Contrast-enhanced magnetic resonance imaging in a nontraumatic rabbit osteonecrosis model

We investigated early osteonecrosis using in vivo magnetic resonance imaging in a nontraumatic rabbit model of serum-sickness osteonecrosis in which osteonecrosis was induced after two intravenous injections of horse serum with a 3-week interval. One week (group A, 17 rabbits) and 3 weeks (group B, 13 rabbits) after the second serum injection, coronal magnetic resonance images of the femur were obtained and it was removed for histological study. Some of the necrotic lesions in the diaphysis were detected on T1-weighted, T2-weighted, or fat-suppression T1-weighted images (six of 24 necrotic lesions in group A and 16 of 18 in group B), and all of the necrotic lesions in the epiphysis, metaphysis, and diaphysis were detected on T1-weighted or fat-suppression T1-weighted images enhanced with gadolinium-diethylene triamine pentaacetic acid. All focal homogeneous enhanced areas on T1-weighted or fat suppression T1-weighted images corresponded to necrotic lesions (22 of 24 necrotic lesions in group A and 18 of 18 in group B); the contours of the enhanced areas were displayed more clearly on the fat-suppression T1-weighted than on the T1-weighted images. The fat-suppression T1-weighted image enhanced with gadolinium-diethylene triamine pentaacetic acid was thus the most sensitive and specific of five kinds of magnetic resonance images for the detection of early necrotic lesions. The results suggest that this image may be useful for early diagnosis of clinical osteonecrosis and for obtaining information about the pathomechanism of osteonecrosis.