enhancement in the femoral head in hips with negative findings and intertrochanteric stasis in advanced osteonecrosis of the femoral head. Such perfusion changes as shown on MRI can occur with early osteonecrosis in the absence of other MRI abnormalities.

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