The influence of bone marrow edema for the assessment of the boundaries of necrotic lesions in patients with osteonecrosis of the femoral head
Abstract This study aimed to investigate the influence of bone marrow edema (BME) for the assessment of the boundaries of necrotic lesions using unenhanced and contrast-enhanced (CE) magnetic resonance (MR) images in patients with osteonecrosis of the femoral head (ONFH). We retrospectively reviewed...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-11-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-23427-y |
| _version_ | 1811223302856769536 |
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| author | Satoshi Ikemura Goro Motomura Ryosuke Yamaguchi Takeshi Utsunomiya Satoshi Hamai Masanori Fujii Shinya kawahara Taishi Sato Daisuke Hara Kyohei shiomoto Takuaki Yamamoto Yasuharu Nakashima |
| author_facet | Satoshi Ikemura Goro Motomura Ryosuke Yamaguchi Takeshi Utsunomiya Satoshi Hamai Masanori Fujii Shinya kawahara Taishi Sato Daisuke Hara Kyohei shiomoto Takuaki Yamamoto Yasuharu Nakashima |
| author_sort | Satoshi Ikemura |
| collection | DOAJ |
| description | Abstract This study aimed to investigate the influence of bone marrow edema (BME) for the assessment of the boundaries of necrotic lesions using unenhanced and contrast-enhanced (CE) magnetic resonance (MR) images in patients with osteonecrosis of the femoral head (ONFH). We retrospectively reviewed 72 consecutive hips in 55 patients of ONFH that were Association Research Circulation Osseous (ARCO) stage III or higher and underwent both unenhanced and contrast-enhanced MR imaging between January 2005 and February 2016. The degree of extension of BMEs, and the boundaries of the necrotic lesions were compared using unenhanced and CE MR images on both mid coronal and mid oblique-axial slices. Forty-two percent of the coronal T1 images, 40% of the coronal fat-saturated T2 images, and 48% of the oblique-axial T1 images showed differences in the boundaries of necrotic lesion, by comparison with those of CET1-weighted MR images. The boundaries of necrotic lesions were clearly detected in all hips on CE coronal slices and 97% of all hips on CE oblique-axial slices. The BME grade in the difference group was significantly higher than in the non-difference group on the coronal plane (P = 0.0058). There were significant differences between the BME grade and duration from the onset of hip pain to MR imaging examination. Multivariate analyses revealed that the duration from the onset to MR imaging examination in both coronal (P = 0.0008) and oblique-axial slices (P = 0.0143) were independently associated with differences in the boundary of necrotic lesion between T1 and CET1-weighted MR images. Our findings suggest that unenhanced MR image may be insufficient for a precise assessment of the boundaries of the necrotic lesions for ONFH cases in the early phase of subchondral collapse due to the diffuse BME. |
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| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-12T08:30:39Z |
| publishDate | 2022-11-01 |
| publisher | Nature Portfolio |
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| spelling | doaj.art-39676733c09e4728930be4e877592bf72022-12-22T03:40:13ZengNature PortfolioScientific Reports2045-23222022-11-011211910.1038/s41598-022-23427-yThe influence of bone marrow edema for the assessment of the boundaries of necrotic lesions in patients with osteonecrosis of the femoral headSatoshi Ikemura0Goro Motomura1Ryosuke Yamaguchi2Takeshi Utsunomiya3Satoshi Hamai4Masanori Fujii5Shinya kawahara6Taishi Sato7Daisuke Hara8Kyohei shiomoto9Takuaki Yamamoto10Yasuharu Nakashima11Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Orthopaedic Surgery, Faculty of Medicine, Fukuoka UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu UniversityAbstract This study aimed to investigate the influence of bone marrow edema (BME) for the assessment of the boundaries of necrotic lesions using unenhanced and contrast-enhanced (CE) magnetic resonance (MR) images in patients with osteonecrosis of the femoral head (ONFH). We retrospectively reviewed 72 consecutive hips in 55 patients of ONFH that were Association Research Circulation Osseous (ARCO) stage III or higher and underwent both unenhanced and contrast-enhanced MR imaging between January 2005 and February 2016. The degree of extension of BMEs, and the boundaries of the necrotic lesions were compared using unenhanced and CE MR images on both mid coronal and mid oblique-axial slices. Forty-two percent of the coronal T1 images, 40% of the coronal fat-saturated T2 images, and 48% of the oblique-axial T1 images showed differences in the boundaries of necrotic lesion, by comparison with those of CET1-weighted MR images. The boundaries of necrotic lesions were clearly detected in all hips on CE coronal slices and 97% of all hips on CE oblique-axial slices. The BME grade in the difference group was significantly higher than in the non-difference group on the coronal plane (P = 0.0058). There were significant differences between the BME grade and duration from the onset of hip pain to MR imaging examination. Multivariate analyses revealed that the duration from the onset to MR imaging examination in both coronal (P = 0.0008) and oblique-axial slices (P = 0.0143) were independently associated with differences in the boundary of necrotic lesion between T1 and CET1-weighted MR images. Our findings suggest that unenhanced MR image may be insufficient for a precise assessment of the boundaries of the necrotic lesions for ONFH cases in the early phase of subchondral collapse due to the diffuse BME.https://doi.org/10.1038/s41598-022-23427-y |
| spellingShingle | Satoshi Ikemura Goro Motomura Ryosuke Yamaguchi Takeshi Utsunomiya Satoshi Hamai Masanori Fujii Shinya kawahara Taishi Sato Daisuke Hara Kyohei shiomoto Takuaki Yamamoto Yasuharu Nakashima The influence of bone marrow edema for the assessment of the boundaries of necrotic lesions in patients with osteonecrosis of the femoral head Scientific Reports |
| title | The influence of bone marrow edema for the assessment of the boundaries of necrotic lesions in patients with osteonecrosis of the femoral head |
| title_full | The influence of bone marrow edema for the assessment of the boundaries of necrotic lesions in patients with osteonecrosis of the femoral head |
| title_fullStr | The influence of bone marrow edema for the assessment of the boundaries of necrotic lesions in patients with osteonecrosis of the femoral head |
| title_full_unstemmed | The influence of bone marrow edema for the assessment of the boundaries of necrotic lesions in patients with osteonecrosis of the femoral head |
| title_short | The influence of bone marrow edema for the assessment of the boundaries of necrotic lesions in patients with osteonecrosis of the femoral head |
| title_sort | influence of bone marrow edema for the assessment of the boundaries of necrotic lesions in patients with osteonecrosis of the femoral head |
| url | https://doi.org/10.1038/s41598-022-23427-y |
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