Skeletal Radiology

, Volume 44, Issue 3, pp 353–359 | Cite as

Evaluation of metal artifacts in clinical MR images of patients with total hip arthroplasty using different metal artifact-reducing sequences

  • Gunilla M. MüllerEmail author
  • Björn Lundin
  • Thord von Schewelov
  • Markus F. Müller
  • Olle Ekberg
  • Sven Månsson
Scientific Article



To evaluate the distortion and artifact area of metal in MR images and to compare artifact reduction using different metal artifact-reducing sequences in patients with metal-on-metal (MoM) and non-MoM total hip prostheses.

Materials and methods

Thirty-six MoM and 15 non-MoM prostheses were examined in a 1.5-T MR scanner using T1-weighted (T1-w) sequences: turbo spin echo (TSE) high-readout bandwidth (hiBW), T1-w; TSE view angle tilting (VAT), T1-w; TSE VAT + slice encoding for metal artifact correction (SEMAC); short tau inversion recovery (STIR) hiBW or matched RF pulses (mRFp). Distortion was quantified using a new method measuring the acetabular roof angle (ARA). The artifact area was defined in the mid-coronal plane of the artifact.


The T1 VAT + SEMAC sequence showed the least distortion compared to T1 VAT and T1-hiBW (150°, 127° and 102°, p < 0.001, in MoM; 152°, 143° and 128°, p ≤ 0.014, in non-MoM). The artifact area was smaller in MoM prostheses using the T1 VAT sequence compared to T1 hiBW and T1 VAT + SEMAC (2506 mm2, 3160 mm2 and 3214 mm2, p < 0.001) and smaller in non-MoM prostheses using T1 VAT compared to T1-hiBW (4296 mm2 and 4831 mm2, p = 0.041). STIR-mRFp substantially reduced the artifact size compared with STIR-hiBW (MoM 4559 mm2 and 6323 mm2; non-MoM 5625 mm2 and 8764 mm2, p < 0.001).


Metal artifacts in MR imaging examinations of hip prostheses can be evaluated for distortion using a distortion angle (ARA) and the degree of signal artifact as determined by measuring the largest cross-sectional artifact area. T1 VAT + SEMAC showed the least distortion; T1 VAT and STIR-mRFp were most efficient for reduction of the artifact area.


MR imaging Metal artifact-reducing sequences (MARS) Metal artifact Hip Hip prosthesis Artifact measurement Image distortion 


Conflicts of interest

None of the authors has a financial interest.


  1. 1.
    Hargreaves BA, Worters PW, Pauly KB, Pauly JM, Koch KM, Gold GE. Metal-induced artifacts in MRI. AJR Am J Roentgenol. 2011;197:547–55.PubMedCrossRefGoogle Scholar
  2. 2.
    Lee MJ, Kim S, Lee SA, et al. Overcoming artifacts from metallic orthopedic implants at high-field-strength MR imaging and multi-detector CT. Radiographics. 2007;27:791–803.PubMedCrossRefGoogle Scholar
  3. 3.
    Lee MJ, Janzen DL, Munk PL, MacKay A, Xiang QS, McGowen A. Quantitative assessment of an MR technique for reducing metal artifact: application to spin-echo imaging in a phantom. Skelet Radiol. 2001;30:398–401.CrossRefGoogle Scholar
  4. 4.
    Potter HG, Nestor BJ, Sofka CM, Ho ST, Peters LE, Salvati EA. Magnetic resonance imaging after total hip arthroplasty: evaluation of periprosthetic soft tissue. J Bone Joint Surg Am. 2004;86-A:1947–54.PubMedGoogle Scholar
  5. 5.
    Suh JS, Jeong EK, Shin KH, et al. Minimizing artifacts caused by metallic implants at MR imaging: experimental and clinical studies. AJR Am J Roentgenol. 1998;171:1207–13.PubMedCrossRefGoogle Scholar
  6. 6.
    White LM, Kim JK, Mehta M, et al. Complications of total hip arthroplasty: MR imaging-initial experience. Radiology. 2000;215:254–62.PubMedCrossRefGoogle Scholar
  7. 7.
    Cho ZH, Kim DJ, Kim YK. Total inhomogeneity correction including chemical shifts and susceptibility by view angle tilting. Med Phys. 1988;15:7–11.PubMedCrossRefGoogle Scholar
  8. 8.
    Olsen RV, Munk PL, Lee MJ, et al. Metal artifact reduction sequence: early clinical applications. Radiographics. 2000;20:699–712.PubMedCrossRefGoogle Scholar
  9. 9.
    Lu W, Pauly KB, Gold GE, Pauly JM, Hargreaves BA. SEMAC: slice encoding for metal artifact correction in MRI. Magn Reson Med. 2009;62:66–76.PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Sutter R, Ulbrich EJ, Jellus V, Nittka M, Pfirrmann CW. Reduction of metal artifacts in patients with total hip arthroplasty with slice-encoding metal artifact correction and view-angle tilting MR imaging. Radiology. 2012;265:204–14.PubMedCrossRefGoogle Scholar

Copyright information

© ISS 2014

Authors and Affiliations

  • Gunilla M. Müller
    • 1
    Email author
  • Björn Lundin
    • 4
  • Thord von Schewelov
    • 2
  • Markus F. Müller
    • 1
  • Olle Ekberg
    • 1
  • Sven Månsson
    • 3
  1. 1.Department of RadiologyLund University, Skåne University HospitalMalmöSweden
  2. 2.Orthopedic SurgeryLund University, Skåne University HospitalMalmöSweden
  3. 3.Medical Radiation PhysicsLund University, Skåne University HospitalMalmöSweden
  4. 4.Department of RadiologyLund University, Skåne University HospitalLundSweden

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