Berkowitz Jennifer L, Potter Hollis G
1 Department of Radiology and Imaging, Hospital for Special Surgery, 535 East 70th St, New York, NY 10021.
AJR Am J Roentgenol. 2017 Sep;209(3):534-543. doi: 10.2214/AJR.16.17789. Epub 2017 May 24.
Imaging the hip joint with optimized MRI protocol parameters provides the radiologist with the ability to reliably diagnose complex hip abnormalities. The institution of appropriate metal artifact reduction techniques and dedicated sequences can enhance visualization of the periprosthetic bone and soft tissues and allow improved detection of the more frequently encountered total hip arthroplasty-related conditions, such as mechanical loosening, polyethylene wear, and adverse local tissue reactions.
Finally, through the use of dynamic contrast-enhanced MRI, abnormal femoral head perfusion, one of the most common complications associated with femoral neck fracture internal fixation, can be detected before the development of femoral head osteonecrosis, subchondral collapse, and secondary osteoarthritis. Thus, through the institution of the techniques described in this review article, the challenges associated with MRI of hip arthroplasty and instrumentation can be overcome, allowing for the diagnosis of common associated complications.
采用优化的MRI协议参数对髋关节进行成像,可为放射科医生提供可靠诊断复杂髋关节异常的能力。采用适当的金属伪影减少技术和专用序列,可增强假体周围骨骼和软组织的可视化,并能更好地检测全髋关节置换术相关的常见情况,如机械性松动、聚乙烯磨损和局部组织不良反应。
最后,通过使用动态对比增强MRI,可在股骨头坏死、软骨下塌陷和继发性骨关节炎发生之前检测到异常的股骨头灌注,这是股骨颈骨折内固定最常见的并发症之一。因此,通过采用本文所述的技术,可克服与髋关节置换术和器械MRI相关的挑战,从而诊断常见的相关并发症。