Advanced MR Imaging after Total Hip Arthroplasty: The Clinical Impact

Khodarahmi, Iman; Fritz, Jan

doi:10.1055/s-0037-1606137

Cited by 27 publications

(34 citation statements)

References 92 publications

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“…The number of patients undergoing hip replacement surgery has drastically increased over the last decades [1]. Despite being one of the surgical procedures with the best outcome, complications such as aseptic loosening, periprosthetic fracture, hardware failure, wear-induced osteolysis/synovitis, and infection occur on a regular basis [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Prospective and longitudinal evolution of postoperative periprosthetic findings on metal artifact–reduced MR imaging in asymptomatic patients after uncemented total hip arthroplasty

et al. 2020

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Objective To prospectively assess the evolution of postoperative MRI findings in asymptomatic patients after total hip arthroplasty (THA) over 24 months (mo). Methods This prospective cohort study included 9 asymptomatic patients (56.7 ± 15.0 years) after THA. Metal artifact–reduced 1.5-T MRI was performed at 3, 6, 12, and 24 mo after surgery. The femoral stem and acetabular cup were assessed by two readers for bone marrow edema (BME), periprosthetic bone resorption, and periosteal edema in addition to periarticular soft tissue edema and joint effusion. Results BME was common around the femoral stem in all Gruen zones after 3 mo (range: 50–100%) and 6 mo (range: 33–100%) and in the acetabulum in DeLee and Charnley zone II after 3 mo (100%) and 6 mo (33%). BME decreased substantially after 12 mo (range: 0–78%) and 24 mo (range: 0–50%), may however persist in particular in Gruen zones 1 + 7. Periosteal edema along the stem was common 3 mo postoperatively (range: 63–75%) and rare after 24 mo: 13% only in Gruen zones 2 and 5. Twelve months and 24 mo postoperatively, periprosthetic bone resorption was occasionally present around the femoral stem (range: 11–33% and 13–38%, respectively). Soft tissue edema occurred exclusively along the surgical access route after 3 mo (100%) and 6 mo (89%) and never at 12 mo or 24 mo (0%). Conclusion Around the femoral stem, BME (33–100%) and periosteal edema (0–75%) are common until 6 mo after THA, decreasing substantially in the following period, may however persist up to 24 mo (BME: 0–50%; periosteal edema: 0–13%) in few non-adjoining Gruen zones. Soft tissue edema along the surgical access route should have disappeared 12 mo after surgery.

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Section: Introductionmentioning

confidence: 99%

Prospective and longitudinal evolution of postoperative periprosthetic findings on metal artifact–reduced MR imaging in asymptomatic patients after uncemented total hip arthroplasty

et al. 2020

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“…Owing to recent advancements in CT and MRI MAR techniques, cross-sectional image evaluation of tissues around metallic implants has undergone a remarkable evolution that yielded meaningful improvements for the evaluation of periprosthetic tissues. 57 Dual-energy CT with virtual monochromatic extrapolation and MAR reconstruction algorithms can substantially reduce metal artifacts and in most cases improve diagnostic image quality. Due to data interpolations implemented in MAR algorithms, images should be interpreted with caution and in concert with the original data set.…”

Section: Resultsmentioning

confidence: 99%

Dedicated CT and MRI Techniques for the Evaluation of the Postoperative Knee

Khodarahmi

Fishman

Fritz

2018

Semin Musculoskelet Radiol

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Advances in surgical techniques, orthopaedic implant design, and higher demands for improved functionality of the aging population have resulted in a high prevalence of patients with metallic implants about the knee. Total knee arthroplasty, knee-replacing tumor prostheses, and osteosynthesis implants create various imaging artifacts and pose special challenges for the imaging evaluation with computed tomography (CT) and magnetic resonance imaging (MRI). CT artifacts can be effectively mitigated with metal artifact reduction reconstruction algorithms, dual-energy data acquisition with virtual monoenergetic extrapolation, and three-dimensional postprocessing techniques, such as volume and cinematic rendering. Artifacts related to metal implants on MRI can be reduced via optimization of the scan parameters and using advanced techniques such as multi-acquisition variable-resonance image combination, and slice encoding for metal artifact correction.

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“…Complications associated with THA may originate from the implant itself, surrounding osseous structures, periprosthetic soft tissues, or synovial reaction. 3 Although complication rates are low, 4 the high prevalence of the hip replacement procedures will result in an overall growing number of patients with complications that will be encountered in daily radiology practice.…”

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confidence: 99%

Metal About the Hip and Artifact Reduction Techniques: From Basic Concepts to Advanced Imaging

Khodarahmi

Isaac

Fishman³

et al. 2019

Semin Musculoskelet Radiol

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Promising outcomes of hip replacement interventions in this era of aging populations have led to higher demands for hip arthroplasty procedures. These require effective methods and techniques for the detection of postoperative outcomes and complications. Based on the presence or absence of radiographic findings, magnetic resonance imaging (MRI) and computed tomography (CT) may be required to detect and further characterize different causes of failing implants. Yet metal-related artifacts degrade image quality and pose significant challenges for adequate image quality. To mitigate such artifacts in MRI, a set of techniques, collectively known as metal artifact reduction sequence (MARS) MRI, were developed that optimize the framework of the conventional pulse sequences and exploit novel multispectral and multispatial imaging methods such as Slice Encoding for Metal Artifact Correction (SEMAC) and Multi-Acquisition Variable-Resonance Image Combination (MAVRIC). Metal-induced artifacts on CT can be effectively reduced with virtual monochromatic reconstruction of dual-energy CT data sets, metal artifact reduction reconstruction algorithms, and postprocessing image visualization techniques.

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Advanced MR Imaging after Total Hip Arthroplasty: The Clinical Impact

Cited by 27 publications

References 92 publications

Prospective and longitudinal evolution of postoperative periprosthetic findings on metal artifact–reduced MR imaging in asymptomatic patients after uncemented total hip arthroplasty

Prospective and longitudinal evolution of postoperative periprosthetic findings on metal artifact–reduced MR imaging in asymptomatic patients after uncemented total hip arthroplasty

Dedicated CT and MRI Techniques for the Evaluation of the Postoperative Knee

Metal About the Hip and Artifact Reduction Techniques: From Basic Concepts to Advanced Imaging

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