Regional variations in MR relaxation of hip joint cartilage in subjects with and without femoralacetabular impingement

Subburaj, Karupppasamy; Valentinitsch, Alexander; Dillon, Alexander; Joseph, Gabby B.; Li, Xiaojuan; Link, Thomas M.; Vail, Thomas P.; Majumdar, Sharmila

doi:10.1016/j.mri.2013.01.009

Cited by 51 publications

(104 citation statements)

References 40 publications

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“…Increased T1q values in the entire hip cartilage and particularly in the anterosuperior area were consistent with the findings published by Subburaj et al [29]. Mamisch et al [17], who used dGEMRIC in hips and described decreased T1 values in hips with cam-type deformity in the entire cartilage but especially in the anterosuperior quadrant, indicated loss of proteoglycan mainly in this region.…”

Section: Discussionsupporting

confidence: 90%

“…Similar findings were published in other studies analyzing T1q in the hip cartilage [5,29] indicating strong intra-and interobserver reliability.…”

Section: Discussionsupporting

confidence: 89%

“…Beck et al [3] first described intraoperative cartilage damage in hips with cam-type FAI mainly in the anterosuperior quadrant, which is consistent with other intraoperative observations [2,14,20] and findings in computer simulation [30]. Although MRI mapping of cartilage in the hip has been shown to be feasible and capable to evaluate the biochemical status of cartilage in dysplasia [19,25,26,29] as well as cam FAI (Table 1) [4,7,9,19,[24][25][26]29], the region-of-interest (ROI) selection used in terms of size and location has varied between studies. Having said that, understanding how to best define and analyze the ROIs is still evolving and is critical to ensure reproducible and comparable results between institutions and studies.…”

Section: Introductionmentioning

confidence: 53%

“…We suspect that some patients with a cam deformity and advanced cartilage damage have falsely low T1q values as a result of loss of acetabular cartilage; subsequently, the T1q values in these hips predominantly reflect the cartilage status of the remaining cartilage on the femoral head, which is less exposed to damage in hips with cam deformity. Having said that, Subburaj et al [29], using 3-T MRI, showed that despite using 3 T, the bilayer technique is actually more reproducible than the single-layer acetabular cartilage and equal to a femoral head cartilage single layer.…”

Section: Discussionmentioning

confidence: 99%

“…T1q relaxation time has been shown to correlate inversely with cartilage proteoglycan concentration in bovine and human cartilage samples, making it a potentially useful tool for detection of early biochemical changes in cartilage tissue occurring in the OA disease [27,31]. Several studies have demonstrated the feasibility of T1q mapping to assess cartilage condition in the knee [11,13,21,23] and hip [26,29].…”

Section: Introductionmentioning

confidence: 99%

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T1ρ Hip Cartilage Mapping in Assessing Patients With Cam Morphology: How Can We Optimize the Regions of Interest?

Anwander

Rakhra

Melkus

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background T1q MRI has been shown feasible to detect the biochemical status of hip cartilage, but various regionof-interest strategies have been used, compromising the reproducibility and comparability between different institutions and studies. Questions/purposes The purposes of this study were (1) to determine representative regions of interest (ROIs) for cartilage T1q mapping in hips with a cam deformity; and (2) to assess intra-and interobserver reliability for cartilage T1q mapping in hips with a cam deformity. MethodsThe local ethics committee approved this prospective study with written informed consent obtained. Between 2010 and 2013, in 54 hips (54 patients), T1q 1.5-T MRI was performed. Thirty-eight hips (38 patients; 89% male) with an average age of 35 ± 7.5 years (range, 23-51 tears) were diagnosed with a cam deformity; 16 hips (16 patients; 87% male) with an average age of 34 ± 7 years (range, 23-47 years) were included in the control group. Of the 38 patients with a cam deformity, 20 were pain-free and 18 symptomatic patients underwent surgery after 6 months of failed nonsurgical management of antiinflammatories and physical therapy. Exclusion criteria were radiologic sings of osteoarthritis with Tönnis Grade 2 or higher as well as previous hip surgery. Three region-of-interest (ROI) selections were analyzed: Method 1: as a whole; Method 2: as 36 to 54 small ROIs (sections of 30°in the sagittal plane and 3 mm in the transverse plane); Method 3a: as six ROIs (sections of 90°in the sagittal plane and one-third of the acetabular depth in the transverse plane: the anterosuperior and posterosuperior quadrants, divided into lateral, intermediate, and medial thirds); and Method 3b: as the ratio (anterosuperior over posterosuperior quadrant). ROIs in Method 3 represent the region of macroscopic cartilage damage, described in intraoperative findings. To asses interobserver reliability, 10 patients were analyzed by two observers (HA, GM). For intraobserver reliability, 20 hip MRIs were analyzed twice by one observer (HA). To assess interscan reliability, three patients underwent two scans within a time period of 2 weeks and were analyzed twice by one observer (HA). T1q values were compared using Student's t test. Interclass correlation coefficient (ICC) and root mean square coefficient of variation (RMS-CV) were used to analyze intraobserver, interobserver, and interscan reliability. Results Patients with a cam deformity showed increased T1q values in the whole hip cartilage (mean: 34.0 ± 3.8 ms versus 31.4 ± 3.0 ms; mean difference: 2.5; 95% confidence interval [CI], 4.7-0.4; p = 0.019; Method 1), mainly anterolateral (2), in the lateral and medial thirds of the anterosuperior quadrant (mean: 32.3 ± 4.9 ms versus 29.4 ± 4.1 ms; mean difference: 3.0; 95% CI, 5.8-0.2; p = 0.039 and mean 36.5 ± 5.6 ms versus 32.6 ± 3.8 ms; mean difference: 3.8; 95% CI, 6.9-0.8; p = 0.014), and in the medial third of the posterosuperior quadrant (mean: 34.4 ± 5.5 ms versus 31.1 ± 3.9 ms; mean difference: 3.1; 95% CI, 6....

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Section: Discussionsupporting

confidence: 90%

“…Similar findings were published in other studies analyzing T1q in the hip cartilage [5,29] indicating strong intra-and interobserver reliability.…”

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

T1ρ Hip Cartilage Mapping in Assessing Patients With Cam Morphology: How Can We Optimize the Regions of Interest?

Anwander

Rakhra

Melkus

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Review: Femoroacetabular Impingement

Pun

Kumar

Lane

2014

Arthritis & Rheumatology

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Cartilage T1ρ and T2 Relaxation Times in Patients With Mild‐to‐Moderate Radiographic Hip Osteoarthritis

Wyatt

Kumar

Lee

et al. 2015

Arthritis & Rheumatology

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Objective. To analyze region-specific T1r and T2 relaxation times of the hip joint cartilage in relation to presence or absence of radiographic hip osteoarthritis (OA) and presence or absence of magnetic resonance imaging (MRI)-detected cartilage defects.Methods. Weight-bearing radiographs and 3T MRI studies of the hip were obtained from 84 volunteers. Based on Kellgren/Lawrence (K/L) scoring of the radiographs, 54 subjects were classified as healthy controls (K/L grade £1) and 30 were classified as having mild or moderate radiographic hip OA (K/L grades 2 or 3, respectively). Two-dimensional fat-suppressed fast spin-echo MRI sequences were used for semiquantitative clinical scoring of cartilage defects, and a T1r/T2 sequence was used to quantitatively assess the cartilage matrix. The femoral and acetabular cartilage was then segmented into 8 regions and the mean T1r/T2 values were calculated. Differences in T1r and T2 relaxation times were compared between subjects with and those without radiographic hip OA, and those with and those without femoral or acetabular cartilage defects.Results. Higher T1r and T2 relaxation times in the anterior superior and central regions of the acetabular cartilage were seen in individuals with radiographic hip OA and those with acetabular cartilage defects compared to their respective controls (P < 0.05). In the femoral cartilage, the differences in T1r and T2 were not significant for any of the comparisons. Significant differences in the T1r and T2 values (each P < 0.05) were found in more subregions of the cartilage and across the whole cartilage when subjects were stratified based on the presence of MRI-detected cartilage defects than when they were stratified based on the presence of radiographic hip OA.Conclusion. T1r and T2 relaxation parameters are sensitive to the presence of cartilage degeneration. Both parameters may therefore support MRI evidence of cartilage defects of the hip.One in 4 individuals has a lifetime risk of developing symptomatic hip osteoarthritis (OA) by the age of 85 years (1). Individuals with hip OA experience substantial pain and disability, suggesting an urgent clinical need for diagnosis and prevention of hip OA (2,3). Hip OA is typically diagnosed through the use of radiographs, and semiquantitative clinical scores, such as the Kellgren/Lawrence (K/L) scores for radiographic damage (4), are used to quantify the severity of OA. However, diagnosis of OA with the use of radiographs is mostly focused on osteophytes and joint space narrowing, features that are indicative of advanced disease, whereas radiography lacks sensitivity for early changes of the soft tissues, such as cartilage and labrum. Magnetic resonance imaging (MRI) can provide information on hip degeneration at an earlier stage, by allowing visualization of morphologic abnormalities of the cartilage, bone marrow, and labrum (5-8).Early changes in OA consist of proteoglycan loss, changes in water content, and collagen disruption (9).

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Regional variations in MR relaxation of hip joint cartilage in subjects with and without femoralacetabular impingement

Cited by 51 publications

References 40 publications

T1ρ Hip Cartilage Mapping in Assessing Patients With Cam Morphology: How Can We Optimize the Regions of Interest?

T1ρ Hip Cartilage Mapping in Assessing Patients With Cam Morphology: How Can We Optimize the Regions of Interest?

Review: Femoroacetabular Impingement

Cartilage T1ρ and T2 Relaxation Times in Patients With Mild‐to‐Moderate Radiographic Hip Osteoarthritis

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