Purpose
To evaluate the diagnostic performance of hip magnetic resonance (MR) arthrography
with a gadolinium-based contrast agent (GBCA) or normal saline (NS) for intra-articular
pathologies.
Methods
This retrospective study was approved by the institutional review board of our hospital,
and the requirement for informed consent was waived. The study included 37 consecutive
patients (38 hips; 21 right hips; 24 males; mean age, 33 years) who underwent GBCA-hip
MR arthrography from July 2011 to January 2020 and 30 consecutive patients (30 hips;
20 right hips; 21 males; mean age, 40 years) who underwent NS-hip MR arthrography
from January 2018 to June 2020. All images were evaluated twice independently by two
radiologists blinded to the arthroscopic findings for the presence of labral tears,
cartilage abnormalities, or ligamentum teres tears. Intrareader and interreader reliabilities
were determined by kappa values (k) using the chi-squared test, and diagnostic performance
was evaluated based on the arthroscopic findings. A P value less than .05 was considered to indicate statistical significance.
Results
Intra-reader reliability in the detection of intra-articular pathologies ranged from
moderate to almost perfect (k = 0.510–0.840) and inter-reader reliability ranged from moderate to substantial (k = 0.441–0.695) for GBCA- and NS-hip MR arthrography. The diagnostic accuracy of GBCA-
and NS-hip MR arthrography was as follows: 81.6–92.1% and 66.7–73.3% for labral tears,
respectively; 68.4–86.8% and 63.3–70.0% for cartilage abnormality, respectively; and
68.4–76.3% and 50.0–56.7% for ligamentum teres tears, respectively.
Conclusion
NS-hip MR arthrography may be less accurate than GBCA-hip MR arthrography.
Level of Evidence
Level II of development of diagnostic criteria (consecutive patients with consistently
applied reference standard and blinding).
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References
- Conventional versus direct magnetic resonance imaging in detecting labral lesions in femoroacetabular impingement—A retrospective multicenter study.Acta Orthop Belg. 2019; 85: 100-106
- Real-time assessment of femoroacetabular motion using radial gradient echo magnetic resonance arthrography at 3 Tesla in routine clinical practice: A pilot study.Arthroscopy. 2019; 35: 2366-2374
- Gadolinium deposition and the potential for toxicological sequelae—A literature review of issues surrounding gadolinium-based contrast agents.Br J Clin Pharmacol. 2018; 84: 2522-2534
- MR imaging safety considerations of gadolinium-based contrast agents: Gadolinium retention and nephrogenic systemic fibrosis.Magn Reson Imaging Clin N Am. 2020; 28: 497-507
- Does MR arthrography cause intracranial gadolinium deposition?.Skeletal Radiol. 2020; 49: 1051-1056
- Iopromide- and gadopentetic acid-derived preparates used in MR arthrography may be harmful to chondrocytes.J Orthop Surg Res. 2017; 12: 98
- In Vitro Assessment of Primary Human Chondrocyte Viability Following Treatment With Intra-articular Contrast Agents and Local Anaesthetic. [Dissertation].Trinity College, Dublin, Ireland2021
- In vitro chondrocyte toxicity following long-term, high-dose exposure to Gd-DTPA and a novel cartilage-targeted MR contrast agent.Skeletal Radiol. 2017; 46: 23-33
- Does gadolinium improve magnetic resonance arthrography of the hip beyond fluid distension alone?.Clin Radiol. 2020; 75: 713.e1-713.e9
- Classification and localization of acetabular labral tears.Skeletal Radiol. 2007; 36: 391-397
- Interrater reliability: The kappa statistic.Biochem Med (Zagreb). 2012; 22: 276-282
- 3.0 T MRI is more recommended to detect acetabular labral tears than MR arthrography: An updated meta-analysis of diagnostic accuracy.J Orthop Surg Res. 2022; 17: 126
- Lesions of ligamentum teres: Diagnostic performance of MRI and MR arthrography-a systematic review and meta-analysis.AJR Am J Roentgenol. 2018; 211: W52-W63
- Comparative reliability and diagnostic performance of conventional 3T magnetic resonance imaging and 1.5T magnetic resonance arthrography for the evaluation of internal derangement of the hip.Eur Radiol. 2018; 28: 963-971
- Femoral cartilage damage occurs at the zone of femoral head necrosis and can be accurately detected on traction MR arthrography of the hip in patients undergoing joint preserving hip surgery.J Hip Preserv Surg. 2021; 8: 28-39
Article info
Publication history
Published online: November 02, 2022
Accepted:
October 20,
2022
Received in revised form:
October 5,
2022
Received:
April 18,
2022
Footnotes
See commentary on page 998
Identification
Copyright
© 2022 by the Arthroscopy Association of North America
