Study of proximal femoral bone perfusion with 3D T1 dynamic contrast-enhanced MRI: a feasibility study
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The objective of this study was to compare measurements of semi-quantitative and pharmacokinetic parameters in areas of red (RBM) and yellow bone marrow (YBM) of the hip, using an in-house high-resolution DCE T1 sequence, and to assess intra- and inter-observer reproducibility of these measurements.
The right hips of 21 adult patients under 50 years of age were studied. Spatial resolution was 1.8 × 1.8 × 1.8 mm3, and temporal resolution was 13.5 seconds. Two musculoskeletal radiologists independently processed DCE images and measured semi-quantitative and pharmacokinetic parameters in areas of YBM and RBM. Signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were calculated. Intra- and inter-observer reproducibility was assessed.
Area under the curve (AUC) and initial slope (IS) were significantly greater for RBM than for YBM (p < 0.05). Ktrans and kep were also significantly greater for RBM (p < 0.05). There was no significant difference in time to peak between the regions (p < 0.05). SNR, CNR, and intra- and inter-observer reproducibility were all good.
DCE study of the whole hip is feasible with high spatial resolution using a 3D T1 sequence. Measures were possible even in low vascularized areas of the femoral head. Ktrans, kep, AUC, and IS values were significantly different between red and yellow marrow, whereas TTP values were not.
• High-spatial-resolution dynamic contrast-enhanced MRI of hip structures is feasible.
• Intra- and inter-observer reproducibility is good.
• Red and yellow bone marrow have different perfusion patterns.
KeywordsMagnetic resonance imaging Perfusion Bone marrow Femur 3D sequence
Yellow bone marrow
Red bone marrow
Field of view
Region of interest
Variable flip angle
Area under the curve
Magnetic resonance imaging
2-fluoro-deoxy-glucose positron emission tomography
The authors wish to thank Dr. Mustapha Azahaf for his kindness and invaluable advice on DCE. The scientific guarantor of this publication is Professor Anne Cotten. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. Mr. David Chechin, PhD, who is one of the co-authors, works for Philips Healthcare, and provided technical expertise during the implementation of the sequence.
The authors state that this work has not received any funding. One of the authors has significant statistical expertise. No complex statistical methods were necessary for this paper. Institutional Review Board approval was not required because the only patient constraint was a slightly longer MRI protocol. No injection was made solely for purposes of the study. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective observational study, performed at one institution.
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