Ana M Crespo-Rodríguez1, Jose C De Lucas-Villarrubia2, Miguel Pastrana-Ledesma3, Ana Hualde-Juvera4, Santiago Méndez-Alonso5, Mario Padron6. 1. Department of Radiology, Hospital Universitario Puerta de Hierro Majadahonda, c/ Joaquín Rodrigo 2, Majadahonda 28222, Madrid, Spain. Electronic address: anacresporodriguez@gmail.com. 2. Department of Orthopaedics and Traumatology at the Hospital Universitario Puerta de Hierro Majadahonda, c/ Joaquín Rodrigo 2, Majadahonda 28222, Madrid, Spain. Electronic address: jclucasv@hotmail.com. 3. Department of Radiology, Hospital Universitario Puerta de Hierro Majadahonda, c/ Joaquín Rodrigo 2, Majadahonda 28222, Madrid, Spain. Electronic address: m.pastrana@telefonica.net. 4. Department of Radiology, Hospital Universitario Puerta de Hierro Majadahonda, c/ Joaquín Rodrigo 2, Majadahonda 28222, Madrid, Spain. Electronic address: ana.hualdej@salud.madrid.org. 5. Department of Radiology, Hospital Universitario Puerta de Hierro Majadahonda, c/ Joaquín Rodrigo 2, Majadahonda 28222, Madrid, Spain. Electronic address: smendez.sma@gmail.com. 6. Department of Radiology, Clínica Cemtro, Avda Ventisquero de la Condesa 42 Madrid 28035, Madrid, Spain. Electronic address: mario.padron@clinicacemtro.com.
Abstract
OBJECTIVE: The aim of this study was to evaluate the diagnostic accuracy of 3-T non-contrast MRI versus 1.5-T MRA for assessing labrum and articular cartilage lesions in patients with clinical suspicion of femoro-acetabular impingement (FAI). SUBJECTS AND METHODS: Fifty patients (thirty men and twenty women, mean age 42.5 years) underwent 1.5-T MRA, 3-T MRI and arthroscopy on the same hip. An optimized high-resolution proton density spin echo pulse sequence was included in the 3-T non-contrast MRI protocol. RESULTS: The 3-T non-contrast MRI identified forty-two of the forty-three arthroscopically proven tears at the labral-chondral transitional zone (sensitivity, 97.7%; specificity, 100%; positive predictive value (PPV), 100%; negative predictive value (NPV), 87.5%; accuracy 98%). With 1.5-T MRA, forty-four tears were diagnosed. However, there was one false positive (sensitivity, 100%; specificity, 85.7%; PPV, 97.7%; NPV, 100%; accuracy 98%). Agreement between arthroscopy and MRI, whether 3-T non-contrast MRI or 1.5-T MRA, as to the degree of chondral lesion in the acetabulum was reached in half of the patients and in the femur in 76% of patients. CONCLUSION: Non-invasive assessment of the hip is possible with 3-T MR magnet. 3-T non-contrast MRI could replace MRA as the workhorse technique for assessing hip internal damage. MRA would then be reserved for young adults with a strong clinical suspicion of FAI but normal findings on 3-T non-contrast MRI. When compared with 1.5-T MRA, optimized sequences with 3-T non-contrast MRI help in detecting normal variants and in diagnosing articular cartilage lesions.
OBJECTIVE: The aim of this study was to evaluate the diagnostic accuracy of 3-T non-contrast MRI versus 1.5-T MRA for assessing labrum and articular cartilage lesions in patients with clinical suspicion of femoro-acetabular impingement (FAI). SUBJECTS AND METHODS: Fifty patients (thirty men and twenty women, mean age 42.5 years) underwent 1.5-T MRA, 3-T MRI and arthroscopy on the same hip. An optimized high-resolution proton density spin echo pulse sequence was included in the 3-T non-contrast MRI protocol. RESULTS: The 3-T non-contrast MRI identified forty-two of the forty-three arthroscopically proven tears at the labral-chondral transitional zone (sensitivity, 97.7%; specificity, 100%; positive predictive value (PPV), 100%; negative predictive value (NPV), 87.5%; accuracy 98%). With 1.5-T MRA, forty-four tears were diagnosed. However, there was one false positive (sensitivity, 100%; specificity, 85.7%; PPV, 97.7%; NPV, 100%; accuracy 98%). Agreement between arthroscopy and MRI, whether 3-T non-contrast MRI or 1.5-T MRA, as to the degree of chondral lesion in the acetabulum was reached in half of the patients and in the femur in 76% of patients. CONCLUSION: Non-invasive assessment of the hip is possible with 3-T MR magnet. 3-T non-contrast MRI could replace MRA as the workhorse technique for assessing hip internal damage. MRA would then be reserved for young adults with a strong clinical suspicion of FAI but normal findings on 3-T non-contrast MRI. When compared with 1.5-T MRA, optimized sequences with 3-T non-contrast MRI help in detecting normal variants and in diagnosing articular cartilage lesions.
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