Diagnostic accuracy of MRI with metal artifact reduction for the detection of periprosthetic joint infection and aseptic loosening of total hip arthroplasty

Schwaiger, Benedikt J.; Gassert, Florian T.; Suren, Christian; Gersing, Alexandra S.; Haller, Bernhard; Pfeiffer, Daniela; Dangelmaier-Dawirs, Julia; Roski, Ferdinand; Eisenhart-Rothe, Rüdiger von; Prodinger, Peter Michael; Woertler, Klaus

doi:10.1016/j.ejrad.2020.109253

Cited by 33 publications

(31 citation statements)

References 31 publications

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“…The speci ty and sensitivity of acetabular bone marrow edema was described to be 88% and 63%, respectively. The speci ty and sensitivity of femoral bone marrow edema was found to be 68% and 91%, respectively [42]. These data also argue in favour of using MARS MRI in diagnostic of painful hip after THA because the pathological ndings in PJI and aseptic loosening are statistically less frequent in patients without aseptic implant loosening and without PJI.…”

Section: Discussionmentioning

confidence: 77%

Metal Artefact Reduction Sequences (MARS) in Magnetic Resonance Imaging (MRI) After Total Hip Arthroplasty (THA). A Non-Invasive Approach for Preoperative Differentiation Between Periprosthetic Joint Infection (PJI) and Aseptic Complications?

Busch

Jäger

Beck

et al. 2022

Preprint

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Background:In the past, radiographic imaging was of minor relevance in the diagnosis of periprosthetic joint infections (PJI). Since metal artefact reduction sequences (MARS) are available, magnetic resonance imaging (MRI) has become a promising diagnostic tool for the evaluation of hip arthroplasty implants. The purpose of the present study was to evaluate the efficacy of MARS MRI in comparison to established diagnostic tools to distinguish between aseptic failure and PJI.Methods:Between July 2018 to September 2019, MARS-MRI was conducted using the optimized parameters at 1.5 T in a coronal and axial STIR (short-tau-inversion recovery), a non-fat-saturated T2 in coronal view and a non-fat-saturated T1 in transverse view in 45 patients with painful hip after THA.Results:Synovial layering and muscle edema were significant features of periprosthetic joint infection, with sensitivities of 100% and specifities of 63.0 - 75.0%. The combined specifity and sensitivity levels of synovial layering and muscular edema was 88.0% and 90.0%. Granulomatous synovitis was a significant feature for aseptic failure, with 90.0% sensitivity and 57.0% specifity.Conclusion:MARS-MRI is as suitable as standard diagnostic tools to distinguish between aseptic failure and PJI in patients with a total hip arthroplasty (TJA). Further studies with larger patient numbers have to prove whether MARS-MRI could be integral part of PJI diagnostic.

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Section: Discussionmentioning

confidence: 77%

Metal Artefact Reduction Sequences (MARS) in Magnetic Resonance Imaging (MRI) After Total Hip Arthroplasty (THA). A Non-Invasive Approach for Preoperative Differentiation Between Periprosthetic Joint Infection (PJI) and Aseptic Complications?

Busch

Jäger

Beck

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…The specifity and sensitivity of acetabular bone marrow edema was described to be 88% and 63%, respectively. The specifity and sensitivity of femoral bone marrow edema was found to be 68% and 91%, respectively [ 42 ]. These data also argue in favour of using MARS MRI in diagnostic of painful hip after THA because the pathological findings in PJI and aseptic loosening are statistically less frequent in patients without aseptic implant loosening and without PJI.…”

Section: Discussionmentioning

confidence: 99%

Metal Artefact Reduction Sequences (MARS) in Magnetic Resonance Imaging (MRI) after Total Hip Arthroplasty (THA)

Busch

Jäger

Beck

et al. 2022

BMC Musculoskelet Disord

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Background In the past, radiographic imaging was of minor relevance in the diagnosis of periprosthetic joint infections (PJI). Since metal artefact reduction sequences (MARS) are available, magnetic resonance imaging (MRI) has become a promising diagnostic tool for the evaluation of hip arthroplasty implants. The purpose of the present study was to evaluate the efficacy of MARS-MRI in comparison to established diagnostic tools to distinguish between aseptic failure and PJI. Methods From July 2018 to September 2019, 33 patients classified as having an aseptic joint effusion were recruited into the study. The group included 22 women and 11 men with a mean age of 70.4 ± 13.7 (42–88) years. In the same period, 12 patients were classified as having a PJI. The group consisted of 9 women and 3 men with a mean age of 72.5 ± 10.6 (54–88) years. MARS-MRI was conducted using the optimized parameters at 1.5 T in a coronal and axial STIR (short-tau-inversion recovery), a non-fat-saturated T2 in coronal view and a non-fat-saturated T1 in transverse view in 45 patients with painful hip after total hip arthroplasty (THA). Normally distributed continuous data were shown as mean ± standard deviation (SD) and compared using student's t-test. Non-normally distributed continuous data were shown as mean and compared using the Mann–Whitney U test. Results Synovial layering and muscle edema were significant features of periprosthetic joint infection, with sensitivities of 100% and specifities of 63.0—75.0%. The combined specifity and sensitivity levels of synovial layering and muscular edema was 88.0% and 90.0%. Granulomatous synovitis was a significant feature for aseptic failure, with 90.0% sensitivity and 57.0% specifity. Conclusion MARS-MRI is as suitable as standard diagnostic tools to distinguish between aseptic failure and PJI in patients with THA. Further studies with larger patient numbers have to prove whether MARS-MRI could be integral part of PJI diagnostic.

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“…To distinguish PJI from aseptic loosening, enlarged lymph nodes were shown to have a sensitivity of 80% and a specificity of 87%. 69…”

Section: Imaging Appearances Of Hip Arthroplasty Complicationsmentioning

confidence: 99%

Postoperative Musculoskeletal Imaging and Interventions Following Hip Preservation Surgery, Deformity Correction, and Hip Arthroplasty

Samim

Khodarahmi

Burke

et al. 2022

Semin Musculoskelet Radiol

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Total hip arthroplasty and hip preservation surgeries have substantially increased over the past few decades. Musculoskeletal imaging and interventions are cornerstones of comprehensive postoperative care and surveillance in patients undergoing established and more recently introduced hip surgeries. Hence the radiologist's role continues to evolve and expand. A strong understanding of hip joint anatomy and biomechanics, surgical procedures, expected normal postoperative imaging appearances, and postoperative complications ensures accurate imaging interpretation, intervention, and optimal patient care. This article presents surgical principles and procedural details pertinent to postoperative imaging evaluation strategies after common hip surgeries, such as radiography, ultrasonography, computed tomography, and magnetic resonance imaging. We review and illustrate the expected postoperative imaging appearances and complications following chondrolabral repair, acetabuloplasty, osteochondroplasty, periacetabular osteotomy, realigning and derotational femoral osteotomies, and hip arthroplasty.

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Diagnostic accuracy of MRI with metal artifact reduction for the detection of periprosthetic joint infection and aseptic loosening of total hip arthroplasty

Cited by 33 publications

References 31 publications

Metal Artefact Reduction Sequences (MARS) in Magnetic Resonance Imaging (MRI) After Total Hip Arthroplasty (THA). A Non-Invasive Approach for Preoperative Differentiation Between Periprosthetic Joint Infection (PJI) and Aseptic Complications?

Metal Artefact Reduction Sequences (MARS) in Magnetic Resonance Imaging (MRI) After Total Hip Arthroplasty (THA). A Non-Invasive Approach for Preoperative Differentiation Between Periprosthetic Joint Infection (PJI) and Aseptic Complications?

Metal Artefact Reduction Sequences (MARS) in Magnetic Resonance Imaging (MRI) after Total Hip Arthroplasty (THA)

Postoperative Musculoskeletal Imaging and Interventions Following Hip Preservation Surgery, Deformity Correction, and Hip Arthroplasty

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