Tsung-Tai Lin1, Cheng-Chuan Hu1, Yi-Chih Hsu1, Chih-Chien Wang2, Shih-Wei Chiang1, Chao-Ying Wang3, Wei-Chou Chang1, Guo-Shu Huang1,4. 1. Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. 2. Department of Orthopedic Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. 3. Department and Graduate Institute of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan. 4. Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Abstract
BACKGROUND: Ischemia before the development of dysbaric osteonecrosis (DON) in femoral heads has never been investigated. We assessed whether quantitative magnetic resonance spectroscopy (MRS) and diffusion weighted imaging (DWI) could detect dysbaric changes in divers with hip pain. METHODS: This IRB-approved exploratory study recruited 17 divers [9 with hip pain (Group 1); 8 asymptomatic (Group 2)] with normal findings on radiographs and conventional magnetic resonance imaging scans were age-, gender- and body-mass-index matched to 17 non-divers as controls (Group 1C, 2C). Apparent diffusion coefficients (ADCs) and MRS spectra were obtained from regions/voxels of interest on the femoral heads of all subjects. LCModel was used to determine water content, lipid composition, and the unsaturation index in bone marrow. Mann-Whitney non-parametric test was used to compare results of quantitative MRS and ADCs of ipsilateral femoral heads between divers and controls. RESULTS: MRS of the ipsilateral femoral heads revealed higher water (peak: 4.7 ppm) content, lower total lipid fraction (TLF), and higher unsaturation index (UI) of lipids in Group 1 than in Group 2 (water: P=0.040; UI: P=0.022) and Group 1C (water: P=0.027; TLF: P=0.039; UI: P=0.009). In contrast, femoral head ADCs were comparable between divers and controls. Five out of nine symptomatic divers were contacted for follow-up MRS and DWI studies, and the mean difference in water content in the femoral heads of patients with osteonecrosis was also higher than that in patients with symptom relief (osteonecrosis: 0.077±0.130 vs. symptom relief: 0.003±0.010). CONCLUSIONS: Dysbaric change in the femoral heads of divers with hip pain can be detected using quantitative MRS, which reveals increases in water content and UI of lipids, and a decrease in TLF. 2022 Quantitative Imaging in Medicine and Surgery. All rights reserved.
BACKGROUND: Ischemia before the development of dysbaric osteonecrosis (DON) in femoral heads has never been investigated. We assessed whether quantitative magnetic resonance spectroscopy (MRS) and diffusion weighted imaging (DWI) could detect dysbaric changes in divers with hip pain. METHODS: This IRB-approved exploratory study recruited 17 divers [9 with hip pain (Group 1); 8 asymptomatic (Group 2)] with normal findings on radiographs and conventional magnetic resonance imaging scans were age-, gender- and body-mass-index matched to 17 non-divers as controls (Group 1C, 2C). Apparent diffusion coefficients (ADCs) and MRS spectra were obtained from regions/voxels of interest on the femoral heads of all subjects. LCModel was used to determine water content, lipid composition, and the unsaturation index in bone marrow. Mann-Whitney non-parametric test was used to compare results of quantitative MRS and ADCs of ipsilateral femoral heads between divers and controls. RESULTS: MRS of the ipsilateral femoral heads revealed higher water (peak: 4.7 ppm) content, lower total lipid fraction (TLF), and higher unsaturation index (UI) of lipids in Group 1 than in Group 2 (water: P=0.040; UI: P=0.022) and Group 1C (water: P=0.027; TLF: P=0.039; UI: P=0.009). In contrast, femoral head ADCs were comparable between divers and controls. Five out of nine symptomatic divers were contacted for follow-up MRS and DWI studies, and the mean difference in water content in the femoral heads of patients with osteonecrosis was also higher than that in patients with symptom relief (osteonecrosis: 0.077±0.130 vs. symptom relief: 0.003±0.010). CONCLUSIONS: Dysbaric change in the femoral heads of divers with hip pain can be detected using quantitative MRS, which reveals increases in water content and UI of lipids, and a decrease in TLF. 2022 Quantitative Imaging in Medicine and Surgery. All rights reserved.
Entities:
Keywords:
Dysbaric change; diffusion-weighted magnetic resonance imaging (diffusion-weighted MRI); diving; femoral head; magnetic resonance spectroscopy (MRS)
Authors: T Tsunenari; M Tsutsumi; K Ohno; Y Yamamoto; M Kawakatsu; K Shimogaki; H Negishi; T Sugimoto; M Fukase; T Fujita Journal: J Bone Miner Res Date: 1993-04 Impact factor: 6.741
Authors: Traci Takahashi; Gwen Lapham; Laura J Chavez; Amy K Lee; Emily C Williams; Julie E Richards; Diane Greenberg; Anna Rubinsky; Douglas Berger; Eric J Hawkins; Joseph O Merrill; Katharine A Bradley Journal: Addict Sci Clin Pract Date: 2017-07-18