MR‐guided direct arthrography of the hip

Abstract

Purpose:To develop an MR-guided technique for direct magnetic resonance arthrography (DMRA) of the hip using a conventional 1.5 Tesla (T) MRI scanner. Materials and Methods:Interactive versions of standard single-shot fast spin echo, coherent gradient echo, and fully balanced steady-state free precession sequences were developed, together with the ability to operate the scanner from within the magnet room. Initial optimization was performed using ex vivo animal joints. After informed consent, five patients underwent DMRA using dilute gadolinium as the contrast medium. Results:The procedure was successful in all five patients and diagnostic quality MR arthrography studies were obtained in all cases. The time taken from the initial placement of skin marker to the introduction of contrast medium reduced with successive patients: 26, 22, and 19 min with the final two studies taking 13 min each. Conclusion:This work demonstrates the feasibility of performing DMRA using MR guidance, avoiding the need for X-ray fluoroscopy facilities but exploiting the available imaging performance of a high-field closed-bore MR system. The use of an in room control and display system together with interactive fluoroscopic imaging sequences simplifies the positioning of the needle and allows rapid confirmation of an intra-articular injection.

Coverage of Femoral Head at Weight-Bearing Interface of the Hip Joint in Children: An MRI Analysis

“…MR provides better muscular-skeletal resolution. FFE is a gradient echo sequence widely used in imaging articular cartilage [8]. There have been several MR studies on development of the hip joint in recent years, and there is a raised interest in imaging the normal shape and pathology of acetabular labrum [4][5][6]9].…”

A novel, general-purpose, MR-compatible, manually actuated robotic manipulation system for minimally invasive interventions under direct MRI guidance

“…In general, a single‐modality approach to MR arthrography is highly desirable , since it effectively reduces possible repeated needle insertion trials and also diminishes the injection‐to‐imaging time, which affects the degree of visualization of different intra‐articular structures and the overall imaging quality . Moreover, it decreases the overall examination time, allows for better scheduling of imaging equipment, the patient is subject to less inconvenience, and neither the patient nor the physician is exposed to ionizing radiation.…”

“…MRI‐guided musculoskeletal procedures reported in the literature have been performed using open‐type MRI systems . Two studies have described MRI‐guided arthrographic procedures using a cylindrical, closed‐type system (of 1.5 and 1.0 T, respectively). These studies, however, employed a technique which effectively requires successive rounds of patient withdrawal/repositioning from/within the magnet bore.…”

Augmented Reality Visualization with Use of Image Overlay Technology for MR Imaging–guided Interventions: Assessment of Performance in Cadaveric Shoulder and Hip Arthrography at 1.5 T

“…Furthermore, fluoroscopy or computed tomographic (CT) guidance (2,3) result in exposure to ionizing radiation and its associated health risks (4-6). Interventional MR imaging can overcome these limitations by combining joint injection and MR imaging in a single setting (7)(8)(9); however, this typically requires targeting and puncture inside the bore of the magnet (1,7,10). Augmented reality (AR) navigation technology instead can provide MR imaging-guided targeting and joint puncture outside the magnet bore.…”