Abstract
Acetabular labrum pathology is associated with early osteoarthritis (OA) of the hip joint. Therefore, early diagnosis and reliable determination of the location and severity of labrum pathology are important to allow for a timely surgical intervention, and thus obviate the risk for the development of advanced osteoarthritic damage. Magnetic resonance imaging (MRI) and MR arthrography (MRA), with their superior soft tissue contrast and capability of multiplanar imaging, are the modalities of choice in noninvasively visualizing the hip joint. However, the acetabular labrum may be difficult to image due to its small size, curved orientation, variable morphological appearance, redundancy of the joint capsule when not distended, and several technical limitations such as the decrease in signal intensity owing to the relatively large distance between the labrum and the coil. MRA combines the advantages of an arthrography including capsule distention and delineation of intra-articular structures with the superior spatial resolution of MRI and remains, despite its potential substitutes and alleged limitations, the imaging modality of choice in patients in whom a labral lesion is suspected. However, MRA by itself does not guarantee an accurate hip joint assessment. Instead, image quality, and thus reliable labrum evaluation, is equally affected by pulse sequence parameter and coil selection. If MRA is not applicable, reliable labrum evaluation without contrast medium administration is feasible, provided that appropriate pulse sequences (i.e., PD-weighted imaging) are being used. High-resolution 3D sequences, which allow for multiplanar and radial reconstructions, are further potential imaging alternatives in the assessment of the hip joint. Today, radial imaging is considered a diagnostic standard of MR hip joint assessment because it facilitates the visualization of the entire acetabular circumference, which is of high value in identifying the exact localization and extent of any existing labrum pathology. Future studies that involve 3 T MR imaging for acetabular labrum imaging will likely show improvements due to increased SNR and CNR, potentially relativizing the traditional concept of hip joint evaluation and MRA.
Keywords
- Magnetic Resonance Arthrography
- Labral Tear
- Labral Lesion
- Labrum Pathology
- Superior Soft Tissue Contrast
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Seldes RM, Tan V, Hunt J, Katz M, Winiarsky R, Fitzgerald RH Jr. Anatomy, histologic features, and vascularity of the adult acetabular labrum. Clin Orthop Relat Res. 2001;382:232–40.
Tschauner C, Hofmann S, Czerny C. Hip dysplasia. Morphology, biomechanics and therapeutic principles with reference to the acetabular labrum. Orthopade. 1997;26:89–108.
Ferguson SJ, Bryant JT, Ganz R, Ito K. The acetabular labrum seal: a poroelastic finite element model. Clin Biomech (Bristol, Avon). 2000;15:463–8.
Hlavacek M. The influence of the acetabular labrum seal, intact articular superficial zone and synovial fluid thixotropy on squeeze-film lubrication of a spherical synovial joint. J Biomech. 2002;35:1325–35.
Fitzgerald RH Jr. Acetabular labrum tears. Diagnosis and treatment. Clin Orthop Relat Res. 1995;311:60–8.
Dorrell JH, Catterall A. The torn acetabular labrum. J Bone Joint Surg Br. 1986;68:400–3.
McCarthy JC, Noble PC, Schuck MR, Wright J, Lee J. The Otto E. Aufranc Award: the role of labral lesions to development of early degenerative hip disease. Clin Orthop Relat Res. 2001;393:25–37.
Byrd JW, Jones KS. Diagnostic accuracy of clinical assessment, magnetic resonance imaging, magnetic resonance arthrography, and intra-articular injection in hip arthroscopy patients. Am J Sports Med. 2004;32:1668–74.
Chan YS, Lien LC, Hsu HL, Wan YL, Lee MS, Hsu KY, et al. Evaluating hip labral tears using magnetic resonance arthrography: a prospective study comparing hip arthroscopy and magnetic resonance arthrography diagnosis. Arthroscopy. 2005;21:1250.
Mintz DN, Hooper T, Connell D, Buly R, Padgett DE, Potter HG. Magnetic resonance imaging of the hip: detection of labral and chondral abnormalities using noncontrast imaging. Arthroscopy. 2005;21:385–93.
James SL, Ali K, Malara F, Young D, O’Donnell J, Connell DA. MRI findings of femoroacetabular impingement. AJR Am J Roentgenol. 2006;187:1412–9.
Smith TO, Hilton G, Toms AP, Donell ST, Hing CB. The diagnostic accuracy of acetabular labral tears using magnetic resonance imaging and magnetic resonance arthrography: a meta-analysis. Eur Radiol. 2011;21:863–74.
Zlatkin MB, Pevsner D, Sanders TG, Hancock CR, Ceballos CE, Herrera MF. Acetabular labral tears and cartilage lesions of the hip: indirect MR arthrographic correlation with arthroscopy—a preliminary study. AJR Am J Roentgenol. 2010;194:709–14.
Winalski CS, Aliabadi P, Wright RJ, Shortkroff S, Sledge CB, Weissman BN. Enhancement of joint fluid with intravenously administered gadopentetate dimeglumine: technique, rationale, and implications. Radiology. 1993;187:179–85.
Ramnath RR. 3T MR imaging of the musculoskeletal system (Part II): clinical applications. Magn Reson Imaging Clin N Am. 2006;14:41–62.
Sundberg TP, Toomayan GA, Major NM. Evaluation of the acetabular labrum at 3.0-T MR imaging compared with 1.5-T MR arthrography: preliminary experience. Radiology. 2006;238:706–11.
Bittersohl B, Steppacher S, Haamberg T, Kim YJ, Werlen S, Beck M, et al. Cartilage damage in femoroacetabular impingement (FAI): preliminary results on comparison of standard diagnostic vs delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC). Osteoarthritis Cartilage. 2009;17:1297–306.
Werlen S. MR-Arthrographietechnik. In: Wirth CJ, Zichner J, editors. Orthopädie und Orthopädische Chirurgie. Stuttgart: Georg Thieme Verlag; 2004. p. 75–8.
Horii M, Kubo T, Hirasawa Y. Radial MRI of the hip with moderate osteoarthritis. J Bone Joint Surg Br. 2000;82:364–8.
Kubo T, Horii M, Harada Y, Noguchi Y, Yutani Y, Ohashi H, et al. Radial-sequence magnetic resonance imaging in evaluation of acetabular labrum. J Orthop Sci. 1999;4:328–32.
Kubo T, Horii M, Yamaguchi J, Terauchi R, Wu Y, Hasegawa Y, et al. Radial magnetic resonance imaging and pathological findings of acetabular labrum in dysplastic hips. Pathophysiology. 2000;7:171–5.
Plotz GM, Brossmann J, von Knoch M, Muhle C, Heller M, Hassenpflug J. Magnetic resonance arthrography of the acetabular labrum: value of radial reconstructions. Arch Orthop Trauma Surg. 2001;121:450–7.
McCarthy J, Noble P, Aluisio FV, Schuck M, Wright J, Lee JA. Anatomy, pathologic features, and treatment of acetabular labral tears. Clin Orthop Relat Res. 2003;406:38–47.
Schmerl M, Pollard H, Hoskins W. Labral injuries of the hip: a review of diagnosis and management. J Manipulative Physiol Ther. 2005;28:632.
Czerny C, Hofmann S, Neuhold A, Tschauner C, Engel A, Recht MP, et al. Lesions of the acetabular labrum: accuracy of MR imaging and MR arthrography in detection and staging. Radiology. 1996;200:225–30.
Magee T, Hinson G. Association of paralabral cysts with acetabular disorders. AJR Am J Roentgenol. 2000;174:1381–4.
Dameron Jr TB. Bucket-handle tear of acetabular labrum accompanying posterior dislocation of the hip. J Bone Joint Surg Am. 1959;41-A:131–4.
Groh MM, Herrera J. A comprehensive review of hip labral tears. Curr Rev Musculoskelet Med. 2009;2:105–17.
Uhthoff HK. The embryology of the human locomotor system. Berlin: Springer; 1990.
Abe I, Harada Y, Oinuma K, Kamikawa K, Kitahara H, Morita F, et al. Acetabular labrum: abnormal findings at MR imaging in asymptomatic hips. Radiology. 2000;216:576–81.
Aydingoz U, Ozturk MH. MR imaging of the acetabular labrum: a comparative study of both hips in 180 asymptomatic volunteers. Eur Radiol. 2001;11:567–74.
Lecouvet FE, Vande Berg BC, Malghem J, Lebon CJ, Moysan P, Jamart J, et al. MR imaging of the acetabular labrum: variations in 200 asymptomatic hips. AJR Am J Roentgenol. 1996;167:1025–8.
Petersilge C. Imaging of the acetabular labrum. Magn Reson Imaging Clin N Am. 2005;13:641–52. vi.
Dinauer PA, Murphy KP, Carroll JF. Sublabral sulcus at the posteroinferior acetabulum: a potential pitfall in MR arthrography diagnosis of acetabular labral tears. AJR Am J Roentgenol. 2004;183:1745–53.
Petersilge CA, Haque MA, Petersilge WJ, Lewin JS, Lieberman JM, Buly R. Acetabular labral tears: evaluation with MR arthrography. Radiology. 1996;200:231–5.
Studler U, Kalberer F, Leunig M, Zanetti M, Hodler J, Dora C, et al. MR arthrography of the hip: differentiation between an anterior sublabral recess as a normal variant and a labral tear. Radiology. 2008;249:947–54.
Czerny C, Hofmann S, Urban M, Tschauner C, Neuhold A, Pretterklieber M, et al. MR arthrography of the adult acetabular capsular-labral complex: correlation with surgery and anatomy. AJR Am J Roentgenol. 1999;173:345–9.
Hodler J, Yu JS, Goodwin D, Haghighi P, Trudell D, Resnick D. MR arthrography of the hip: improved imaging of the acetabular labrum with histologic correlation in cadavers. AJR Am J Roentgenol. 1995;165:887–91.
Plotz GM, Brossmann J, Schunke M, Heller M, Kurz B, Hassenpflug J. Magnetic resonance arthrography of the acetabular labrum. Macroscopic and histological correlation in 20 cadavers. J Bone Joint Surg Br. 2000;82:426–32.
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Bittersohl, B., Zilkens, C. (2014). Labral Disease. In: Kim, YJ., Mamisch, T. (eds) Hip Magnetic Resonance Imaging. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1668-5_11
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