The purpose of this study was to compare the utility of two-dimensional high-resolution (2D), 3-dimensional with multiplanar reconstruction (3D MPR), and radially reformatted (RR) MRIs when evaluating the complexities of the hip joint in patients with femoroacetabular impingement (FAI). We hypothesized RR would be superior in detecting labral pathology and 2D would be superior in detecting transition zone and acetabular cartilage injury.
Materials and methods
2D, 3D MPR, and RR MRIs of 33 patients, who later underwent surgical treatment for FAI, were evaluated for sensitivity, specificity, and accuracy. Bland-Altman methods were used to estimate agreement between each method and the gold-standard, arthroscopic visualization of the hip joint, regarding the percentage of the hip joint affected by each injury type.
3D MPR and RR groupings were associated with the highest sensitivity and accuracy for labral injury. 3D MPR demonstrated the smallest bias in assessing the percentage of joint affected by labral injury and was the most accurate in identifying acetabular cartilage injury, whereas RR had the smallest mean difference in assessing the percentage of joint affected by acetabular cartilage injury. 2D was the most accurate in identifying transition zone injuries, while RR was superior in assessing the percentage of the joint affected by transition zone injury.
Our results suggest that including both 3D MPR and RR MRI groupings is favorable for accurate joint visualization and well-informed treatment planning, especially given that labral injury is a main source of pain and dysfunction for FAI patients.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Crespo-Rodriquez AM, de Lucas Villarrubia JC, Pastrana-Ledesma MA, Millan SI, Padron M. Diagnosis of lesions of the acetabular labrum, of the labral-chondral transition zone, and of the cartilage in femoroacetabular impingement: correlation between direct magnetic resonance arthrography and hip arthroscopy. Radiologia. 2015;57(2):131–41.
James SL, Ali K, Malara F, Young D, O’Donnell J, Connell DA. MRI findings of femoroacetabular impingement. AJR Am J Roentgenol. 2006;187(6):1412–9.
Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;417:112–20.
Bittersohl B, Hosalkar HS, Apprich S, Werlen SA, Siebenrock KA, Mamisch TC. Comparison of pre-operative dGEMRIC imaging with intra-operative findings in femoroacetabular impingement: preliminary findings. Skelet Radiol. 2011;40(5):553–61.
Naraghi A, White LM. MRI of labral and chondral lesions of the hip. Am J Roentgenol. 2015;205(3):479–90.
Rakhra KS. Magnetic resonance imaging of acetabular labral tears. J Bone Joint Surg Am. 2011;93(Suppl 2):28–34.
Potter HG, Schachar J. High resolution noncontrast MRI of the hip. J Magn Reson Imaging. 2010;31(2):268–78.
Omar IM, Blount KJ. Magnetic resonance imaging of the hip. Top Magn Reson Imaging. 2015;24(4):165–81.
Li AE, Jawetz ST, Greditzer HG, Burge AJ, Nawabi DH, Potter HG. MRI for the preoperative evaluation of femoroacetabular impingement. Insights Imaging. 2016;7(2):187–98.
Ziegert AJ, Blankenbaker DG, De Smet AA, Keene JS, Shinki K, Fine JP. Comparison of standard hip MR arthrographic imaging planes and sequences for detection of arthroscopically proven labral tear. AJR Am J Roentgenol. 2009;192(5):1397–400.
Petchprapa CN, Dunham KS, Lattanzi R, Recht MP. Demystifying radial imaging of the hip. RadioGraphics. 2013 May;33(3):E97–112.
Beck M, Kalhor M, Leunig M, Ganz R. Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br. 2005;87(7):1012–8.
Outerbridge RE. The etiology of chondromalacia patellae. J Bone Joint Surg Br. 1961;43B(4):752–7.
Blankenbaker DG, De Smet AA, Keene JS, Fine JP. Classification and localization of acetabular labral tears. Skelet Radiol. 2007;36(5):391–7.
Philippon MJ, Michalski MP, Campbell KJ, Goldsmith MT, Devitt BM, Wijdicks CA, et al. An anatomical study of the acetabulum with clinical applications to hip arthroscopy. J Bone Joint Surg Am. 2014 Oct 15;96(20):1673–82.
Philippon MJ, Stubbs AJ, Schenker ML, Maxwell RB, Ganz R, Leunig M. Arthroscopic management of femoroacetabular impingement: osteoplasty technique and literature review. Am J Sports Med. 2007;35(9):1571–80.
Byrd JW, Jones KS, Gwathmey FW. Femoroacetabular impingement in adolescent athletes: outcomes of arthroscopic management. Am J Sports Med. 2016;44(8):2106–11.
Crespo-Rodríguez AM, de Lucas-Villarrubia JC, Pastrana-Ledesma M, Hualde-Juvera A, Méndez-Alonso S, Padron M. The diagnostic performance of non-contrast 3-tesla magnetic resonance imaging (3-T MRI) versus 1.5-tesla magnetic resonance arthrography (1.5-T MRA) in femoro-acetabular impingement. Eur J Radiol. 2017 Mar;88:109–16.
Linda DD, Naraghi A, Murnaghan L, Whelan D, White LM. Accuracy of non-arthrographic 3T MR imaging in evaluation of intra-articular pathology of the hip in femoroacetabular impingement. Skelet Radiol. 2017;46(3):299–308.
Magee T. Comparison of 3.0-T MR vs 3.0-T MR arthrography of the hip for detection of acetabular labral tears and chondral defects in the same patient population. Br J Radiol. 2015;88(1053):20140817.
Sutter R, Zubler V, Hoffmann A, Mamisch-Saupe N, Dora C, Kalberer F, et al. Hip MRI: how useful is intraarticular contrast material for evaluating surgically proven lesions of the labrum and articular cartilage? AJR Am J Roentgenol. 2014;202:160–9.
Tian CY, Wang JQ, Zheng ZZ, Ren AH. 3.0 T conventional hip MR and hip MR arthrography for the acetabular labral tears confirmed by arthroscopy. Eur J Radiol. 2014;83:1822–7.
The study protocol was approved by the Colorado Multiple Institutional Review Board. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Mayer, S.W., Skelton, A., Flug, J. et al. Comparison of 2D, 3D, and radially reformatted MR images in the detection of labral tears and acetabular cartilage injury in young patients. Skeletal Radiol 50, 381–388 (2021). https://doi.org/10.1007/s00256-020-03566-x
- Labral tear
- Cartilage injury