Increased perfusion in dynamic gadolinium-enhanced MRI correlates with areas of bone repair and of bone necrosis in patients with Kienböck's disease.
J Magn Reson Imaging
; 50(2): 481-489, 2019 08.
Article
em En
| MEDLINE
| ID: mdl-30556360
ABSTRACT
BACKGROUND:
Osteonecrosis of the lunate, Kienböck's disease, can lead to fragmentation of the lunate, carpal collapse, and severe osteoarthritis. Since the etiology of Kienböck's disease is impaired circulation, a diagnostic method capable of assessing perfusion would be valuable. Recent studies have suggested that dynamic contrast-enhanced (DCE) MR examinations at 3 T can assess perfusion in healthy carpal bones.PURPOSE:
To evaluate the use of DCE-MR for assessing perfusion in the lunate bone in patients with Kienböck's disease. Furthermore, to compare perfusion with histopathology with a focus on bone viability. STUDY TYPE Prospective case-control study. POPULATION Fourteen patients with Kienböck's disease and a control group of 19 healthy subjects. Field Strength 3 T with T1 -weighted fat-saturated contrast-enhanced gradient echo series. ASSESSMENT Features of the enhancement curves from the DCE-MR examinations, time to peak (TTP), maximum slope (MS), and maximum enhancement (ME) assessed by a radiologist. Six of 14 patients were surgerized with lunate excision, allowing comparison between features of the enhancement curves and histopathology. STATISTICAL TESTS Mann-Whitney U-test. P < 0.05 was considered a statistically significant difference.RESULTS:
Patients with Kienböck's disease showed significantly higher and faster perfusion parameters compared with the control group, the mean value of the TTP in patients was 126.73 sec, in controls 189.79 sec (P = 0.024), ME in patients 173.55 AU, in controls 28.46 AU (P < 0.001), and MS in patients 5.04 AU, in controls 1.06 AU (P < 0.001). When compared with histopathology, increased perfusion was seen in areas of bone formation but also in necrosis. Areas of normal bone showed low perfusion. DATACONCLUSION:
DCE-MRI at 3 T can diagnose altered perfusion in patients with Kienböck's disease. Increased perfusion cannot definitely be used as a marker of bone viability. LEVEL OF EVIDENCE 1 Technical Efficacy Stage 3 J. Magn. Reson. Imaging 2019;50481-489.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Osteonecrose
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Osso e Ossos
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Imageamento por Ressonância Magnética
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Ossos do Carpo
/
Gadolínio
Tipo de estudo:
Observational_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Magn Reson Imaging
Assunto da revista:
DIAGNOSTICO POR IMAGEM
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Suécia