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Acetabular labral tears and cartilage lesions of the hip: indirect MR arthrographic correlation with arthroscopy--a
Michael B Zlatkin1, Deborah Pevsner, Timothy G Sanders
1National Musculoskeletal Imaging, 1930 N Commerce Pkwy, Ste. 5, Weston, FL 33326, USA. mzlatkin@nationalrad.com
Objective:
The purpose of this study was to assess the diagnostic correlation between indirect MR arthrography, conventional MRI, and arthroscopy in acetabular labral and cartilage lesions of the hip.
Materials And Methods:
Fourteen patients who underwent conventional and indirect MR arthrography with arthroscopic correlation were studied over the course of 18 months. MR studies were performed on a 1.5-T magnet. Sequences consisted of unilateral sagittal turbo spin-echo proton density fat-suppressed, axial turbo spin-echo T2 fat-saturated, and coronal turbo spin-echo proton density fat-saturated images. Whole-pelvis coronal T1 and STIR sequences were also performed. Patients received IV gadolinium contrast material and exercised for 15 minutes. Gadolinium-enhanced fat-saturated T1 sequences were obtained in three planes. Arthroscopy was performed by two orthopedic surgeons who specialize in treating hip disorders. Cases were then retrospectively reviewed by two experienced musculoskeletal radiologists who were blinded to the arthroscopic findings. Cases were examined for acetabular labral tears and chondral lesions. Extraarticular findings of femoral acetabular impingement were recorded. Unenhanced and gadolinium-enhanced images of the labrum were compared for differences and changes in diagnosis. Comparison was made between the arthroscopic and MR findings for analysis of the results.
Results:
Of the 13 labral tears found at arthroscopy, 85% were detected by conventional MRI, whereas 100% were identified via indirect MR arthrography. Seventy percent of the labral tears identified on conventional MRI were better delineated by indirect MR arthrography. Identification of chondral abnormalities was not improved via indirect MR arthrography over conventional MRI.
Conclusion:
IV contrast-enhanced indirect MR arthrography appears to be an effective means of hip evaluation for labral tears. It does not appear to improve detection of cartilage abnormalities when compared with conventional MRI.
Insights
Indirect MR arthrography effectively detects hip labral tears, surpassing conventional MRI. However, it does not improve the identification of cartilage abnormalities compared to standard MRI scans.
Area of Science:
- Orthopedic imaging
- Diagnostic radiology
Background:
- Acetabular labral and cartilage lesions are common causes of hip pain.
- Accurate diagnosis is crucial for effective treatment planning.
Purpose of the Study:
- To evaluate the diagnostic accuracy of indirect MR arthrography compared to conventional MRI and arthroscopy for hip labral and cartilage lesions.
Main Methods:
- Retrospective review of 14 patients undergoing conventional MRI, indirect MR arthrography, and arthroscopy.
- Comparison of imaging findings with arthroscopic results by blinded radiologists.
Main Results:
- Indirect MR arthrography identified 100% of labral tears, compared to 85% with conventional MRI.
- Cartilage abnormality detection was not significantly improved by indirect MR arthrography.
Conclusions:
- Indirect MR arthrography is a valuable tool for diagnosing hip labral tears.
- It offers no significant advantage over conventional MRI for detecting cartilage lesions.
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