Christoph Schleich1, Tobias Hesper2, Harish S Hosalkar3,4, Fanni Rettegi5, Christoph Zilkens5, Rüdiger Krauspe5, Gerald Antoch1, Bernd Bittersohl5. 1. Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf, Düsseldorf, Germany. 2. Department of Orthopedic Surgery, Medical Faculty, University of Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany. tobias.hesper@med.uni-duesseldorf.de. 3. Joint Preservation and Deformity Correction, Paradise Valley Hospital, San Diego, CA, USA. 4. Hip Preservation, Tri-city Medical Center, San Diego, CA, USA. 5. Department of Orthopedic Surgery, Medical Faculty, University of Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
Abstract
OBJECTIVES: To assess the diagnostic accuracy of a high-resolution, three-dimensional (3D) double-echo steady-state (DESS) sequence with radial imaging at 3 Tesla (T) for evaluating cartilage and labral alterations in the hip. METHODS: Magnetic resonance imaging (MRI) data obtained at 3 T, including radially reformatted DESS images and intraoperative data of 45 patients (mean age 42 ± 13.7 years) who underwent hip arthroscopy, were compared. The acetabular cartilage and labrum of the upper hemisphere of the acetabulum and the central femoral head cartilage were evaluated. Sensitivity, specificity, accuracy, and negative and positive predictive values were determined. RESULTS: Sensitivity, specificity and accuracy of the DESS technique were 96.7%, 75% and 93.7% for detecting cartilage lesions and 98%, 76.2% and 95.9% for detecting labral lesions. The positive and negative predictive values for detecting or ruling out cartilage lesions were 96% and 78.9%. For labral lesions, the positive and negative predictive values were 97.5% and 80%. CONCLUSION: A high-resolution, 3D DESS technique with radial imaging at 3 T demonstrated high accuracy for detecting hip cartilage and labral lesions with excellent interobserver agreement and moderate correlation between MRI and intraoperative assessment. KEY POINTS: • High-resolution, 3D DESS with radial imaging allows accurate cartilage and labrum evaluation. • DESS demonstrated high sensitivity, specificity, accuracy for detecting cartilage and labral lesions. • Highly accurate sequence may influence treatment decisions in patients with hip pain.
OBJECTIVES: To assess the diagnostic accuracy of a high-resolution, three-dimensional (3D) double-echo steady-state (DESS) sequence with radial imaging at 3 Tesla (T) for evaluating cartilage and labral alterations in the hip. METHODS: Magnetic resonance imaging (MRI) data obtained at 3 T, including radially reformatted DESS images and intraoperative data of 45 patients (mean age 42 ± 13.7 years) who underwent hip arthroscopy, were compared. The acetabular cartilage and labrum of the upper hemisphere of the acetabulum and the central femoral head cartilage were evaluated. Sensitivity, specificity, accuracy, and negative and positive predictive values were determined. RESULTS: Sensitivity, specificity and accuracy of the DESS technique were 96.7%, 75% and 93.7% for detecting cartilage lesions and 98%, 76.2% and 95.9% for detecting labral lesions. The positive and negative predictive values for detecting or ruling out cartilage lesions were 96% and 78.9%. For labral lesions, the positive and negative predictive values were 97.5% and 80%. CONCLUSION: A high-resolution, 3D DESS technique with radial imaging at 3 T demonstrated high accuracy for detecting hip cartilage and labral lesions with excellent interobserver agreement and moderate correlation between MRI and intraoperative assessment. KEY POINTS: • High-resolution, 3D DESS with radial imaging allows accurate cartilage and labrum evaluation. • DESS demonstrated high sensitivity, specificity, accuracy for detecting cartilage and labral lesions. • Highly accurate sequence may influence treatment decisions in patients with hip pain.
Entities:
Keywords:
3D DESS; Acetabular labrum; Hip arthroscopy; Hip cartilage; Magnetic resonance imaging
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