Diagnostic performance of direct traction MR arthrography of the hip: detection of chondral and labral lesions with arthroscopic comparison
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To assess diagnostic performance of traction MR arthrography of the hip in detection and grading of chondral and labral lesions with arthroscopic comparison.
Seventy-five MR arthrograms obtained ± traction of 73 consecutive patients (mean age, 34.5 years; range, 14–54 years) who underwent arthroscopy were included. Traction technique included weight-adapted traction (15–23 kg), a supporting plate for the contralateral leg, and intra-articular injection of 18–27 ml (local anaesthetic and contrast agent). Patients reported on neuropraxia and on pain. Two blinded readers independently assessed femoroacetabular cartilage and labrum lesions which were correlated with arthroscopy. Interobserver agreement was calculated using κ values. Joint distraction ± traction was evaluated in consensus.
No procedure had to be stopped. There were no cases of neuropraxia. Accuracy for detection of labral lesions was 92 %/93 %, 91 %/83 % for acetabular lesions, and 92 %/88 % for femoral cartilage lesions for reader 1/reader 2, respectively. Interobserver agreement was moderate (κ = 0.58) for grading of labrum lesions and substantial (κ = 0.7, κ = 0.68) for grading of acetabular and femoral cartilage lesions. Joint distraction was achieved in 72/75 and 14/75 hips with/without traction, respectively.
Traction MR arthrography safely enabled accurate detection and grading of labral and chondral lesions.
• The used traction technique was well tolerated by most patients.
• The used traction technique almost consistently achieved separation of cartilage layers.
• Traction MR arthrography enabled accurate detection of chondral and labral lesions.
KeywordsMRI Arthrography Traction Hip joint Chondral/labral lesions
fast low-angle shot
fast imaging with steady-state precession
lateral centre edge angle
The scientific guarantor of this publication is Ehrenfried Schmaranzer. The authors of this manuscript declare relationships with the following companies: Menges Medical GmBH.The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.
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