J. Brossmann et al., MR-arthrography of the acetabular larbrum - radiologic-pathologic correlation in 20 cadaveric hip joints., ROFO-F RONT, 171(2), 1999, pp. 143-148
Citations number
14
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging
Journal title
ROFO-FORTSCHRITTE AUF DEM GEBIET DER RONTGENSTRAHLEN UND DER BILDGEBENDEN VERFAHREN
Purpose: To investigate frequency of acetabular labral lesions in elderly h
ip joints, and to determine sensitivity and specificity of MR arthrography
(MRa) for the detection of these abnormalities. Materials and Methods: Twen
ty cadaveric hip joints were examined by MRa. For MRa, 15 ml of a solution
of iodinated contrast solution (Solutrast 300) and Gd-DTPA (100:1) were inj
ected under fluoroscopic guidance. MR imaging was performed on a 1.5 T MR s
canner (Vision, Siemens; FOV 16 cm, matrix 256 x 256, fat-suppressed 3D-FLA
SH). Multiplanar image reconstructions were done perpendicular to the aceta
bulum in the oblique-coronal, oblique-axial, and radial planes. The labral
specimens were examined macroscopically. Results: In 12/20 hips (60%), a la
bral lesion was found on pathologic examination. In 7 specimens, the labrum
was partially or completely detached in the weight-bearing superior region
. One flap-like variant of the labrum was seen; in 4 hip joints, the labrum
was degenerated (one cystic degeneration). Pathologic findings were confir
med by MRa in 8/12 specimens (sensitivity 67%). All degenerated labra were
correctly diagnosed on MRa. Three small labral detachments and the flap-lik
e variant were misinterpreted as being normal. There were no false positive
findings (specificity 100%). The accuracy was 80%. Labral lesions were see
n in 6/8 and in 6/12 of hips with and without osteoarthritis, respectively.
Conclusion: MRa is well suited to delineate the acetabular labrum and to d
iagnose labral abnormalities. Detection of small labral detachments and ana
tomic variants is difficult and requires some experience. Labral lesions ar
e correlated to osteoarthritis of the hip, but may be frequently seen in th
e elderly without underlying osteoarthritis.