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Use of MR arthrography in detecting tears of the ligamentum teres with arthroscopic correlation
Connie Y Chang1, Corey M Gill, Ambrose J Huang
1Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA, cychang@mgh.harvard.edu.
Objective:
To demonstrate the normal appearance of the ligamentum teres on MR arthrography (MRA) and evaluate the accuracy of MRA in detecting ligamentum teres tears with arthroscopic correlation.
Materials And Methods:
Institutional Review Board approval was obtained with a waiver for informed consent because of the retrospective study design. A total of 165 cases in 159 patients (111 females, 48 males; mean age 41 ± 12 years) who underwent both MRA and hip arthroscopy were evaluated for appearance of the ligamentum teres, including the size, number of bundles, and ligamentum teres tears. Marrow edema of the fovea capitis adjacent to the ligamentum teres insertion and the presence of hip plicae were also recorded.
Results:
The mean thickness and length of the ligamentum teres were 3.5 ± 1.5 mm and 25.2 ± 3.8 mm, respectively. Sensitivity, specificity, positive and negative predictive value, and accuracy of MRA for the detection of ligamentum teres tears were 78, 97, 74, 97, and 95%, respectively.
Conclusion:
MRA is an accurate method to evaluate the normal morphology and to detect tears of the ligamentum teres.
Insights
MR arthrography (MRA) accurately identifies normal ligamentum teres anatomy and detects tears. This imaging technique shows high diagnostic performance, aiding in clinical decision-making for hip conditions.
Area of Science:
- Radiology
- Orthopedic Imaging
- Hip Arthroscopy
Background:
- The ligamentum teres is a crucial intra-articular hip structure.
- Accurate assessment of ligamentum teres tears is important for diagnosing hip pathology.
Purpose of the Study:
- To characterize the normal appearance of the ligamentum teres using MR arthrography (MRA).
- To determine the diagnostic accuracy of MRA in detecting ligamentum teres tears compared to arthroscopic findings.
Main Methods:
- Retrospective analysis of 165 hip MRAs in 159 patients who also underwent arthroscopy.
- Evaluation of ligamentum teres size, bundle structure, tears, and associated findings like marrow edema and plicae.
Main Results:
- Mean ligamentum teres dimensions: thickness 3.5 mm, length 25.2 mm.
- MRA demonstrated high accuracy (95%) for detecting ligamentum teres tears.
- Sensitivity and specificity for tear detection were 78% and 97%, respectively.
Conclusions:
- MR arthrography is a reliable imaging modality for assessing ligamentum teres morphology.
- MRA accurately detects tears of the ligamentum teres, correlating well with arthroscopic findings.
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