Purpose
To evaluate radially reconstructed 3.0-Tesla 3-dimensional multiple-echo recombined
gradient echo (MERGE) magnetic resonance imaging (MRI) without arthrography for the
assessment of acetabular labrum tears, using arthroscopic evaluation as the reference
standard.
Methods
A total of 71 consecutive hips, including 29 with femoroacetabular impingement, 26
with borderline developmental dysplasia of the hip, and 16 with early-stage osteoarthritis,
were evaluated in this retrospective study. MERGE MRI findings were evaluated according
to the modified Czerny classification for 3 regions of interest: anterior region,
anterolateral region, and lateral region. Cases with severe degeneration that was
not concordant with any stage in the original Czerny classification were defined as
stage Ⅳ. MERGE MRI findings were compared with arthroscopic findings, and the sensitivity,
specificity, positive predictive value, and negative predictive value in terms of
the existence of labrum tears were calculated.
Results
MERGE MRI findings revealed labrum tears more frequently in the anterolateral region
than in the anterior and lateral regions (P < .01). In cases of femoroacetabular impingement and borderline developmental dysplasia
of the hip in particular, labrum tears were more frequently observed on MRI in the
anterolateral region than in the lateral region (P < .05). In comparison with MRI findings and arthroscopic findings, our newly defined
stage IV in the modified Czerny classification was more frequently observed in cases
with a Multicenter Arthroscopy of the Hip Outcomes Research Network (MAHORN) classification
of degenerative or complex (P < .01). The average sensitivity and specificity of all regions for the existence
of labrum tears were 85% and 56%, respectively. Sensitivity and specificity were 79%
and 50%, respectively, in the anterior region; 96% and 50%, respectively, in the anterolateral
region; and 70% and 57%, respectively, in the lateral region.
Conclusions
We validated the diagnostic performance of 3.0-Tesla 3-dimensional MERGE MRI for evaluating
acetabular labrum tears and made comparisons with arthroscopic findings. Radially
reconstructed MERGE magnetic resonance images showed excellent sensitivity for the
diagnosis of labrum tears, particularly in the anterolateral region. The newly defined
stage IV was distinctive of early-stage osteoarthritis cases with degeneration and/or
complex arthroscopic findings. The noninvasive imaging modality of radially reconstructed
MERGE MRI may be an alternative to magnetic resonance arthrography for evaluating
labrum tears.
Levels of Evidence
Level Ⅱ, development of diagnostic criteria.
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Article info
Publication history
Accepted:
May 1,
2019
Received:
December 20,
2018
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
See commentary on page 2866
Identification
Copyright
© 2019 by the Arthroscopy Association of North America
ScienceDirect
Access this article on ScienceDirectLinked Article
- Editorial Commentary: Advances in 3-Dimensional Imaging are the Key to Improving our Surgical Precision in Hip Arthroscopy and BeyondArthroscopyVol. 35Issue 10
- PreviewAdvances in high-resolution magnetic resonance imaging have driven a wealth of knowledge in orthopaedic basic science. The application of these novel techniques to clinical practice is the next logical step for enhancing our understanding of intra-articular pathology and morphology. The specific diagnostic challenge presented by hip labral and chondral pathology is a particular point of interest, given the increasing popularity of hip arthroscopy. As our field continues to progress in complexity, the integration of new, higher-resolution imaging sequences such as multiple-echo recombined gradient echo and double-echo steady state provide the potential to enhance preoperative planning and ultimately the effectiveness of our arthroscopic techniques.
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