Jean-François Budzik1,2, Guillaume Lefebvre3, Hélène Behal4, Sébastien Verclytte5, Pierre Hardouin6, Pedro Teixeira7, Anne Cotten8,3. 1. Imaging Department, Lille Catholic Hospitals, Lille Catholic University, F-59000, Lille, France. Budzik.jean-francois@ghicl.net. 2. Lille University, Littoral Côte d'Opale University, EA 4490, PMOI, Physiopathologie des Maladies Osseuses Inflammatoires, F-59000, Lille, France. Budzik.jean-francois@ghicl.net. 3. Musculoskeletal Imaging Department, Centre de Consultation et d'Imagerie de l'Appareil Locomoteur, CHU Lille, University of Lille Nord de France, F-59000, Lille, France. 4. Biostatistics Department, Lille Regional University Hospital, University of Lille Nord de France, F-59000, Lille, France. 5. Imaging Department, Lille Catholic Hospitals, Lille Catholic University, F-59000, Lille, France. 6. Littoral Côte d'Opale University, Lille University, EA 4490, PMOI, Physiopathologie des Maladies Osseuses Inflammatoires, F-59000, Lille, France. 7. Service d'Imagerie Guilloz, Hôpital Central, Centre Hospitalier Universitaire de Nancy, 29 Ave du Maréchal de Lattre de Tassigny, F-54035, Nancy, France. 8. Lille University, Littoral Côte d'Opale University, EA 4490, PMOI, Physiopathologie des Maladies Osseuses Inflammatoires, F-59000, Lille, France.
Abstract
OBJECTIVE: The objective was to describe MR perfusion characteristics of the femoral head, with a focus on the subchondral bone. MATERIALS AND METHODS: This prospective monocentric study was approved by our local Ethics Committee. Written informed consent was obtained from all subjects. Dynamic contrast-enhanced MRI of the right hip was performed in 59 adults with suspected spondyloarthritis (32 women, 28 men). Mean age was 37.5 (±12.5) years. Regions of interest were drawn in the femoral head epiphysis, in the subchondral areas the most exposed to mechanical load (superolateral, anterosuperior, and posterior zones) and in areas less exposed to mechanical load (inferior subchondral zone and center of the femoral head). Semi-quantitative and pharmacokinetic parameters were calculated using the Tofts model. Statistical analysis was performed with a linear mixed model to compare the perfusion parameters in the different femoral head zones. RESULTS: Extravascular extracellular volume and area under the curve were lower in the superolateral zone than in the inferior zone (p = 0.0135 and p < 0.0001 respectively) and the central zone (p = 0.007 and p = 0.0134 respectively). Extravascular extracellular volume and rate constant were lower in the anterosuperior zone than in the inferior zones (p = 0.011 and p = 0.029). In the anterosuperior zone, extravascular extracellular volume was lower, and time to peak was higher than in the central zones (p = 0.0056 and p = 0.0013 respectively). No significant differences were found for any values between other paired zones. CONCLUSION: The perfusion of femoral head subchondral bone assessed with dynamic contrast-enhanced magnetic resonance imaging is not homogeneous: the areas exposed to more mechanical loading are less perfused.
OBJECTIVE: The objective was to describe MR perfusion characteristics of the femoral head, with a focus on the subchondral bone. MATERIALS AND METHODS: This prospective monocentric study was approved by our local Ethics Committee. Written informed consent was obtained from all subjects. Dynamic contrast-enhanced MRI of the right hip was performed in 59 adults with suspected spondyloarthritis (32 women, 28 men). Mean age was 37.5 (±12.5) years. Regions of interest were drawn in the femoral head epiphysis, in the subchondral areas the most exposed to mechanical load (superolateral, anterosuperior, and posterior zones) and in areas less exposed to mechanical load (inferior subchondral zone and center of the femoral head). Semi-quantitative and pharmacokinetic parameters were calculated using the Tofts model. Statistical analysis was performed with a linear mixed model to compare the perfusion parameters in the different femoral head zones. RESULTS: Extravascular extracellular volume and area under the curve were lower in the superolateral zone than in the inferior zone (p = 0.0135 and p < 0.0001 respectively) and the central zone (p = 0.007 and p = 0.0134 respectively). Extravascular extracellular volume and rate constant were lower in the anterosuperior zone than in the inferior zones (p = 0.011 and p = 0.029). In the anterosuperior zone, extravascular extracellular volume was lower, and time to peak was higher than in the central zones (p = 0.0056 and p = 0.0013 respectively). No significant differences were found for any values between other paired zones. CONCLUSION: The perfusion of femoral head subchondral bone assessed with dynamic contrast-enhanced magnetic resonance imaging is not homogeneous: the areas exposed to more mechanical loading are less perfused.
Entities:
Keywords:
Bone marrow; Dynamic-contrast enhanced MRI; Femur; MRI; Subchondral bone
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