AI Article Synopsis

  • MRI is effective for diagnosing osteonecrosis of the femoral head (ONFH), but its ability to detect fractures is less reliable than CT, making staging challenging during the peri-collapse period.* -
  • This study aimed to enhance MRI's accuracy in differentiating between ARCO stage 2 and stage 3A ONFH by evaluating various MRI signs and using CT as a reference standard.* -
  • Results showed a high effectiveness of combined MRI signs in distinguishing between the stages, with a sensitivity of 100% and specificity of 88.71%, indicating promising potential for improved diagnosis.*

Article Abstract

Background: MRI is the most effective diagnostic tool of osteonecrosis of the femoral head (ONFH), especially for early diagnosis, but its detection of subchondral or cortical fractures is less accurate than CT. Therefore, it is difficult to accurately stage ONFH in the peri-collapse period by MRI.

Purpose: To improve the accuracy of MR for distinguishing between Association Research Circulation Osseous (ARCO) stages 2 and 3A in ONFH.

Study Type: Retrospective.

Subjects: One hundred and fifty five cases of ARCO stage 2/3A of ONFH underwent MR examinations, M/F = 72/83. CT was used as reference standard for collapse, which was decided by an orthopedist and a radiologist in consultation.

Field Strength/sequence: 3 T/axial and coronal T -weighted Turbo Spin Echo (T W TSE) sequence, axial T -weighted fat-saturated (T W FS) TSE sequence, and coronal proton density-weighted imaging (PDWI)-FS-Dixon fat/water image.

Assessment: Five potential MR signs (the maximum width of the necrotic-viable interface, bone marrow edema (BME), irregular articular surface of the femoral head, T heterogeneous high signal, and the absence of a necrotic-viable interface with the morphology of closed loop) were evaluated blindly by five radiologists independently and the total scores of different combinations of MR signs were calculated.

Statistical Tests: Mann-Whitney U test and Chi-square test were used to evaluate age, gender, and MR signs differences between the two groups. ROC curve was used to access the distinguishing value of MR signs. The consistency of the five radiologists was analyzed by intraclass correlation coefficient.

Results: The area under the curve of the combined MR signs 2 for distinguishing between ARCO stages 2 and 3A was the greatest (0.967), sensitivity and specificity were 100.00% and 88.71% respectively, and greater than 1 was the threshold.

Data Conclusion: Combined MR signs 2 has great values in distinguishing between ARCO stages 2 and 3A in ONFH, thus helping clinical therapy.

Level Of Evidence: 4 TECHNICAL EFFICACY: Stage 2.

Download full-text PDF

Source
http://dx.doi.org/10.1002/jmri.27860DOI Listing

Publication Analysis

Top Keywords

arco stages
16
femoral head
12
osteonecrosis femoral
8
tse sequence
8
necrotic-viable interface
8
combined signs
8
distinguishing arco
8
signs
6
arco
5
analysis signs
4

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!